When do you need urgent help?
Call emergency services for sudden chest pain or pressure that does not go away, severe difficulty breathing or loss of consciousness. If this is your first episode or it feels markedly different from previous ones, seek medical assessment even if it eases.
Where should you start?
Once the episode eases, you may feel ready to get back to your day. While it is fresh in your mind, note how it began and what you felt afterwards.
- Your heart suddenly raced or felt as though it skipped beats.
- You noticed shaking, sweating, dizziness or shortness of breath.
- After the strongest wave passed, you felt tired or anxious, or wanted to avoid the place where it happened.
Yav in the institute’s framework means your body and your present circumstances. At the visit, describe what you felt, in what order and how it affected your day.
Which doctor should you see first?
A GP or primary care doctor is a good starting point when the cause is unclear. They can review symptoms and medicines, examine you and refer you to a cardiologist or another specialist if needed.
A psychiatrist or another qualified mental health clinician can assess whether you have panic disorder and discuss treatment. If attacks recur, mention any fear of another episode and the things you have started putting off.
Which tests might help?
There is no specific blood test for a panic attack. Tests help a clinician assess whether something else might account for your symptoms.
| Test | Why it might help |
|---|---|
| ECG | To check your heart rhythm, especially if you describe skipped beats or a racing heart. |
| Full blood count | To look for signs of anaemia if your symptoms or examination suggest it. |
| TSH and other thyroid tests | To check thyroid function if your clinician suspects it may be related to your symptoms. |
Ask your clinician which tests are appropriate for you. Bring any recent results so you can discuss whether anything needs repeating.
What can make it hard to book a visit?
When your heart races, you may want an explanation immediately. A sensitive alarm can sound loud without telling you what set it off. You can describe intense sensations to a clinician even if you do not know what to call them.
| What adds pressure | What you can do |
|---|---|
| “I should get every test first.” | Start with an appointment and bring the results you already have. |
| “It passed, so I can forget it.” | Note the timing, what you felt first and what changed afterwards. |
| “I have to prove it was serious.” | Describe one situation in your own words and say what worries you. |
You can ask for help before you have an explanation for what happened.
What can you notice in past experiences?
Nav in Alexander Zharkov’s framework means past experience and learned rules, including family patterns. A “breach in your boundaries” is a metaphor for a situation where someone else’s urgency makes it harder to take a pause. A clinician assesses the causes of physical symptoms.
- What was happening before the episode and what did you feel first?
- What made it hard to take a break or ask for help?
- What familiar rule came to mind?
What can you do during a familiar attack?
During a familiar attack, follow the plan agreed with your clinician. If you are somewhere safe and can sit comfortably, try this short grounding practice.
- Sit and notice the seat supporting your weight. Put both feet on the floor.
- Rest your hands on your thighs. Let your breathing follow a comfortable rhythm.
- Choose an object nearby and silently name its colour.
Stop if you feel worse or uncomfortable. Call for help if you notice warning signs.
What should you write down before your visit?
Prav in the institute’s framework means the direction you take next. A few lines describing what you noticed are enough to prepare for your visit.
- When it started, how long it lasted, what you felt first and when it eased.
- What was happening around you, whether you had slept poorly and what medicines, supplements or caffeinated drinks you had taken.
- Whether it has happened again, how it affects sleep, travel or work and what you want to ask your clinician.
The institute offers a 40-day programme for separately exploring habits and boundaries. Discuss testing and treatment with your clinician.
How can medical care and the Zhiva approach fit together?
| Support | What it covers |
|---|---|
| Medical care | Symptoms, possible causes, tests that might help and treatment options. |
| The institute’s consultation | One life situation, a pattern of putting off asking for help and a possible next step. |
Questions about assessment for panic attacks
Which doctor should I see if the episode has passed?
If it was your first episode or it keeps happening, speak to your GP or primary care doctor. Describe what you felt, how long it lasted and how it eased.
Which blood tests should I get before my visit?
Start with an appointment. Your clinician will decide whether an ECG, full blood count or thyroid test would help based on your symptoms and examination.
Does a normal ECG mean it was a panic attack?
A normal ECG on its own cannot confirm a panic attack. The clinician considers the whole episode, the examination and any other relevant findings.
Who assesses panic disorder?
A psychiatrist or other qualified mental health clinician can assess panic disorder. If you are unsure where to start, your GP or primary care doctor can guide you.
Where can you start a personal consultation?
If you are already discussing health questions with a clinician and want to explore how to ask for a pause or support, choose one conversation. Quantum Diagnostics is a consultation about past experience, present circumstances and your next decision, using Alexander Zharkov’s approach.
Individual text consultation · €30. Continuing with a programme is optional.
How the personal consultation works