Panic

What is panic?

Panic disorder is a diagnosable anxiety condition marked by repeated, unexpected panic attacks and a lasting fear of having another one. A panic attack itself is a sudden wave of intense fear or discomfort that peaks within minutes, bringing physical symptoms that can feel alarming even though the body is not actually in danger.

A panic attack is the body’s alarm system firing when there is no real threat to respond to. The heart pounds, breathing quickens and muscles tense, exactly as they would if you needed to run or fight, except the trigger might be a queue at the till, a train pulling into Brighton station, or nothing identifiable at all. For some people this happens once or twice during a difficult period and settles on its own. For others, the attacks recur, and the fear of the next one starts to shape daily decisions: which routes to avoid, which situations to leave early, which plans to quietly cancel.

Panic disorder is common among adults and affects people across all walks of life, including students, commuters and professionals working long hours. It often develops during a period of stress or change, though it can also appear with no obvious trigger.

Symptoms of panic

A panic attack combines physical and mental symptoms that arrive together and build quickly. Physical signs include a racing or pounding heart, tightness or pain in the chest, breathlessness, dizziness, trembling, sweating, nausea and a feeling of pins and needles or numbness in the hands and face. Because several of these overlap with symptoms of a heart problem, many people’s first panic attack ends with a visit to A&E or a GP, which is a sensible precaution if you have not been checked before.

Alongside the physical symptoms, panic often brings a sharp fear of losing control, fainting or dying, and a strange sense of unreality, as though the room or your own body has become distant or unfamiliar. These sensations usually peak within about ten minutes and fade within half an hour, though the aftermath, feeling shaken, tired or on edge, can last longer. Over time, repeated attacks can lead to avoidance of the places or situations where they occurred, which is where panic starts to narrow someone’s life.

Types of panic

Panic attacks are not all the same, and the pattern matters for how therapy is shaped. Some attacks come out of nowhere, with no obvious trigger, which is typical of panic disorder itself. Others are cued, appearing reliably in specific situations such as crowded spaces, driving, or public speaking, and are often linked to a specific fear such as social anxiety or health anxiety rather than panic disorder alone.

Some people experience nocturnal panic attacks, waking suddenly from sleep with the same racing heart and breathlessness as a daytime episode. Others develop agoraphobia alongside panic disorder, avoiding situations where escape might feel difficult, such as trains, lifts or busy shops in the Lanes or North Laine. Working out which pattern fits is part of a proper assessment, since the approach for panic disorder differs from the approach for panic that sits within another anxiety condition.

How therapy can help

Cognitive behavioural therapy (CBT) is the treatment most consistently recommended for panic disorder, and it works by addressing the cycle that keeps panic going rather than just the symptoms themselves. A key part of this cycle is the tendency to misread normal bodily sensations, a fast heartbeat after climbing stairs, for example, as a sign of danger. That misreading triggers more anxiety, which produces more physical sensations, which feels like confirmation that something is wrong.

Therapy works through this cycle step by step. It typically includes psychoeducation about what is actually happening in the body during panic, breathing retraining to counter the effects of hyperventilation, and gradual, planned exposure to the sensations and situations that have come to feel threatening. This last part, sometimes called interoceptive exposure, involves deliberately bringing on mild versions of panic sensations, such as through brief exercise or spinning, in a controlled way so the brain can relearn that they are uncomfortable rather than dangerous.

Our approach

We are clinical psychologists for Brighton and East Sussex, working online with adults, covering the city itself along with Hove, Kemptown, Preston Park, Hanover, Withdean and Portslade. Every course of therapy begins with an assessment to understand your specific pattern of panic, what tends to trigger it, how long it has been going on and what you have already tried. From there we build a formulation together, a shared picture of how the panic cycle is working for you specifically, before agreeing a plan.

Sessions take place by video call, which means they fit around work, study or caring responsibilities without travel time, and appointments can be kept private in a way that suits your circumstances. We will update this site as the practice develops.

What does panic therapy involve?

A typical course starts with one or two sessions of assessment and formulation, followed by weekly sessions working through the components of CBT for panic: understanding the physical mechanics of panic, learning breathing and grounding techniques, identifying the thoughts that turn a sensation into a threat, and gradually facing avoided situations or sensations in a planned, manageable way. Homework between sessions is a normal part of this work, whether that is practising a breathing technique, keeping a brief record of attacks, or trying a small piece of exposure.

Progress is reviewed regularly rather than assumed, and the plan adjusts if something is not working. Most people find that the frequency and intensity of attacks reduces well before the fear of them disappears completely, and the later stages of therapy often focus on that residual fear, along with building confidence that a bad day does not undo the progress made.

When to seek help

It is worth arranging an assessment if panic attacks are becoming more frequent, if you are avoiding places, transport or plans because of them, or if the fear of the next attack is starting to affect work, relationships or your general confidence day to day. Panic disorder tends not to resolve simply by waiting for it to pass, and earlier support usually means less has been built up around it to unpick.

If you experience chest pain, prolonged breathlessness or any symptom you have not had checked before, contact your GP or call NHS 111 to rule out a physical cause first. If you are in crisis or worried about your immediate safety, contact 999 or go to your nearest A&E.