FFFPanic Disorder In Children And Adolescents

No. 50; Updated October 2023

Panic disorder is a common and treatable disorder. Children and adolescents with panic disorder have unexpected and repeated times of intense fear or discomfort, along with other symptoms such as a racing heartbeat or feeling short of breath. These periods are called "panic attacks" and last minutes to hours. Panic attacks frequently develop without warning, but there may also be recognizable triggers.

Symptoms of a panic attack include:

  • Intense fearfulness (a sense that something terrible is happening)
  • Racing or pounding heartbeat
  • Dizziness or lightheadedness
  • Shortness of breath or a feeling of being smothered
  • Trembling or shaking
  • Sense of unreality
  • Fear of dying, losing control, or losing your mind

More than 3 million Americans will experience panic disorder during their lifetime. Panic disorder often begins during adolescence, although it may start during childhood, and sometimes runs in families.

If not recognized and treated, panic disorder and its complications can be devastating. Panic attacks can interfere with a child's or adolescent's relationships, schoolwork, and normal development. Attacks can lead to not just severe anxiety but can also affect other parts of a child's mood or functioning. Children and adolescents with panic disorder maystart to feel anxious most of the time, even when they are not having panic attacks. Some begin to avoid activities where they fear a panic attack may occur, or events where help may not be available. For example, a child may be reluctant to go to school or be separated from his or her parents. In severe cases, the child or adolescent may be afraid to leave home. As with other anxiety disorders, this pattern of avoiding certain places or situations is called "agoraphobia." Some youth with panic disorder can develop severe depression and may be at risk of suicidal behavior. As an attempt to decrease anxiety, some adolescents with panic disorder may use alcohol or drugs.

Panic disorder in children can be difficult to diagnose. This can lead to many visits to physicians and medical tests that are costly and even potentially painful. When properly evaluated and diagnosed, panic disorder usually responds well to treatment. Children and adolescents with symptoms of panic attacks should first be evaluated by their family physician or pediatrician. If no other physical illness or condition is found as a cause for the symptoms, a comprehensive evaluation by a child and adolescent psychiatrist should be obtained.

Several types of treatment are effective. Specific medications may stop panic attacks. Psychotherapy may also help the child and family learn ways to reduce stress or conflict that could otherwise cause a panic attack. With techniques taught in "cognitive behavioral therapy," the child may also learn new ways to control anxiety or panic attacks when they occur. Many people with panic disorder respond well to the combination of medication and psychotherapy. With treatment, most can be helped to both prevent panic attacks and control the attack if it occurs. Early treatment can prevent the complications of panic disorder such as agoraphobia, depression, and substance abuse.

For more information about panic disorder, visit the National Institute of Mental Health's website at www.nimh.nih.gov or call 1-800-64-PANIC.

See also: The Freedom from Fear's website www.freedomfromfear.org.

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