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Panic Attacks and Agoraphobia

This blog will help to explain what a panic attack is, why people have them, and how they are connected with Agoraphobia.

What is a panic attack?

Panic attacks are a sudden onset of distressing physical changes to our body. Typically panic attacks are acute, meaning the symptoms are intense but short-lived, with most panic attack peaks lasting minutes rather than hours.
Panic attacks can sometimes occur spontaneously, but mostly arise when our primitive brain perceives danger (which may not be real).

Symptoms of a panic attack

Panic attack symptoms can be unique to each person, but commonly include physical symptoms such as:
* shortness of breath
* tight chest
* racing heart
* light-headed
* stomach churning
* pins and needles
* wobbly legs
* feeling shaky
* hot and sweaty

The fight, flight or freeze response

In order to understand panic attacks, we need to understand the fight, flight and freeze response. This is an evolutionary survival response, developed many many years ago when humans faced far more life and death situations on a frequent basis. It’s an incredibly helpful automatic mechanism that we would be extremely grateful for should real danger present itself. It would allow us to fight our way out of danger, run away from danger, or stay super still to avoid detection in situations of danger.

However the problem with this is our survival response can be a bit over-protective. It can be triggered off when there is no real danger, a bit like a smoke alarm going off when there’s no smoke or fire. This is the most important thing to learn if you are to overcome anxiety – the alarm is false. They bodily changes we experience are part of our body preparing us to deal with the (false) danger. We don’t need to do anything for the alarm to stop, it will stop by itself after a bit of time. However often because the symptoms can be super scary, and can easily be misinterpreted as something medically serious – e.g. a heart attack, a stroke, losing consciousness etc – this is what starts the panic attack – us panicking about the false alarm.

What is Agoraphobia?

Agoraphobia is anxiety in places where someone might feel trapped, or where it feels like immediate escape is not viable. Agoraphobia typically arises as a result of avoiding situations where panic attacks have previously happened, or there’s a fear panic attacks could happen.
Common situations this applies to include:
* Formal restaurants
* Theatres or Cinemas
* Sporting events
* Large shopping centres
* Trains, planes or taxis
* Busy places with lots of people
* Large supermarkets

Treatment for panic attacks

Treatment for panic attacks can include medication support – typically beta blockers like propranolol prescribed short term, as well as CBT Therapy.

Therapy for panic attacks and Agoraphobia

CBT is the recommended treatment for panic attacks and Agoraphobia. It focuses on providing psychological education, challenging your incorrect thoughts or assumptions, and helping to build your confidence in facing the situations you might be currently avoiding.


Other useful blogs:
You can read further information about Exposure Therapy for Anxiety here:
Exposure therapy – Anxiety Treatment for Agoraphobia and Phobias | Hannah Paskin (

I am an Anxiety therapist providing CBT. You can read more about me here:
Why Should I Choose You? | Hannah Paskin (

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