CBT for panic attacks
Panic attacks can be frightening and overwhelming. You may experience a sudden surge of intense fear, sometimes seemingly out of nowhere, alongside physical sensations such as a racing heart, dizziness, breathlessness or feeling disconnected from your surroundings.
After experiencing a panic attack, it is understandable to become worried about it happening again. You may start avoiding certain places or situations, monitoring your body for signs of panic, or changing what you do in an attempt to prevent another attack.
Over time, this fear of panic itself can become part of the problem.
Cognitive Behavioural Therapy (CBT) can help you understand the panic cycle, reduce your fear of physical sensations and regain confidence in situations you may have started avoiding.
I offer face-to-face CBT for panic attacks in Guildford, Godalming and Farnham, as well as online therapy for adults throughout the UK.
What is a panic attack?
A panic attack is a sudden episode of intense fear or discomfort that can involve a range of physical and psychological symptoms.
You might experience:
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A racing or pounding heart
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Chest tightness or discomfort
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Shortness of breath or a feeling that you cannot breathe properly
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Dizziness or light-headedness
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Feeling shaky or weak
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Sweating or feeling hot
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Nausea or stomach discomfort
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Tingling or numbness
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Feeling detached from yourself or your surroundings
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A feeling that something terrible is about to happen
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Fear of losing control
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Fear of fainting, collapsing or dying
Although panic attacks can feel extremely frightening, the sensations are part of the body's normal fight-or-flight response.
Understanding what is happening during a panic attack can be an important first step towards reducing the fear surrounding it.
Why do panic attacks keep happening?
Panic often develops into a cycle.
A physical sensation, thought or situation may trigger a feeling of anxiety. You might then interpret the sensation as dangerous — for example, thinking "Something is wrong with me" or "I'm going to lose control."
This interpretation increases your fear, which activates your body's alarm system further. The resulting physical sensations can then feel like confirmation that something is wrong.
You may also begin using safety behaviours to try to prevent something bad from happening. This might include checking your heart rate, carrying medication or water everywhere, sitting near an exit, avoiding exercise, travelling only with someone else or repeatedly seeking reassurance.
These behaviours can make you feel safer in the short term, but they can unintentionally reinforce the belief that the situation or physical sensation is dangerous.
How can CBT help?
CBT helps you understand the cycle that maintains panic and gradually develop a different response to the sensations and situations you fear.
Therapy may involve:
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Understanding how panic attacks work
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Identifying your individual panic cycle
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Exploring how you interpret physical sensations
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Identifying thoughts and predictions that increase fear
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Understanding the role of avoidance and safety behaviours
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Learning to respond differently to physical sensations
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Gradually facing situations you have been avoiding at your own pace
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Building confidence in your ability to cope with anxiety
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Reducing the fear of having another panic attack
A key part of CBT for panic is learning that the sensations associated with panic are uncomfortable but do not necessarily mean that you are in danger.
Rather than trying to eliminate every sensation of anxiety, we can work towards helping you feel less afraid of the sensations when they occur and more confident in your ability to cope.
We will work collaboratively and at a pace that is appropriate for you, applying these strategies to the situations and difficulties that are most relevant to your life.
What if I am avoiding certain situations because of panic?
It is common for people who experience panic attacks to begin avoiding situations where they are worried about having another attack.
You might avoid:
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Public transport or driving
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Shops or busy places
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Exercise
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Being far from home
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Being alone
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Queues or enclosed spaces
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Social situations
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Travelling
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Places where you feel it would be difficult to leave quickly
Avoidance can provide immediate relief, but it can also make these situations feel increasingly threatening over time.
CBT can help you gradually approach situations that have become difficult, where this is appropriate, at a pace that allows you to build confidence in your ability to cope.
What can I expect from therapy with you?
We'll start by developing an understanding of your experience of panic and what may be keeping the cycle going. Together, we'll identify the situations, sensations, thoughts and behaviours that are most relevant to you.
Depending on your needs, therapy may involve learning to respond differently to physical sensations, reducing safety behaviours and gradually approaching situations that you've been avoiding.
Any exercises will be discussed collaboratively and introduced at a pace that feels manageable for you. We'll regularly review your progress and adapt therapy as we go.
Frequently Asked Questions
What is the difference between panic attacks and panic disorder?
Having a panic attack does not necessarily mean that you have panic disorder. Panic attacks can occur in the context of a number of different difficulties, including anxiety.
Panic disorder involves recurrent unexpected panic attacks alongside ongoing concerns about having further attacks or significant changes in your behaviour as a result.
Whatever your diagnosis or circumstances, therapy can focus on understanding your individual experience and the patterns that are keeping your anxiety going.
Can CBT stop panic attacks?
CBT can help reduce the frequency and impact of panic attacks for many people. An important part of treatment is also reducing the fear of panic itself and increasing your confidence in coping with the sensations when they occur.
What if I am afraid that a panic attack means something is medically wrong?
Panic symptoms can feel very physical and can sometimes be difficult to distinguish from other causes of physical symptoms. If you have new, severe or unexplained physical symptoms, it is important to seek appropriate medical advice.
Once physical causes have been appropriately considered, CBT can help you understand how anxiety and the interpretation of physical sensations may contribute to your experience.
Will I have to deliberately make myself panic?
Some CBT approaches for panic can involve exercises designed to help you become less fearful of particular physical sensations. If these are appropriate, they would be discussed and introduced collaboratively and at a suitable pace.
Can CBT help with panic attacks if I don't have panic disorder?
Yes. Panic attacks can occur alongside other difficulties, including general anxiety, health anxiety and social anxiety. Therapy can focus on the specific patterns contributing to your panic regardless of whether you meet criteria for panic disorder.
Take the first step
If panic attacks are affecting your everyday life or leading you to avoid things that matter to you, therapy can help you understand the cycle of panic and develop new ways of responding.
If you'd like to find out whether therapy with me could be helpful, you can book a free 15-minute initial consultation.
