The film Inside Out 2 depicts 13-year-old Riley experiencing a panic attack during a hockey game timeout as she begins puberty. The movie effectively illustrates the sensation of a panic attack, where the character Anxiety becomes frantic, reflecting Riley’s loss of control. Panic attacks, however, are not exclusive to teenagers; they can also occur in younger children. It is crucial to recognize the signs and learn how to respond appropriately to anxiety or panic, to assist you and your child in managing these distressing symptoms.
A panic attack is characterized by a sudden, overwhelming sense of fear or discomfort, accompanied by four or more symptoms. In children, these attacks can last from a few minutes to half an hour. They may describe them as feeling trapped, in danger, losing control, having a heart attack, or even dying, often unaware that these feelings are related to anxiety. This experience can be terrifying for both the children and those around them who do not understand what is happening.
A common misconception is that panic attacks only affect teenagers or adults, but studies reveal this is untrue. Although less frequent in younger children compared to teens, panic attacks do happen, with research suggesting that around 3–5% of children experience them. They can start at any age but often begin between five and eighteen years old. Panic attacks can either occur unexpectedly without a clear cause, known as “uncued” panic attacks, or in response to specific anxiety-provoking situations, referred to as “cued” panic attacks. The latter tend to be more frequent in children. Sometimes, these attacks are triggered when children focus intensely on physical symptoms of anxiety, such as shortness of breath, which can escalate into more anxiety or a panic attack.
If children learn to recognize these physical symptoms as anxiety-related instead of serious health issues, they may avoid worsening the symptoms. If your child hyperventilates, stay calm and encourage them to breathe normally. Reassure them that these sensations are temporary and not harmful. Redirecting their focus using techniques like the 3-3-3 rule—encouraging them to identify three things they hear, see, and touch—can help manage their symptoms. Acknowledge and understand their symptoms if they are not experiencing a full-blown panic attack and reassure them once you are confident the symptoms are not due to a health problem. After a panic attack, explain to your child that these episodes are common and not dangerous, despite feeling frightening and uncomfortable. They are temporary.
One effective method for managing panic attacks, supported by cognitive behavioral therapy, is “exposure,” which involves confronting the situations or symptoms that cause the panic. Although exposure is often done with a therapist’s guidance, programs are becoming available for parents to use with their child. Experiencing a panic attack does not necessarily mean a child has an anxiety disorder, though attacks often occur in children with anxiety or other mental health conditions like depression or PTSD. Panic disorder, characterized by recurrent panic attacks, is rare in children but more common in adolescents or adults.
If a child frequently and unexpectedly experiences panic attacks and worries about future ones for a month or more, or avoids situations due to fear of panic attacks, they may have panic disorder. Similarly, if the child’s panic attacks occur in specific situations impacting daily life, this could indicate an anxiety disorder. Consult with a GP or psychologist if you are concerned about your child’s mental health. Though no GP referral is needed to see a psychologist, a GP can provide a mental health treatment plan for a Medicare rebate on up to ten sessions. Various online resources are also available.