Paul had been suffering from night time panic attacks for about six months when he had his first daytime experience of panic. When he called me he was upset and worried because he didn't want panic to rear it's head when he might be at work or out with friends. "It's bad enough at night" he told me "but at least then it's private and I've got my routine to cope with it. Actually it's been a bit better lately and I really don't understand why I should suddenly feel like a panic attack's coming on in the day when it never has before."

I asked him what he was doing when he started to feel the symptoms of a panic attack and he began telling me about helping a friend move an old TV out of their house. It was big and heavy and as he was lifting it into his van he noticed his heart was beating fast and from there feelings of panic instantly washed over him. He felt hot, and breathless and he just wanted to escape.