Anxiety and panic attacks: symptoms, causes and treatment
Anxiety becomes a clinical problem when the alarm stays on after the danger has gone, when worry runs most days, the body stays tense and you begin avoiding ordinary things. It is one of the most common reasons people contact us, and one of the most treatable.
What anxiety actually looks like
Worry you cannot switch off, often about several things at once
A racing heart, tight chest, shallow breathing or shaking with no medical cause
Panic attacks that peak within minutes and feel like a heart attack
Trouble falling asleep because the mind will not stop
Avoiding calls, gatherings, exams, driving or being alone
Stomach problems, nausea and constant muscle tension
Irritability and a short fuse with the people closest to you
Needing repeated reassurance that nothing bad will happen
Why it happens
Anxiety is usually a mix of a sensitive threat system, chronic stress and learned avoidance. In Pakistan we most often see it in students under exam and admission pressure, young adults facing financial or visa uncertainty, women carrying unspoken marital or in-law strain and anyone who grew up where mistakes were punished rather than discussed. Avoidance is what keeps it alive: every time you dodge the feared thing, the fear is reinforced.
When to speak to a professional
Speak to a clinician if worry has run most days for over a month, if you have had more than one panic attack, if you are avoiding work, study or people or if you are using sleeping pills, cigarettes or other substances to manage it.
How we treat anxiety
Anxiety responds well to structured, short-term therapy. Most clients notice a measurable change within six to eight sessions, and we track it with a standard scale rather than guessing.
Cognitive Behavioural Therapy (CBT)
Identifying the thoughts that inflate threat, testing them against evidence and rebuilding realistic appraisal. The strongest evidence base for anxiety disorders.
Graded exposure
Approaching avoided situations in a planned, tolerable order until the fear response settles, the part of treatment that produces lasting change.
Applied breathing and body regulation
Slow-breathing and grounding protocols that interrupt a panic attack, practised until they work under real pressure.
Acceptance and Commitment Therapy (ACT)
For long-standing worry: reducing the struggle with anxious thoughts and reinvesting energy in what actually matters to you.
What a course of treatment looks like
A typical course is 8 to 12 weekly sessions of 50 minutes, with brief home practice between them. Where anxiety is severe or accompanied by significant depression, we coordinate with a psychiatrist so that medication and therapy are working in the same direction.
Anxiety self-check
Over the last two weeks, how often has each been true? This is an educational screen, not a diagnosis, a clinician confirms anything it suggests.
1. Feeling nervous, anxious or on edge
2. Not being able to stop or control worrying
3. Trouble relaxing, or feeling restless
4. Becoming easily annoyed or irritable
5. Feeling afraid as if something awful might happen
No. Overthinking is one symptom. Clinical anxiety involves a physical stress response, heart rate, muscle tension, sleep disruption, that does not switch off with willpower or advice.
Often not. Mild to moderate anxiety usually responds to therapy alone. If your symptoms are severe or you cannot function, we will suggest a psychiatric consult alongside therapy and you decide.
They are extremely unpleasant but not physically dangerous. Learning that, and proving it through practice, is a central part of treatment.
Most clients report a noticeable shift by session four to six. Full courses usually run eight to twelve sessions.
Key takeaways
- Anxiety is your body’s alarm system getting stuck on high.
- Common signs include racing thoughts, a pounding heart, poor sleep and avoiding things.
- CBT is one of the most effective treatments and most people improve within 8 to 12 sessions.
- You don’t have to wait until it gets worse to ask for help.