Fear of a heart attack
Chest pain, palpitations and breathlessness may be interpreted as signs of serious illness, even after medical reassurance.
Panic attacks and panic disorder
When fear arrives suddenly and feels completely overwhelming.
A panic attack is a sudden surge of intense fear accompanied by powerful physical sensations. It can feel as though you are having a heart attack, about to faint, losing control or going mad.
The symptoms are frightening, but panic itself is not dangerous. Therapy helps you understand what is happening, reduce fear of the sensations and regain confidence in the situations panic has taken away from you.
Common experiences
Panic can change how you live, even between attacks.
After one or more panic attacks, many people become frightened of the next one. This can lead to constant monitoring, anticipatory anxiety and avoidance.
Fear of fainting
Dizziness and light-headedness may create a strong belief that collapse is imminent, although people rarely faint during panic.
Fear of losing control
You may worry that you will scream, behave strangely, run away or be unable to control what happens next.
Fear of going mad
Derealisation, racing thoughts and intense fear can feel so unfamiliar that they are mistaken for signs of mental collapse.
Anticipatory anxiety
You may spend long periods worrying about when the next attack will happen and whether help will be available.
Avoidance and agoraphobia
Supermarkets, public transport, driving, queues, crowds or unfamiliar places may be avoided because escape feels difficult.
Body monitoring
You may repeatedly check your pulse, breathing, balance or other sensations for signs that panic is beginning.
Safety behaviours
Carrying medication, sitting near exits, travelling with someone or avoiding exertion may feel protective but can maintain fear.
The panic cycle
Why the symptoms intensify so quickly.
Panic usually begins with a bodily sensation: a skipped heartbeat, dizziness, breathlessness, warmth or a sense of unreality.
The sensation is interpreted as dangerous. Thoughts such as “I am having a heart attack” or “I am going to pass out” activate more adrenaline, which increases the physical symptoms.
This creates a rapid feedback loop. The body reacts to the fear, and the fear reacts to the body.
Mind, body and behaviour
Panic creates intense symptoms, but the body is designed to recover.
The physical sensations are produced by the fight-or-flight response. They can feel severe, but they are temporary and naturally reduce as adrenaline falls.
Physical symptoms
- Racing or pounding heart
- Chest tightness or discomfort
- Shortness of breath
- Dizziness or light-headedness
- Tingling or numbness
- Sweating, shaking or trembling
- Nausea or stomach discomfort
Thoughts and perceptions
- Fear of dying
- Fear of fainting
- Fear of losing control
- Fear of going mad
- Feeling detached from yourself
- Feeling the world is unreal
- Believing escape is urgently necessary
Behaviour patterns
- Avoiding feared places
- Staying close to exits
- Travelling only with another person
- Checking pulse or breathing
- Avoiding exercise or caffeine
- Carrying medication or water
- Repeatedly seeking reassurance
How therapy can help
Learning that panic is frightening, not dangerous.
CBT for panic attacks focuses on changing catastrophic interpretations, reducing safety behaviours and rebuilding confidence in bodily sensations and everyday situations.
Understand the physiology of panic
Knowing how adrenaline, breathing and the threat response create symptoms can reduce the belief that panic signals catastrophe.
Work with catastrophic thoughts
We examine beliefs about heart attacks, fainting, losing control or going mad and test whether they fit the evidence.
Interoceptive exposure
Carefully planned exercises can help you experience feared sensations in a safe, controlled way and discover that they pass naturally.
Reduce safety behaviours
You can gradually stop relying on exits, companions, checking and other strategies that accidentally teach the brain panic is dangerous.
Return to avoided situations
Graded exposure helps you rebuild confidence in driving, shopping, travelling, queues, crowds and other important situations.
Use hypnotherapy to support calm and confidence
Hypnotherapy can support relaxation, reduce anticipatory anxiety and help rehearse more confident responses to panic sensations.
Free support
Resources for understanding panic.
The Resources page includes structured panic modules, diaries, exposure worksheets and CBT tools.
CCI panic modules
A structured series covering the panic cycle, bodily sensations, catastrophic thinking and behavioural change.
Panic diary
Record triggers, physical sensations, predictions, responses and outcomes to identify the patterns maintaining panic.
Graded exposure
Use structured exposure planning to return gradually to situations that panic or agoraphobia has restricted.
Free telephone consultation
You do not have to organise your life around panic.
Contact me for a free initial conversation. We can discuss your panic attacks, the situations you now avoid and whether CBT or hypnotherapy may help.