February 2, 2022

Panic Attacks in Children [Preventing & Responding]

While panic attacks tend to be more common in adults than children, research shows that about 1-3% of youth experience them. As a parent or loved one, it is imperative to understand the key warning signs and treatment approaches. 

Understanding Panic Attacks

Panic attacks are physiological responses to stress. They can range in severity, but they often feel highly distressing. In some cases, they can be downright debilitating. Unfortunately, if someone doesn’t know they’re having a panic attack, they might mistake their symptoms for a stroke or heart attack.

It’s important to note that panic attacks are unique to each person. Symptoms may even look different during different attacks. That said, here are some common symptoms most people experience:

  • Sense of intense weakness.
  • Chest pains (feeling like something heavy is on your chest)
  • Nausea or vomiting
  • Hyperventilating
  • Difficulty breathing or shortness of breath
  • Trembling and uncontrollable shakiness
  • Heart palpitations
  • Feeling like you’re going to pass out or die
  • Numbness in some or all of the body
  • Tingling sensations

Panic attacks also vary in length. Most attacks peak around ten minutes. However, some symptoms will linger for several hours or the rest of the day. For this reason, many people report feeling exhausted after the attack.

Researchers have not identified a single variable that causes panic attacks. But people with preexisting anxiety conditions and a history of trauma may be at an elevated risk. In addition, ongoing, chronic stress can also play a role.

Why Panic Attacks Can Be Harder on Children 

It doesn’t matter how old you are. Panic attacks can be brutal and difficult for anyone to endure. 

But children lack the emotional and cognitive understanding to fully recognize how their emotions work. They may not have the language to articulate how they feel. At the same time, they might experience immense shame for their reactions.

As a result, children may conceal their anxiety symptoms. Depending on their age, they may also “act them out” in different ways, such as by:

  • Having extreme tantrums.
  • Disobeying parents or other authoritative parents.
  • Regressing in basic functions like going to the bathroom or eating.
  • Experiencing sleep disturbances.
  • Withdrawing from relationships or usual interests.
  • Having physical symptoms like stomachaches or headaches.

For these reasons, anxiety may go undetected. Parents or other adults may dismiss symptoms as part of ordinary development. Or, they might perceive the child as being difficult or defiant.

Even if they do recognize anxiety symptoms, they might dismiss or intellectualize them. Unfortunately, we live in a society that often views children as overly resilient. Therefore, we don’t necessarily understand that their mental health is also fragile and needs care and attention.

Supporting a Child Who Experiences Panic Attacks 

Panic attacks can be scary for both children and their loved ones. You may not know what to say or do. This is normal, but it’s important to educate yourself on strategies you can use to support your child. 

Teach Children How to Identify Their Feelings 

Labeling feelings is an important mental health tool that can help children feel empowered. Unfortunately, most children only know simple terms like good or bad when it comes to describing their emotions.

Labeling feelings starts with you. Make sure that you regularly use feelings words when describing your own reactions to specific situations. For example, you might say, I felt really scared when we got in that car accident. Or, I felt sad after watching that movie.

You can also give your child a feelings chart and have them practice identifying different emotions throughout the day. Make sure to remind them that it’s normal to experience multiple emotions at the same time. 

Most importantly, avoid questioning or shaming any emotions a child expresses. Feelings are natural impulses. But if you mock or criticize someone for how they feel, you risk exacerbating more shame.

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Label Panic Attacks for What They Are 

Children thrive when they have the language to articulate their experiences. This explains why you see a toddler light up when they connect a word to a specific item. They feel overjoyed when they realize you can now understand what they are saying!

If you have identified that your child has panic attacks, take the time to educate them on what’s happening. Of course, you may need to adjust your script based on their age and maturity level.

You can start by saying, When it feels like you can’t breathe and your chest really hurts, you might be having a panic attack. They aren’t your fault, but they can be scary. It’s your body’s way of letting you know that you’re feeling really overwhelmed. Sometimes, you might be able to identify the source of stress. But sometimes, the panic attacks might feel totally random. If you have another one, will you please make sure you let me know?

Your child may have several questions for you. They might feel it’s okay if you don’t have all the answers. Be honest at all times. If you don’t know how to respond to something, consult with a pediatrician or therapist.

Remind Them It’s Not Their Fault

Even if it seems like common sense, it’s important to continue reiterating that their symptoms or struggles are not their fault. They are not responsible for what’s going on. 

With that, it’s also important to avoid blaming any other, specific culprit. For example, don’t blame their teacher for assigning too much homework or their favorite coach for putting too much pressure on them. These comments, even if they seem harmless or logical, can trigger a child’s guilt or shame.

Teach Them Relaxation Exercises

School may teach children how to read and complete math problems, but most kids don’t learn emotional regulation skills. Furthermore, because most adults struggle with these skills, they don’t pass them along to their children.

If a child struggles with anxiety or panic attacks, teaching relaxation exercises can be one of the best gifts you give them. Here are some simple suggestions.

Progressive muscle relaxation: Instruct the child to focus on tightening and releasing one muscle group at a time. Have them start at the top of their head, moving all the way down to their toes. For example, have them practice squeezing their eyes shut and then relaxing the eyes altogether.

Five senses: This is a simple grounding exercise that a child can practice anywhere. Have them take a deep breath and identify five things they see, four things they hear, three things they feel, two things they smell, and one thing they taste. Even if they can’t answer all of them completely, thinking about their answers offers a helpful distraction.

Safe place: A safe place refers to a pleasant real or imagined location that triggers a sense of peace and joy. Instruct the child to imagine being in this place whenever they feel overwhelmed. Encourage them to focus on taking in all the senses and allowing themselves to remain there as long as needed.

Deep breathing: Even toddlers can start grasping the concept of deep, intentional breathing. Instruct the child to place one hand on their belly to feel the air move in and out. Have them inhale through their nose and hold for five counts. Then, have them exhale through their mouth for five counts. Repeat this exercise at least 5-10 times.

Say Positive Affirmations Aloud Together

Anxiety is rooted in rigid, negative thoughts that distort reality. When we feel anxious, it’s because we’re anticipating something bad might happen.

Positive affirmations can counteract some of that dread and fear. It can be helpful to teach these affirmations to children and encourage them to write or say them whenever needed.

Some good examples include:

  • I am safe.
  • I will be okay.
  • I have people who love and care about me.
  • I just need to breathe.
  • I trust that things will pass.
  • I am allowed to ask for help right now.

Remember that it can also be helpful to practice these affirmations in your daily life. After all, children watch everything you do. So the more you can model healthy stress management, the more they will pick up on your cues. 

Stay Connected With Their Pediatrician and Teachers 

Anxiety may be an underlying symptom of other mental health or physical conditions. Therefore, it’s important to share any concerns with your child’s doctor. 

Keep in mind that no symptom is too small or too insignificant. Doctors rely on parental data to help them screen for certain issues appropriately. Because children may not speak about these issues on their own, you need to be their advocate.

A pediatrician may recommend a psychiatric referral for medication. Certain medications, like SSRIs, can help with mood stabilization. All medications have various risks and benefits, but it can be helpful to talk with your child’s doctor about potential options. 

Having a proactive and open mindset also applies to the school setting. Start building a proactive relationship with your child’s teacher. Let them know what’s going on at home. If things have become particularly stressful, keep the school in the loop. If your child is having problems in the classroom, your insight can help teachers provide the right support. 

Consider Family Therapy 

A child’s anxiety can signify problems within other dynamics in their life. Furthermore, anxiety can be hereditary, with some research suggesting that children are seven times more likely to have an anxiety disorder if one of their parents has one. 

Other family factors may also be at play. For example, any stress or recent life changes can affect someone’s mental health. Children may be especially vulnerable to various transitions, even if parents don’t always recognize it.

Family therapy provides a safe and non-judgmental environment for families to learn healthier communication strategies. It can help family members learn how to support one another. In this therapy, the focus isn’t on the child or a single problem. Instead, the focus is on the entire family system. Tips on finding the right mental health provider.

Preventing Panic Attacks

Highly-specific situations may trigger panic attacks. However, some attacks can seemingly present out of nowhere. Most of the time, these attacks occur in response to stress. Unfortunately, this stress can be chronic, and managing it isn’t always straightforward.

First, it’s important to remember that nothing can specifically prevent panic attacks altogether. Instead, ongoing management and intervention are key. Preparing your child and practicing optimal stress management will be the best strategy for avoiding future problems.

Listen Attentively 

Build a close and supportive relationship with your child. Focus on actively listening to them when they come to you for support. Don’t always just rush to give advice.

Even if they present as fiercely independent, children rely on their parents for love and guidance. You play an influential role in mitigating stress and establishing their confidence. If they feel safe at home, they are more likely to feel safe in other environments.

Cultivate Healthy Coping Skills

All children need to practice healthy coping skills to build their self-esteem and manage their mental health. You can reinforce these activities from a young age.

Encourage plenty of physical activity, creative expression, and building a strong support network. Praise your child when you recognize them “working” through their stress. At the same time, make sure that you don’t shame them if they’re struggling with their emotions. 

Likewise, make sure you model healthy coping yourself! If you have difficulties managing stress, make it a priority to work on this issue. Consider seeking your own therapy for additional support. 

Recognize Triggers

Specific triggers may exacerbate anxiety. Encourage your child to reflect on particular situations or people that make them feel overwhelmed. You may notice some of these patterns yourself.

While you can’t always avoid triggers, planning for them can help you and your child feel more empowered. 

Final Thoughts

Panic attacks can feel distressing, but they do not have to ruin someone’s life. Children often need extra care or support. If you know a child is struggling, be there for them! Get them the help and treatment they need. Let them know that their anxiety is not their identity and things can improve. 

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Disclaimer: This information is not specific medical advice and does not replace information you receive from your healthcare provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or lifestyle choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care provider’s advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you.

You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care provider’s advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you.

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