I think my child is having panic attacks. What should we do?

In the movie Inside Out 213-year-old Riley, who recently entered puberty, has a panic attack during a hockey game timeout.

The anxiety (the emotion responsible for the panic attack) becomes completely frenzied and Riley feels like he’s losing control. After a while, the anxiety subsides and Riley’s panic attack subsides.

The film does a great job of conveying the experience of a panic attack. But panic attacks (and anxiety) aren’t just for teenagers – younger children can have them too.

Knowing what to look for and how to respond to anxiety or panic is important to help you and your child better manage these scary symptoms.

What does a panic attack look like in a child?

A panic attack is a sudden, intense feeling of fear or discomfort associated with four or more of the following:

• feeling very hot or cold
• racing heart
• shortness of breath
• tightness in the neck or chest
• sweating
• tingling sensations
• dizziness.

Panic attacks in children can last from a few minutes to up to 30 minutes.

Some children describe a panic attack as feeling trapped or in danger, that something terrible is happening to them, losing control of their body, having a heart attack, or even dying.

Often, a child is unaware that their symptoms are related to anxiety. This experience can be very frightening for children and others around them who do not know what is happening.

How common are panic attacks and at what age can they start?

There is a common myth that panic attacks only occur in teenagers or adults, but research shows that this is not the case.

Although less common than in teenagers, panic attacks also occur in children. Studies show around 3-5% of children experience panic attacks.

They can start at any age, though usually appear first in children and adolescents between five and 18 years of age.

What causes a panic attack?

In some children, panic attacks can happen unexpectedly and without cause. These are known as ‘unspecified’ panic attacks.

For other children, panic attacks can be treated. This means they occur in specific stressful situations, such as being separated from a caregiver or speaking in class.

Panic attacks tend to be more common in children than impossible panic attacks.

Sometimes a panic attack can occur when a child’s physical symptoms (from feeling anxious) become the focus of their attention. For example, if a child notices a physical symptom (such as shortness of breath) and worries about it, it can make them feel anxious, leading to more anxiety or a panic attack.

If children realize that their physical symptoms are signs of stress and not a serious physical health problem, they may learn not to pay too much attention to these symptoms and stop a vicious cycle from occurring.

What can parents do right now to support their child?

If your child is breathing too fast or is hyperventilating, try to stay calm and encourage them to breathe normally.

Tell your child that these feelings are temporary and not dangerous. Focusing your child’s attention on their rapid breathing or other symptoms can sometimes make things worse.

Try to help your child focus on something else by using the 3-3-3 rule: “Tell me three things you can hear, three things you can see, and three things you can touch.” Ask them to say these out loud.

If your child is complaining of physical symptoms—but not experiencing a full-blown panic attack—try to understand and recognize the symptoms they’re experiencing.

Once you’re satisfied their symptoms aren’t a physical health problem, tell them it’ll be fine and then move on to something else. This will help divert their attention and stop the stress and symptoms from escalating.

What happens next?

When your child’s panic attack is over, you can teach them about panic attacks. Explain that panic attacks are common and not dangerous, even though they can feel scary and uncomfortable and are a temporary sensation.

An effective strategy for panic attacks is a technique from cognitive behavioral therapy called “exposure,” which encourages children to face their fears. For panic attacks, this could be dealing with specific situations or objects that trigger the panic attack or exposure to the actual physical symptoms.

Exposure is usually done with the support of a therapist, but increasingly programs are available to support parents in providing exposure therapy with their child.

Does a panic attack mean my child has an anxiety disorder?

If your child has a panic attack, it doesn’t mean they have an anxiety disorder. Panic attacks can occur in all children with or without anxiety disorders or mental health conditions.

However, frequent panic attacks answer in children with anxiety disorders or other mental disorders, such as depression or post-traumatic stress disorder.

Panic disorder is a specific type of anxiety disorder in which panic attacks are a key feature. It’s panic disorder it is not common in childrenand appears in less than 1% preadolescent children. It usually appears in adolescence or adulthood.

If your child has frequent and unexpected panic attacks, has persistent worry (for at least a month) about additional panic attacks, or avoids situations that might trigger panic attacks, it may indicate that he has a panic disorder.

If your child has panic attacks in response to specific situations or fears, such as separation from a caregiver, and their fears interfere with daily life, it may indicate an anxiety disorder.

Where can I look for help?

If you are concerned that your child has an anxiety disorder, talk to your doctor or a psychologist about it.

You don’t need a doctor’s referral to see a psychologist, but a doctor can set one up mental health treatment plan which allows you to claim a Medicare rebate for up to ten sessions.

There are also a number of online resources.