"I sincerely felt that I was at risk of keeling over and dying in the gutter." -- Carl

"I couldn't breathe, I couldn't move, and I started crying." -- Olivia

"I feel like I'm jumping out of my own skin." -- Jonathan

"I'm being held underwater with no way of coming up for air." -- Lindsey

All of these quotes describe the feelings of a panic attack from people who have had them.

Both adults and children can have panic attacks.

If you're a parent or someone who works with children or teens, you need to be ready to help them regain control if a panic attack strikes.

A panic attack is a sudden, brief episode of intense anxiety, which causes physical sensations of fear.

Are panic attacks in children the same as in adults?

Yes and no.

The most significant difference in panic disorder between adults and children is their ability to recognize and express their anxiety.

Because of this, children will cope better with a panic attack when an adult is there to support them.

Typical symptoms seen in children having a panic attack:

• Crying or tantrums

• Inability to concentrate

• Restlessness

• Nightmare or disturbed sleep

• Irritability

• Falling asleep in school

Children may also experience similar symptoms to adults:

• A strong feeling of dread, danger, or foreboding

• Fear of dying

• Feeling lightheaded and dizzy

• Trembling or shaking, sweating

• Accelerated heart rate

• Feeling of having a heart attack

• Breathing difficulties, including shortness of breath

• Nausea or abdominal distress

• Tense muscles

• Dry mouth

Panic attacks are often confused with anxiety attacks. Children with anxiety often also have panic attacks.

How can you tell the difference?

Panic Attack

• Begins suddenly

• Usually last 5-15 minutes

• Symptoms often more intense, including feeling like you're having a heart attack or dying

Anxiety Attack

• Builds gradually

• Can last indefinitely

• Symptoms are less intense, but usually last longer

Is treatment the same?

Treatment for anxiety is usually ongoing. Successful treatment for anxiety often leads to fewer panic attacks.

Types of treatment for children with anxiety include:

• play therapy

• cognitive behavior therapy

Treatment for a panic attack focuses on helping the child cope in the immediate moment.

Most panic attacks end within 15 minutes. The goal for the adult is to stay calm and try to help the child cope until the attack is over.

Children often don't have the words to explain how they're feeling and don't have strategies to get through the episode. They need an adult to help them.

Describe the episode

1. Briefly explain what is happening. For example:

   You are having a panic attack. You are safe. It will be over soon.

Model and coach deep breathing

1. Breath in through the mouth

2. Hold your breath briefly

3. Breath out slowly

For younger children, you can say:

Smell the flowers and blow out the candles.

Model and coach grounding techniques

Try to shift focus from the panic attack to something else.

54321 Technique

Name 5 things you can see

Name 4 things you can feel

Name 3 things you can hear

Name 2 things you can smell

Name 1 thing you can taste

ABCD Technique

Name something you see that starts with the letter A.

Name something you see that starts with the letter B.....

Guide muscle relaxation

Coach the child to relax stressed muscles using a guided method, starting with the feet, and working up to the head. For example:

Squeeze your toes as tightly as you can — 1,2,3,4,5. Let go.

Squeeze your calves as tightly as you can — 1,2,3,4,5. Let go.

Helping a child cope with a panic attack can be stressful. Would you like to learn more about other steps you can take?