Panic Attacks and Panic Disorder in Children and Teens
Written by Rachel Ealy, M.Ed, LPC-Intern
Anxiety disorders are common but can be difficult to diagnose in children. Panic attacks occur within the realm of anxiety disorders; however, they are not exclusive to anxiety disorders. Your child may complain about physical symptoms such as stomachaches, headaches, or other aches and pains. In order to rule out any medical conditions or physical illness, many mental health professionals recommend seeking out an evaluation by a pediatrician or family physician. Panic Disorder, in particular, is characterized by “an abrupt surge of intense fear or intense discomfort [that can] occur from a calm state or an anxious state” (American Psychiatric Association, 2013). Oftentimes, somatic and/or cognitive symptoms occur during a panic attack. Somatic symptoms are physical symptoms while cognitive symptoms are related to the mind and thoughts. In the list below I have labeled somatic symptoms in red and cognitive symptoms in blue. The American Academy of Child and Adolescent Psychiatry (2013) reported that, “more than 3 million Americans will experience panic disorder during their lifetime.” The cause of panic disorder is unknown however children whose parents suffer from anxiety, depression, and/or bipolar disorder are more likely to have panic disorder (“Panic Disorder,” n.d.).
What are the symptoms of a panic attack? (“Panic Disorder in Children and Adolescents,” 2013).
· Intense fearfulness or a sense that something terrible will happen/is happening
· Accelerated heart rate, pounding heart and/or heart palpitations (feeling your heart beating hard, fast, or fluttering)
· Feeling dizzy, lightheaded, unsteady, or faint
· Shortness of breath and/or tightness in chest
· Trembling or shaking
· Derealization (sense of unreality) or depersonalization (feeling detached from oneself) (American Psychiatric Association, 2013).
· Fear of dying, losing control, or losing your mind
What to look for:
Begin by referring to the symptoms listed above. On average, a panic attack peaks at about 10 minutes. After the attack, your child’s fear of having another panic attack may linger. Without the proper tools and coping skills, this can lead to avoidance of situations, places, or activities that your child thinks might trigger a panic attack.
What can you do?
You can begin by seeking psychological services such as counseling and an evaluation for a proper diagnosis. Your child’s counselor can work with your child to better understand their panic attacks and develop coping skills to manage them in a healthy way. We have counselors at Heights Family Counseling that specialize in treating childhood and adolescent anxiety.
1) Teach your child about anxiety and facts about panic attacks
a. Have your child write a list of their somatic and cognitive symptoms
b. Name the anxiety to begin externalizing it: Mr./Mrs. Worry, bully, pink monster etc.
c. Remember: anxiety is normal and it helps us prepare for dangerous situations. Anxiety only becomes a problem when our body prepares us for a dangerous situation when there is no real danger.
d. Facts about panic attacks:
1. Panic attacks are our body’s fight-flight-or freeze response. Adrenaline begins pumping though our bodies, digestion stops, and your heart beats faster to pump more blood throughout the body so you are able to react quickly.
2. Even though panic attacks feel very uncomfortable, they cannot hurt you.
3. Panic attacks are usually brief (peaking on average at 10 minutes) even though, in the moment, it feels like it will never end (“Home Management Strategies for Panic Disorder,” n.d.).
2) Progressive Muscle Relaxation
a. Have your child sit or lie down in a comfortable position in a quiet space
b. Begin either at the very top of the head or toes. Slowly move through each muscle group by tensing each muscle for 3-5 seconds and then relaxing. If beginning with the toes have your child scrunch their toes as tight as they can and then relax. Move up to the calf muscle, then to the thigh, stomach, and so on.
c. While tensing each muscle group, focus on breathing deeply though the nose and slowly out through the mouth.
d. You can also try following a guided progressive muscle relaxation routine such as this one: https://www.youtube.com/watch?v=86HUcX8ZtAk (D’Amico, 2014).
American Academy of Child and Adolescent Psychiatry. (2013). Panic disorder in children and adolescents. Retrieved from https://www.aacap.org/aacap/families_and_youth/facts_for_families/fff-guide/Panic-Disorder-In-Children-And-Adolescents-050.aspx
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Anxiety Canada. (n.d.). Home management strategies for panic disorder. Retrieved from https://www.anxietycanada.com/parenting/home-management-strategies-panic-disorder
Panic disorder. (n.d.). Retrieved from https://www.mentalhealth.org/what-to-look-for/anxiety-disorders/panic-disorder
D’Amico, Joanne. [Relax For A While]. (2014, March 1). Progressive muscle relaxation [Video file]. Retrieved from https://www.youtube.com/watch?v=86HUcX8ZtAk