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Key Takeaways:
- Children can develop panic attacks due to brain abnormalities, chemical imbalances, chronic stress, past trauma, and other factors.
- Panic attacks can manifest physically, emotionally, and behaviorally, affecting children in many ways.
- Treatment for panic attacks in children includes medications, behavioral therapy, and exposure therapy.
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Panic attacks in children can feel terrifying. Their fears can make them lose their breath, feel pain in their chest, and even make them believe they’re dying. However, with the right coping strategies and resources, your child can learn to overcome their fears and manage their triggers.
Learn what causes panic attacks in children, what symptoms to observe, and what you can do to help.
What is a Panic Attack?
Panic attacks are a type of anxiety disorder that causes severe physical reactions and intense fear as a response to a trigger [*]. They can be frightening and cause people to feel they are losing control or having a heart attack. Panic attacks occur suddenly and are difficult to foresee or predict. They can occur at any time and happen frequently or occasionally.
What Causes Panic Attacks in Children?
While there is no singular cause of panic attacks in children, there are factors that can influence the probability of developing a panic disorder.
Biological factors:
- Genetics or occurrence of panic disorder in family members
- Brain abnormalities disrupting cerebral blood flow and metabolism
- Amygdala dysfunctions affecting how the brain processes fear
- Chemical imbalances affecting cortisol and serotonin production
Psychological factors:
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Chronic stress and triggering life events
- Exposure to phobic objects, people, or places
- Sensitivities to negative emotions
- Poor communication style or lack of assertiveness
Environmental factors:
- Social problems and poor interpersonal relationships
- Health and lifestyle causing medical problems
- Interpersonal problems and low social class
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Substance use
Coexisting conditions:
- Agoraphobia, or an avoidance of triggers, fears, and situations that may cause panic
- Social phobias, such as fears of being in crowds or places requiring social interactions
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Selective mutism, in which children refuse to speak in certain social situations
What are the Symptoms of a Panic Attack in a Child?
Panic attacks in children can manifest physically, emotionally, and behaviorally. If your child suffers from panic attacks, they’re likely to display symptoms in the following ways.
Physical symptoms:
- A pounding/racing heart and increased heart rate
- Sweating or experiencing hot/cold flashes
- Shaking, fidgeting, and tremors
- Shortness of breath or difficulty breathing
- Chest pain or tightness
- Stomach cramps, nausea, or vomiting
Emotional symptoms:
- Intense fear of an object, person, or place, and a fear of losing control or dying
- Intense and unstoppable crying
- Feeling like being outside of reality or outside of one’s body
- Feeling frozen in place or unable to move
Behavioral symptoms:
- Screaming or lashing out
- Extreme avoidance of triggers and fears
- Obsessing over or feeling excessively preoccupied with their triggers
How are Panic Attacks Diagnosed in Children?
Parents can arrange a diagnosis for their child by speaking with their healthcare provider or pediatrician. Your child’s doctor will first rule out other possible causes, such as post-traumatic stress disorder (PTSD), which may mimic symptoms of panic disorder [*].
If the diagnostician rules out other causes, they will consider whether the child has regular panic attacks and if they display significant behavioral changes, such as avoidance and withdrawal. Diagnosticians may also interview parents, siblings, and teachers to understand the child’s behavior.
Additionally, they’ll review the child’s medical history and perform a mental health exam, which may include extra interviews and exams.
How are Panic Attacks Treated in Children?
Children with panic attacks can benefit from a variety of treatments. The best option for them will ultimately depend on the severity of their condition and what their pediatrician recommends. Here are some options you can explore.
Medication
Children who are unable to calm down during panic attacks may benefit from benzodiazepines and selective serotonin reuptake inhibitors (SSRIs). These medications influence neurotransmitters, which carry anxiety signals to the brain [*].
While benzodiazepines are effective for treating panic attacks, they can cause drowsiness and impair a child’s executive functioning or working memory.
Behavioral Therapy
Alongside medication, behavioral therapy proves an effective treatment for panic disorder in children. In particular, cognitive behavior therapy (CBT) encourages children to think more flexibly about their triggers [*]. Therapists help children eliminate negative thoughts associated with these triggers by introducing calming techniques and mental tools to overcome the overwhelming sensations involved.
As children practice these techniques, their fear of these attacks diminishes, and they become ready to face triggers in the real world.
Exposure Therapy
As its name suggests, exposure therapy involves exposing children to their triggers through reality or imagination. During an exposure therapy session, a clinician encourages the child to tolerate uncomfortable feelings associated with their triggers while introducing relaxation techniques to eliminate their fears.
Clinicians may practice exposure therapy in the following ways:
- In vivo or directly/in person
- Imaginal, or asking the child to picture the trigger in their mind
- Through virtual reality
- Interoceptive, or triggering a physical sensation
How to Help a Child During a Panic Attack
Watching your child experience a panic attack can be a painful and challenging process, but there are ways to keep them and yourself calm and in control. Here are some ways you can help your child during a panic attack:
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Stay calm and validate their feelings: Children who experience panic attacks often feel like they’ve lost control. You can soothe and ground them more effectively when you stay in control. Validate your child’s feelings by reassuring them they are safe but communicating that you understand they are scared.
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Introduce coping skills: Teaching your child about panic attack coping skills can help them direct their attention away from triggers. Consider introducing mindfulness skills, such as repeating calming affirmations or practicing breathing exercises. You can also try progressive muscle relaxation (PMR), which helps children relieve tension in the body.
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Learn more about panic attacks: Panic attacks can be easy to mistake for heart attacks, especially if your child experiences chest tightness. Thus, learning about how panic attacks manifest is helpful so you know how best to address your child’s symptoms.
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Challenge negative thoughts: How your child perceives their triggers can determine how they react. For instance, if your child feels as though they’re “dying” during a panic attack, you can reassure them that they are safe and that you are present to help them. Repeating this reassurance can help them overcome unhelpful thoughts in the future.
The Bottom Line
Panic attacks in children can feel disabling, but they can overcome these triggers with time and practice. If your child experiences persistent panic attacks, it’s best to seek professional help.
Use our anxiety worksheets to help your child learn more about their triggers and responses and discover more information about panic disorder through these resources:
Sources:
- Clark DM. “A Cognitive Model of Panic Attacks.” Taylor & Francis, 2013.
- Cougle JR, Feldner MT, Keough ME, Hawkins KA, Fitch KE. “Comorbid panic attacks among individuals with posttraumatic stress disorder: Associations with traumatic event exposure history, symptoms, and impairment.” Journal of Anxiety Disorders, 2009.
- Quagliato L. “Risks and benefits of medications for panic disorder: a comparison of SSRIs and benzodiazepines.” Expert Opinion on Drug Safety, 2018.
- Pincus D. “Cognitive-Behavioral Treatment of Panic Disorder in Adolescence.” Journal of Clinical Child & Adolescent Psychology, 2010.
