How to Tell the Difference Between Anxiety and Panic Attacks in Children

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Panic Disorder in Children

Panic disorder is a type of anxiety disorder. Children with panic disorder will experience recurrent and unexpected panic attacks. These panic attacks cannot be caused by a substance (drug or medication) and cannot be explained by another medical condition.

In order to be diagnosed with panic disorder, one has to experience at least one panic attack, and a month or more of worrying about another panic attack happening. 

Panic Attacks 

According to the DSM-5, a panic attack is defined as a sudden onset of intense fear that includes four or more of the following symptoms:⁽¹⁾

• Shortness of breath
• Nausea
• Racing heartbeat or palpitations
• Feeling of choking
• Sweating
• Feeling chills or warmth
• Shaking or trembling
• Dizziness or lightheadedness
• Feeling detached from reality
• Chest pain or discomfort
• Fear that one is dying 
• Feeling a loss of control
• Numbness or tingling sensations

Prevalence of Panic Disorder in Children

Anxiety disorders are among the most common mental health disorders in childhood, with an estimated lifetime prevalence of 31.9% among U.S. adolescents aged 13-18.⁽²⁾

Panic disorder is one type of anxiety disorder under the umbrella of anxiety disorders. Estimates show the lifetime prevalence of panic disorder in 13 to 18-year-olds is 2.3%.⁽³⁾

Anxiety in Children

How does panic differ from something like general anxiety or social anxiety in kids?

One of the biggest differences between panic and other types of anxiety is that panic attacks are unexpected and usually happen without any warning signs. Anxiety is generally a response to a specific trigger, such as public speaking or transitioning to a new school.⁽⁴⁾ 

With social anxiety, for example, a child may feel anxious about an upcoming event such as a school play or presentation. This type of anxiety may be more manageable because the child knows when the event will happen and can prepare for it. In contrast, a child with panic disorder may not know when a panic attack will occur.

Children with a generalized anxiety disorder generally experience worries and fears that persist for months or even years. These can be about many things, such as school performance, making friends, or bad things happening to them. 

The symptoms of anxiety can look like excessive worrying and restlessness. It can also manifest as trouble sleeping, tantrums, stomachaches, frequent crying, and difficulty concentrating. Sometimes, children with anxiety may avoid certain situations or activities altogether. 

The signs of anxiety are generally broader than a panic attack and can range from mild to severe.

Panic Symptoms vs. Anxiety Symptoms 

Because panic and anxiety in children can look very similar, it's not always easy to tell the difference. 

There are some key distinctions, however, that can help you identify which one your child is experiencing. 

How to Help a Child Experiencing a Panic Attack

If your child is experiencing a panic attack, the best thing you can do is try to remain calm yourself, and provide reassurance. 

Here are some things you can do in the moment to support your child through the panic. 

Breathing Exercises

Try to encourage your child to take slow, deep breaths. You can explain to them that when they are having a panic attack, their breathing may become shallow and rapid, which can make the symptoms feel worse.

Focusing on the breath, and slowing down the exhalation can help to calm the body down.

Stay Calm and in Control

During a panic attack, your child may feel like they are losing control. With a gentle and soothing voice, tell them that you are there with them. 

Don't minimize their feelings by telling them that it's not a big deal, or that they are overreacting. But do reassure them that the panic attack will pass, that you are there to help them get through it.

Refocus Their Attention

If your child is fixated on the symptoms they are experiencing, try to refocus their attention. This can be done by gently asking them questions about their surroundings, or by having them name objects in the room. 

You can also help them to do muscle relaxing exercises, or visualize a positive memory. This can help to take their mind off of the panic attack and help the symptoms subside more quickly. 

Support Them in Facing Their Fears

When the panic attack is over, it's common for your child to want to avoid the activity or situation they were in when the panic attack occurred. While it's understandable to want to avoid triggers, it's important not to reinforce the anxiety by giving in to their avoidance. 

Instead, assure them that they can handle the situation, and that you will be there to support them. This can be difficult for your child to do on their own, which is why there are specialized therapists who can help treat panic disorder. 

Treatment for Panic Disorder

Anxiety disorders do not generally go away on their own, and panic disorder is no exception. If your child is experiencing panic attacks, it's important to seek professional help. 

If you're not sure whether your child is experiencing anxiety or panic, the best thing to do is to consult with a mental health professional. A clinician can assess your child, offer a treatment plan, and provide support for you and your family. 

Cognitive behavioral therapy (CBT) is the gold-standard treatment for panic disorder. CBT works by helping your child to identify and change the thoughts and behaviors that are contributing to their distress. 

A therapist can teach your child healthy coping skills and help them develop a plan for dealing with future panic attacks.

Medication is another type of treatment for anxiety disorders and panic disorder, and it is often used in conjunction with CBT. Medication has the potential for side effects, so it's important to discuss the risks and benefits with a clinician before starting any medication. 

In general, medication should not be the first line of treatment for anxiety disorders in children, but it can be an effective part of a comprehensive treatment plan.

How to Get Support for Panic Disorder

If your child is struggling with panic attacks, seeking professional help is the best course of action. At Handspring, therapists are experienced in helping children and teens overcome panic disorder. We offer cognitive behavioral therapy, which has been shown to be the most effective treatment for panic disorder.

Our therapists are passionate about helping children overcome panic and live happy, healthy lives. If you're ready to take the first step, book your free consultation today. 

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References:

1. https://www.ncbi.nlm.nih.gov/books/NBK519712/ 
2. https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder
3. https://www.nimh.nih.gov/health/statistics/panic-disorder 
4. https://www.medicalnewstoday.com/articles/321798 

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