Recognizing Panic Attacks in Children: Early Signs Parents “Should NOT” Ignore
Meredith Rappaport, PA-C, CAQ-Psy, LCSW
Watching your child suddenly freeze, clutch their chest, or cry without an obvious reason can be unsettling for any parent. At first glance, it may seem like a simple tantrum, a reaction to stress, or even a physical health issue. But sometimes, these episodes are signs of a panic attack. Panic attacks in children are more common than many realize, and recognizing them early can make a significant difference. By understanding what panic attacks look like, how to respond in the moment, and when to seek help, parents can provide their child with both comfort and the right support.
What Are Panic Attacks in Children?
A panic attack is a sudden surge of fear or discomfort that peaks quickly and comes with physical symptoms like rapid heartbeat, chest tightness, trembling, dizziness, or a sense of unreality. Often, children can’t explain it—they might freeze, say they feel “weird,” or cling tightly for fear something awful is happening. These attacks may occur unexpectedly or in response to a stressor. Over time, a pattern of repeated attacks combined with avoidance can develop into panic disorder, which, if left untreated, may disrupt school, friendships, and family routines.
What Does a Panic Attack Look Like in a Child?
Children rarely say, “I’m having a panic attack.” Instead, you might notice:
- Sudden, intense physical symptoms—like racing heart, shallow breathing, trembling, sweating, stomach aches, or lightheadedness.
- Emotional signs—crying, lethargy, clinginess, wide-eyed fear, or saying they feel detached or like they’re “crazy” or about to die.
- Behavioral shifts—meltdowns that seem different from normal tantrums or a refusal to go to school because “something terrible might happen.”
- Rapid escalation—these episodes usually peak within minutes, even if they feel much longer to everyone involved.
How to Stop a Child’s Panic Attack?
Your calm presence is powerful. In the thick of a panic attack, your job isn’t to erase the fear—it’s to validate and ground.
- Stay calm, stay connected. Say something like: “I see how scared you feel. I’m right here with you. You’re safe.”
- Breathe gently together. Keep instructions short. E.g., “Let’s breathe slowly—just in…and out.”
- Use the 3-3-3 Rule (see next section). It’s a simple but effective grounding tool kids can learn quickly.
- Reduce sensory overload. Dim lights, remove tight clothing or heavy backpacks, move to a calmer space.
- Comfort, don’t reinforce avoidance. Let them know you believe in them, and plan small, safe steps forward—not pulling them out permanently. Because removing them from every scary situation teaches their brain that the only way to feel safe is to escape. Over time, this can make anxiety stronger and future situations even harder to face.
If the child has trouble breathing, collapses, or expresses suicidal thoughts, call medical help immediately.
What Is the 3-3-3 Rule for Anxious Children?
This nifty grounding strategy gently pulls children back into the here-and-now by using their senses—no worksheets, no lectures, just a quick, engaging script to disrupt panic.
Here’s how it works:
- Name 3 things you can see (e.g., “Your blue backpack, the window, your own hands.”)
- Name 3 things you can hear (e.g., “The hum of lights, traffic, your breathing.”)
- Move 3 body parts—wiggle fingers, stomp feet, shrug shoulders—or touch 3 different textures.
It helps the brain shift from:
Threat/survival system: Amygdala + sympathetic nervous system → to
Regulation/logic system: Prefrontal cortex + parasympathetic nervous system
Panic Attacks in Children Treatment
When to Seek Treatment
If panic attacks become frequent, disrupt daily life, or trigger avoidance—please reach out. Panic disorder is treatable, and early intervention creates better outcomes.
Evidence-Based Treatments
- Cognitive Behavioral Therapy (CBT): This is the first-line treatment for pediatric anxiety. Most kids respond well, gaining long-term skills to manage panic and anxiety.
- Medication: In moderate to severe cases, SSRIs prescribed by a pediatric psychiatrist may be recommended—usually alongside therapy.
- Combined Care: The best outcomes often come when therapy, medication (if needed), school-based support, and family involvement all align.
Helpful Tips for Families
- Track what triggers panic or soothes it. Small patterns can guide treatment.
- Build routine. Consistent sleep, meals, and play nurture resilience.
- Use exposure—carefully and gradually, with professional guidance, to rebuild confidence in challenging situations.
- Model calm. When you show regulated responses to your own anxiety, kids notice—and copy.
Final Thoughts
Panic attacks in children can feel terrifying—but if you catch them early, show up calmly, and get professional help when needed, they’re entirely manageable. Tools like the 3-3-3 Rule give kids a friend at the moment. Therapy gives them tools for the long run. Your support gives them confidence. And with the right ensemble of care—home, school, therapy—kids can get back to breathing easy and living fully.
Responsibly edited by AI
Animo Sano Psychiatry is open for patients in North Carolina, Georgia and Tennessee. If you’d like to schedule an appointment, please contact us.
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