Panic attacks — what they are, what helps in the moment, and the body-based work that builds capacity over time
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Last Updated
October 1, 2026
Panic attacks are medical — and the body-level work between attacks is what regulates the system long-term.
A panic attack is a sudden surge of intense fear with strong physical symptoms: a racing heart, breathlessness, chest tightness, dizziness. Your GP diagnoses panic disorder and leads treatment, usually CBT, sometimes medication. At our Islington clinic we support that care with somatic coaching, mindfulness and breath practice, nutritional therapy and, where clenching is involved, jaw-tension care.
Visible Signs & Symptoms
A panic attack is a sudden, intense wave of fear in which the body's alarm system fires at full strength. It usually builds within minutes and then passes, although it can feel far longer. Attacks can follow an obvious trigger or arrive out of nowhere, including at night.
A single panic attack is common and not, in itself, a disorder. When attacks recur unexpectedly and you begin to worry about the next one, or change your life to avoid them, a GP may diagnose panic disorder. Panic can also occur within wider anxiety.
Physical signs
- A pounding, racing or fluttering heart
- Breathlessness, or a feeling of not being able to get enough air
- Chest tightness or pain
- Dizziness, light-headedness or feeling faint
- Tingling or numbness in the hands, feet or lips
- Sweating, trembling, hot flushes or chills
- Nausea or a churning stomach
What it can feel like
- A sense of dread or that something terrible is about to happen
- Fear of losing control, collapsing or dying
- Feeling detached from yourself or your surroundings, as if things are unreal
Because these symptoms overlap with heart and breathing problems, many people first seek emergency care believing something is physically wrong. That is a sensible response, not an overreaction. See the red flags below.
Between attacks
People living with repeated panic often notice a background of alertness: shallow breathing, tight shoulders, a clenched jaw, lighter sleep and a habit of scanning the body for warning signs. Dentists sometimes see the effect of that sustained tension as worn teeth or tender jaw muscles. These signs are not a diagnosis, but they show how much of panic is carried in the body.
Clinical Root Causes
A panic attack is the fight-or-flight response switching on when there is no physical threat to meet. Adrenaline rises, the heart speeds up and breathing quickens. Those sensations are then read as danger, which drives more fear and more symptoms, a spiral that usually peaks and then settles.
Factors that make panic more likely
- Stress and life events: sustained pressure, bereavement, illness, a new baby or a major change
- Background anxiety: a nervous system already running on alert has less margin
- Family history: panic and anxiety tend to run in families
- Difficult past experiences, including frightening medical or dental experiences
- Stimulants and withdrawal: caffeine, nicotine, alcohol and some recreational drugs can trigger or worsen attacks
- Physical health: conditions such as thyroid problems, asthma or heart rhythm disturbances can produce similar symptoms or interact with panic, which is why a GP assessment matters
Breathing patterns
Fast, upper-chest breathing can produce dizziness, tingling and a feeling of air hunger, which closely resemble panic and can tip a sensitive system into an attack. This is one reason we favour slow, gentle, exhale-led breath practice and steer people away from intense or rapid breathing techniques. More on this in our guide to breathwork.
Avoidance and the fear of fear
After a frightening attack, it is natural to avoid the place or situation where it happened. Over time, avoidance tends to widen the circle of things that feel unsafe, and worry about the next attack becomes a trigger in its own right. Breaking that cycle is the central aim of CBT for panic.
Dental settings
For people with dental anxiety, lying back in a chair with limited ability to speak can be a trigger. We plan dental care for these patients with time, pacing and agreed signals to pause.
Why addressing panic attacks matters
A panic attack is frightening but is not, in itself, physically harmful. The difficulty lies in what repeated attacks can do to a life: avoiding travel, crowds, work situations or being alone, and living with a constant watchfulness for the next episode. Panic disorder is treatable, and most people improve with the right support, so it is worth seeking help early rather than adapting your life around it.
Red flags: get help now
- Chest pain, especially if it spreads to the arm, jaw, neck or back, or comes with breathlessness, sweating or nausea: call 999. If you are unsure whether it is panic or your heart, treat it as your heart.
- A first episode of this kind, or symptoms that feel different from your usual attacks: seek urgent medical assessment
- Thoughts of harming yourself, or feeling unable to keep yourself safe: call 999 or go to A&E
- Urgent advice that is not an emergency: call NHS 111
- Someone to talk to at any hour: Samaritans on 116 123, free
When to see your GP
- You have had more than one panic attack
- You worry about having another, or have started avoiding places or activities
- Attacks are affecting work, sleep or relationships
Your GP can check for physical causes and discuss CBT, medication or referral. In England you can also refer yourself to NHS Talking Therapies. Our support is designed to sit alongside that care.
What body-level support actually means (and the framework we use)
Diagnosis and treatment of panic disorder come from your GP, NHS Talking Therapies or a specialist. NICE recommends CBT as a first-line treatment for panic disorder, and medication is a decision for you and your doctor, not for us. We are a private clinic and do not diagnose, prescribe or provide psychiatric care. What we offer is body-level support for the space between attacks, so that your system has more capacity to settle.
In the moment
If you know the pattern and the red flags above do not apply, slow the breath with a longer out-breath than in-breath, feel your feet on the floor, and let the wave peak and pass rather than fighting it. Your CBT practitioner may give you specific techniques; use those first.
Building capacity between attacks
- Somatic coaching with Laura-Maria Schober (MSc, EMCC) works gently with breath, posture and held tension, helping you recognise early body signals and practise settling. It is carefully paced so that the system is not overwhelmed. It is not psychological treatment and complements CBT rather than replacing it.
- Mindfulness with Laura-Maria Schober builds the habit of noticing sensations without immediately reading them as danger.
- Nutritional therapy with Nicoletta Peloni (mGNC, mANP) looks at regular meals, blood-sugar dips, caffeine and alcohol, all of which can feed physical symptoms that resemble panic. If digestion is also a concern, see our page on gut health.
- Ayurvedic consultations with Dr Reena Sohal focus on routine, sleep timing and diet from an Ayurvedic perspective.
When panic affects decisions or relationships
If panic has shaped choices about work or relationships, life and relationship coaching with Binta Patel (ICF ACC) can help you plan steps forward. Coaching is not mental-health treatment.
If your jaw is involved
Dr Vishal Patel, our principal dentist, assesses clenching and grinding. Where appropriate he makes a Davies-technique splint to protect the teeth and ease night-time loading on the jaw muscles. For patients who find dental visits themselves a trigger, we plan treatment with extra time and pauses.
How we choose with you
We start with a free 20-minute discovery call, ask what medical care is already in place, and suggest one starting point. If your attacks are new or have not been assessed, we will ask you to see your GP first. Progress with panic is rarely a straight line: a calmer few weeks may be followed by an attack, and that is not a sign that the work has failed. We review together, adjust the pace and, with your consent, keep your GP informed.
Cost
- Discovery call (20 minutes, phone): free
- Mindfulness session: £65
- Life coaching session: £75
- Nutritionist session (90 minutes): £75
- Ayurvedic medicine session: £75; Ayurvedic review appointment: £50
- Davies splint: £495
Somatic coaching fees are confirmed during your discovery call. Results vary, and we make no promises about outcomes.
Getting here. We are at 222 Essex Road, Islington N1 3AP, two minutes from Essex Road station on the Great Northern line (one stop from Highbury & Islington). Buses 38, 56, 73, 341 and 476 stop on Essex Road, and many patients cycle or arrive by Lime or Forest e-bike. Appointments run Monday to Friday, 8am to 7pm; we do not take walk-ins.
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If your question isn't here, call reception on 020 8127 4567 or book a free discovery call.Text Link
View all FAQs →How do I know if I'm having a panic attack or a heart attack?
Honestly, in the moment you often can't be certain. If this is your first episode, you have cardiac risk factors, or the chest pain radiates to an arm, jaw or back, treat it as cardiac and call 999.
Can somatic therapy stop panic attacks?
It's better to say it builds capacity than that it "stops" them. Somatic work isn't first-line treatment, but for patients who've plateaued after GP and CBT input, it can help recondition the underlying autonomic activation over months.
Are panic attacks dangerous?
Not directly — the episode itself won't damage you. What is dangerous is going untreated long-term, as panic disorder can become limiting and drive avoidance behaviour.
How do I stop a panic attack in the moment?
Slow exhale: breathe in for 4 seconds, hold briefly, breathe out for 6-8 seconds, repeated for 2-3 minutes. The longer exhale activates the vagus nerve and shifts the nervous system back toward parasympathetic.
What's the difference between a panic attack and an anxiety attack?
"Anxiety attack" isn't a formal clinical term. Panic attacks peak within 10 minutes with four or more physical symptoms. Anxiety attacks build more slowly and may not reach the full panic threshold.
Will I always have panic attacks?
For most people, no. Panic disorder is treatable. Combined cognitive and physiological approaches produce remission in the majority of patients within 6-18 months.
Should I be on medication for panic attacks?
That's a GP and psychiatrist decision, not ours. Medication has strong evidence for panic disorder. Some patients try CBT and body-level work first; others benefit from medication early on.
Can breathwork trigger panic attacks?
For some people, yes. Intense or fast breathing techniques can provoke sensations that tip a vulnerable nervous system into panic, which is why we steer patients toward slow, gentle, exhale-led practice.
Can dental treatment trigger panic attacks?
Yes, for patients with dental anxiety or trauma history. At DWL we plan dental treatment for these patients with explicit nervous-system support, including pre-session breathwork and pacing protocols.
