Panic attacks are brief, intense episodes of physiological distress that can affect people of all ages. Children, in particular, may feel more distressed and terrified by their panic attacks, particularly as they might not recognize what’s happening. Some children may experience them only once in a while, while others have them consistently.
What Are Panic Attacks in Children?
A panic attack is a distinct episode of acute emotional distress. The presence of frequent or severe panic attacks may indicate an anxiety disorder. Panic attacks are short and rarely lost longer than 30 minutes. They have a distinct beginning and end point. Anxiety attacks, on the other hand, are defined less rigidly and often refer to sustained periods of anxiety, nervousness, and restlessness.
Research shows that about 11% of the American population experiences a panic attack at some point during their lifetime.1 The average onset of attacks usually occurs within the teen or early adult years. It is not as common for young children to experience attacks, but they can and do occur. While there isn’t a hard number for panic disorder, someone may develop panic disorder if they have a history of recurrent panic attacks coupled with a pervasive worry or phobia about another attack happening.2
Symptoms of Panic Attacks in Children
It’s important for loved ones to understand the risk factors and symptoms of panic attacks in children. While symptoms may have some variances- and episodes can vary in intensity- panic attacks are distinct. Most panic attack symptoms last between 5-20 minutes, although lingering symptoms of anxiety may persist for several more hours.
Symptoms of a panic attack in children may include:3
- Racing heartbeat
- Shortness of breath
- Choking sensation
- Sweating or feeling very hot
- Feeling unreal or disconnected
- Fear of going crazy or losing control
- Chest pain
Possible Causes of Panic Attacks in Children
Anyone can have a panic attack or panic disorder. Genetics, environment, and individual temperament play a role in shaping mental health. With that, mental health experts believe that a combination of specific risk factors may increase someone’s likelihood of experiencing this type of anxiety.
Environmental factors, like childhood trauma or emotional abuse, may increase a child’s vulnerability to panic attacks. Certain parenting styles, like authoritarian parenting, can cause a child to feel significant pressure at home or school. These factors can all exacerbate anxiety, which may coincide with panic attacks.
Mental illness likely has a genetic component, as research shows that anxiety disorders run in families. Children with anxiety disorders are 2-3 times more likely to have at least one parent with an anxiety disorder. In addition, some studies suggest that children with panic disorder are more likely to have mothers (but not fathers) with panic disorder.4
Specific phobias refer to heightened, particular fears. A child can have a phobia of anything, but some common phobias include spiders, dogs, the dark, flying, and heights. Phobiaa typically lead to avoidance behavior, as the child does not want to experience the feared situation. Therefore, direct exposure to their phobia may cause a panic attack.
Mental Health Conditions
Panic attacks can be a symptom of certain mental health issues in childhood, like depression, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). Panic attacks might be more intense and persistent during times of stress. If the child is not receiving adequate mental health support, they may feel more anxious, leaving them more susceptible.
Certain Substances or Medications
Substances are rarely the cause of a panic attack. However, caffeine, nicotine, alcohol, and prescription medications (such as stimulants or steroids) may exacerbate anxiety. Jitteriness, a racing heart, and sweating are all known side effects, and it’s important to consider your child’s consumption of such substances when evaluating their struggles with panic attacks.5
Stress with family, peers, or school can all aggravate anxiety. If your child does not know how to manage stress adequately (or struggles to implement healthy coping skills), they might be more vulnerable to panic attacks. If traumatic grief is involved with the stress, there may be additional mental health complications.
Significant Life Changes
Parents don’t always recognize the impact of transitions, including moving to a new home, starting school, trying out a different sport, or starting puberty, on a child’s mental health. Keep in mind that even positive changes often feel stressful, particularly if they disrupt your child’s sense of safety or established routine. These changes may correlate with panic attacks..
8 Ways to Support a Child With Panic Attacks
As a parent or caregiver, it’s essential to focus on how you can be present and compassionate if your child experiences a panic attack. Keep in mind that you do not have to be an expert to help someone with a panic attack. The overarching goal is be supportive.
Here are 8 ways to support a child with panic attacks:
Teach Mindfulness Techniques
Mindfulness for kids includes recognizing bodily sensations, attuning to feelings, and trying to stay in the present moment. As children learn and implement these skills, they tend to have better mental health.
Teach Breathing Exercises
Breathwork can help control and reduce anxiety by promoting a sense of calmness. These exercises can also give children a sense of control over their bodies.
Educate Them About Panic Attacks
Labeling symptoms and experiences can be powerful. If a child knows what a panic attack is, they can develop insight into what may cause their anxiety. Likewise, they won’t feel as caught off-guard if another attack happens in the future.
Validate Their Experience
As much as possible, aim to be validating during and after the panic attack. Do not discount their feelings or ask harsh questions like, “What are you even anxious about?” Instead, try to understand where they’re coming from and be mindful that they might not want to talk until they feel better.
Offer to Stay With Them
Some children may prefer to be left alone during a panic attack, especially if they experience shame. But many children want and need support. Let them know you are here in whatever way they need. Maybe it’s holding their hand or hugging them. It may also be distracting them with a funny video or a favorite warm drink.
Help Them Cope with Triggers
Start paying attention to potential situations, people, or emotions that trigger your child’s panic attacks. While not everything happens in patterns, you’ll find sequences often do exist. Talk to your child about alternative ways they can cope with their anxiety triggers. Try to model these skills in your own life- children are more apt to do what you do rather than just do what you say.
Engage in Gentle Exposure
If phobias trigger panic attacks, it may be helpful to plan ahead if you know a feared situation is happening. Talk openly about the situation and spend time checking in with them, but also be respectful of their boundaries and avoid joking about these issues with others. Your job isn’t to prevent all triggers (and doing so is often counterintuitive). But you can support them in acknowledging and respecting the fear. You can also be affectionate, validating, and encouraging when your child confronts their fear directly.
Ask Them About Their Feelings
During and after the panic attack, it may be helpful to ask what your child is feeling. Anxious, nervous, or scared are the obvious emotions, but what else lies underneath? You might find that your child also feels angry, sad, embarrassed, or lonely.
Check In the Next Day
Even if your child seems fine the next day, or if things look like they have gone back to normal, don’t assume everything has passed. Anxiety often ebbs and flows, but the end of a panic attack doesn’t mean the end of anxiety. Make it a point to let them know you are here to talk to and support them unconditionally.
Treatment for Panic Attacks in Children
If panic attacks persist or anxiety seems to worsen, it’s important to seek professional help. While treatment doesn’t cure certain conditions, children can learn how to manage their symptoms and gain control over their emotional well-being. Parental involvement is essential, and early action can help prevent current symptoms from worsening or new symptoms from emerging.
Treatment options for a child with panic attacks include:
Therapy for Panic Attacks in Children
Therapy is often recommended for children with anxiety and panic attacks. This applies to children of all ages. Some children may be engaged and motivated to speak to a professional, while others are more hesitant. Qualified child-based therapists are familiar with supporting children with all different types of presentations. Finding a therapist that fits your child’s needs and connects with them can be a critical part of managing their symptoms. Ask your child’s pediatrician or school for a referral and what to expect from children’s counseling. You may also find that online therapy options help you fit therapy into a busy schedule.
Therapy options for childhood panic attacks may include:
- Cognitive-behavioral therapy (CBT): CBT for kids focuses on the relationship between thoughts, feelings, and behaviors. By changing anxious thoughts, children may feel better overall.
- Family therapy: Family therapy is often recommended when a child has anxiety. Many therapists examine systemic processes when treating mental health problems, so they will examine how the family plays a role in maintaining or reinforcing anxious patterns.
- Play therapy: Play therapy may be beneficial for young children experiencing panic attacks. Play allows them to express their experiences and feelings when they lack the language to do so.
- Eye movement desensitization and reprocessing (EMDR): EMDR is recommended as a trauma treatment for children. If panic attacks coincide with trauma triggers, this may be a helpful treatment model.
- Group therapy: Group therapy can provide peer support for children with anxiety. Schools, nonprofit groups, mental health clinics, and therapists in private practice often facilitate groups for specific ages.
Medications for Panic Attacks in Children
Medication may be appropriate for treating or preventing panic attacks in children. Medication is most effective when coupled with therapy.
Medication options for panic attacks in children may include:
- Selective serotonin reuptake inhibitors (SSRIs): SSRIs, such as Zoloft or Prozac, are antidepressant medications, but they are also prescribed for anxiety and panic attacks. SSRIs have a black box warning for children, as they are associated with an increased risk of suicidality.
- Benzodiazepines: Benzodiazepines like Valium or Klonopin are antianxiety medications sometimes prescribed for children with anxiety. They also come with a black box warning for misuse or abuse, as it’s possible to develop a tolerance for them. Research shows they are largely only beneficial for short-term use.
Panic attacks can be concerning. However, parents play an integral role in supporting their children during these episodes. Aim to be compassionate, understanding, and validating, regardless of the situation. And if anxiety continues escalating, or if it impacts your child’s everyday life, seek support.