When Your Child Has a Panic Attack

Your daughter is on the bathroom floor saying she cannot breathe. Her hands are tingling, her heart is going, and she is convinced something is seriously wrong with her.

You are frightened too, and the two of you are feeding each other. The first job is getting through the next ten minutes.

What is happening to them

Panic is the body's alarm going off at full volume with nothing to fight. Adrenaline, a fast heart, quick shallow breathing, tingling hands and lips, chest tightness, feeling unreal or far away, sometimes feeling sick.

All of that is frightening and none of it is dangerous. Panic peaks within a few minutes and comes down on its own; nobody stops breathing from it, and children do not have heart attacks from it.

The tingling and the breathlessness usually come from breathing too fast rather than from not getting enough air, which is why trying to take big gulps makes it worse.

What to do in the moment

Your calm is the main tool you have, and children borrow a parent's nervous system more than they borrow their words.

So slow everything down. Lower your voice, slow your own breathing, sit down rather than standing over them. Say little and say it in short sentences.

Name it plainly: this is panic, it is horrible, it will pass, I am here. Children generally find a name far more reassuring than reassurance.

Then help the breathing out rather than in. Breathe out slowly with them, longer than the in-breath; blowing through pursed lips, or at an imaginary candle, works better with children than any counting instruction.

Give them something physical to hold on to. Feet flat on the floor, a hand pressed into yours, a cold washcloth, a cold drink, their back against the wall. Something to look at and name out loud: five things you can see in this room.

And do not insist they leave the situation if they can stay. Staying put while it passes teaches them something that leaving does not.

What not to do

Do not ask a lot of questions mid-panic. They cannot think, and questions raise the pressure.

Do not say there is nothing to worry about. The sensations are real, and being told they are imaginary makes a child feel both frightened and unbelieved.

Do not take over the breathing with a complicated technique, and do not use a paper bag, which is not safe advice.

And try not to let your own fear run the room: no rushing, no multiple adults, no immediate talk of hospitals unless something genuinely suggests a physical emergency.

Afterward, keep it ordinary

When it has passed, children take their cue from how you treat it.

Something steady helps: that was panic, you got through it, it went away on its own like it always does. Then a drink, something to eat, something dull and normal.

Avoid the long debrief that evening. Picking over every sensation tends to install the fear more firmly. A short, warm conversation the next day is more useful than an hour at bedtime.

And let them get back to what they were doing where possible. Panic shrinks a child's world fast, and the thing that keeps it small is the day off, the collection from school, the dropped club.

The pattern matters more than the episode

One panic attack is a bad hour. The worry about the next one is what turns it into a problem.

So watch for avoidance: no more sleepovers, not going to assembly, needing you on the phone, refusing the bus, insisting on checking their pulse. Each of those brings relief and teaches the alarm that it was right.

Work the other way, gently and in small steps, and sooner than feels comfortable. The shop with you, then the shop alone. One lesson, then the morning. Praise the going rather than the outcome.

Be careful about your own reassurance becoming part of it, too. Answering the same question for the tenth time, or always being reachable, settles the moment and feeds the pattern.

Look at the conditions

Children in panic are very often short of sleep, running on little food, over-caffeinated from energy drinks, or carrying something they have not mentioned.

Ask about school, friendships, social media, and anything frightening they have seen or heard, in a low-key way and not at bedtime.

And have the obvious physical things checked once: asthma, anemia, thyroid, hearing and vision. One proper check is reassuring; repeated checking is not.

When to get help

Please talk to your child's doctor if the attacks are happening regularly, if they are missing school, if they have started avoiding ordinary things, or if you are not sure the symptoms are panic.

Say it plainly to the doctor: these look like panic attacks, they are happening weekly, and this is what my child has stopped doing. Panic in children responds very well to treatment, usually in a small number of sessions, and a therapist, school counselor or pediatrician are all reasonable doors in.

Treat it as urgent rather than ordinary if your child is harming themselves, if they talk about not wanting to be here, or if they are frightened of something happening to them that they will not explain. In those cases speak to a doctor the same day rather than working on the panic. In the US you can call or text 988 at any time.