Panic attacks

A panic attack lasts a few minutes and leaves behind a conviction that lasts months: that it could happen again, at any moment, and that next time will be worse. People who have had one rarely fear the attack itself. They fear being on the underground, on the motorway, in a queue at the post office when it arrives.

Almost everyone, the first time, goes to A&E certain it is their heart. The tests come back normal and the reassurance does not last, because the body said something the results do not contradict: the alarm really did go off.

How life narrows

The greater harm is almost never the attack. It is what gets built around it: the longer route that avoids the tunnel, the seat near the door, the bottle of water in the bag, the person to call. Every precaution brings immediate relief and confirms to the fear that it was right. Life narrows a centimetre at a time.

What we can do with it

The work looks at two things together. The first is the mechanism: what the body does, why it does it, and how the precautions feed it. The second is slower and usually matters more: what was happening in your life when the alarm first went off. Panic almost always arrives in a period, not at random.

If you have had a first episode recently, a medical check is a sensible step. Ruling out a physical cause is not wasted time; it is what lets us work calmly on what remains.