Panic Disorder
What is Panic Disorder?
Children and teens with Panic Disorder experience unexpected and repeated panic attacks. This is typically followed by at least one month of concern about having additional attacks and/or a fear of something bad happening because of the panic attack (such as going crazy, losing control, or dying).
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Key Points:
- Panic Disorder usually begins in late adolescence.
- Girls are more likely to experience panic attacks than boys.
- Children and teens with a family history of anxiety or depression are at greater risk for developing Panic Disorder.
- Problems associated with Panic Disorder include low self-esteem, poor school performance, problems with peer and family relationships, difficulty separating from parents or transitioning from home to school, sleep problems, and depression, as well as drug or alcohol use in teens.
Stories
The Story of 11-Year-Old Andrea
Andrea is an 11-year-old girl, who lives with her parents and older brother. As a baby, she often cried for hours on end. As she got older, she became upset whenever she was separated from her parents, and often "froze up" in social situations. More recently, Andrea has started worrying about her school performance. About a month ago, she had her first panic attack just before taking a test at school. Andrea said she had chest pain and trouble breathing. Her teacher thought it was a medical emergency and Andrea was taken to the school nurse. Since then, Andrea has had several panic attacks at school. Each time, the school nurse calls Andrea's mother, who comes, picks her up and takes her home. Recently, Andrea had another panic attack while out for dinner with her family. Now, she refuses to go to restaurants and has missed several days of school because of a fear of having another attack.
The Story of 15-year-old Ben
Ben is 15 years old, and lives with his mother. Four months ago, while riding as a passenger in a car that was traveling through a tunnel, Ben said his throat started to tighten and he was having trouble breathing. His mother noticed that he was very upset, and immediately took him to the E.R., where he was tested for allergies. The results were negative. Although he eventually settled and was able to breathe normally, he was shaken by the experience and was unsure why it happened. Unexpectedly, Ben had the same choking sensation a week later, while sitting alone in his bedroom. This time, he also felt dizzy and nauseous. Since the first attack in the tunnel, Ben has experienced 10 more episodes. Each time, the sensations come on suddenly and intensely, last for about 10 minutes, and passes over the next 30 minutes. Ben has started to worry about having additional attacks. He refuses to drive through tunnels and has started to avoid going shopping, out for dinner, or spending time with friends, especially if it means leaving his neighborhood.
What are Panic Attacks?
A panic attack is a sudden rush of intense fear or discomfort, which reaches a peak within 10 minutes, and includes at least four of the following symptoms:
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Note:
Panic attacks are fairly common, and having one does not mean that your child has panic disorder. Panic attacks become a problem when someone worries about having more attacks, or fears something bad will happen because of a panic attack. Also, panic attacks can occur in other anxiety disorders. For example, children or teens with a phobia of dogs might have a panic attack when they are near a dog. In this case, however, the panic attack is expected, and the child is afraid of the dog, not the panic attack. In Panic Disorder, the panic attacks are unexpected.
What is Agoraphobia?
Children and teens can have Panic Disorder with or without agoraphobia. Agoraphobia involves fear and avoidance of situations or places where escape might be difficult, or where help might not be available should one have a panic attack. Children and teens can become fearful of entering situations where they might have a panic attack. For example, children or teens with agoraphobia might be afraid to go to school, be separated from parents, or be alone. They may also be fearful of going over bridges or into open spaces, traveling away from home, entering public or crowded places (such as restaurants or malls) or being in small enclosed places (such as elevators).
Recognizing Panic Disorder in Children & Teens
- Children, especially if they are young, may have trouble describing their symptoms. Instead, younger children are more likely to talk about their physical symptoms (such as pounding heart, upset stomach, chest pain, or nausea), rather than psychological symptoms (such as a fear of "going crazy"). Teens may be better at describing what they experience during a panic attack.
- Children and teens having a panic attack may become suddenly very frightened or upset for no apparent reason. They might feel like something is wrong or that something bad will happen; however, they may not able to identify exactly what is going to happen.
Note: Some children and teens might be embarrassed by their symptoms, and may not want to openly discuss what is happening.
- Children and teens may stop participating in activities that they think could lead to panic attacks, such as driving through a tunnel, entering crowded places, or participating in physical activities (e.g., running). They may also refuse to attend school or participate in hobbies and interests.
- They may do things to try and make themselves feel safer, such as traveling with someone they trust, staying where others can see them, or carrying something with them (such as a cell phone or water bottle).
- Children and teens may experience more symptoms at home than at school. This is because they feel less need to hide their symptoms at home.
Note: If you suspect that your child has Panic Disorder, it is advisable to take him or her to a family physician for a medical check-up. Medical problems (such as diabetes, inner-ear disorders, or thyroid problems), excessive caffeine use, or adverse reaction to medication (such as asthma medications) may be playing a role in your child's anxiety or panic-like reactions.
Click here for Home Management Strategies for Panic Disorder