Help for Panic Attacks and Panic Disorder in the UK: Where to Start

The NHS describes a panic attack as a rush of intense mental and physical symptoms that can come on very quickly, often for no apparent reason. Symptoms can include a racing heartbeat, feeling faint, sweating, nausea, chest pain, shortness of breath, trembling, dizziness, pins and needles, a choking sensation, feeling disconnected from your body, and a feeling of dread or a fear of dying. Most attacks last between 5 and 20 minutes, and some have been reported to last up to an hour.

The NHS says someone may be diagnosed with panic disorder if they have regular, unexpected panic attacks followed by at least a month of continuous worry about having more. You may start to avoid places or situations that you fear will trigger an attack, which can create a cycle of “fear of fear”. Source: NHS: panic disorder.

The NHS suggests that the next time you feel a panic attack coming on you:

• stay where you are, if possible
• breathe slowly and deeply
• remind yourself that the attack will pass
• focus on positive, peaceful and relaxing images
• remember that it's not life threatening

To help prevent further attacks, the NHS suggests CBT-based self-help books (ask your GP to recommend one), relaxing activities such as yoga and pilates, breathing exercises, regular physical exercise, and avoiding sugary food and drinks, caffeine and alcohol, and smoking, which can all make attacks worse.

The NHS says talking therapies and medicine are the main treatments for panic disorder. You can refer yourself directly to a talking therapies service for treatment based on cognitive behavioural therapy (CBT): find your local NHS talking therapies service (England only). If you prefer, you can see a GP, who may ask about your symptoms and may examine you to rule out other conditions, and can refer you. In Scotland, Wales and Northern Ireland, a GP is usually the first step. For under-18s, see NHS: mental health support for children and young people.

In CBT, the NHS says your therapist may talk with you about how you react during a panic attack and what you think about, and teach you ways of changing your behaviour to help you keep calm. If you and your doctor think it might help, a GP may also prescribe medicine, and the NHS says antidepressants can take 2 to 4 weeks to start working and up to 8 weeks to work fully. Medicines are a decision for you and a doctor. If symptoms do not improve, a GP may refer you to a mental health specialist such as a psychiatrist or clinical psychologist.

The NHS lists these for people with panic disorder, and suggests asking your GP about support groups near you:

• Anxiety UK
• No Panic
• Triumph Over Phobia (TOP UK)
• Free and low-cost therapy: charities, workplaces, universities and training clinics.

If you want to start sooner, choose who you see, or have longer-term therapy, you can see a private practitioner. Several professions work with panic and anxiety, and none is better for everyone. Ask about their training and experience with panic, and whether they offer CBT or another approach:

• CBT therapists.
• Practitioner psychologists, such as clinical and counselling psychologists, who are on the HCPC register.
• Counsellors and psychotherapists with anxiety and panic experience.
• Arts therapists, if putting feelings into words is hard.
• Occupational therapists, who can help when panic affects work, study or daily routines.
• Psychiatrists, medical doctors who can assess, diagnose and prescribe.

Whoever you choose, check their register and ask about fees, session length and how you will review progress together. See questions to ask before you book and how much therapy costs. On Therapist Circle, each practitioner's registration is checked when they join, and their profile shows the register and number so you can check it yourself.