What it is
Panic attacks consist of a period of intense fear or discomfort during which at least four of the following symptoms develop abruptly and peak within 10 minutes: palpitations, sweating, trembling or shaking, sensations of shortness of breath, feeling of choking, chest pain or discomfort, nausea or abdominal distress, feeling dizzy, unsteady, lightheaded or faint, feelings of unreality or being detached from oneself, fear of losing control or going crazy, fearing of dying, numbness or tingling sensations, chills or hot flashes. Panic attacks may occur within the context of another anxiety. For example, someone with social anxiety disorder may experience a panic attack before or during an oral presentation. Panic disorder is specifically characterized by sudden, unexpected panic attacks followed by at least one month of persistent concern about having another attack. Given the strong physiological component of panic disorder, many people who suffer from panic disorder often visit emergency rooms or doctors, believing that they have a serious life-threatening illness.
Some people experience panic disorder with agoraphobia. Agoraphobia (technically defined as fear of open spaces) refers to a morbid fear of having a panic attack or panic-like symptoms in situations in which help would not be available or escape would be difficult or embarrassing. Those who suffer from agoraphobia typically avoid public places or places where they have experienced a panic attack. They may become restricted to their home or fixed routes or territories in which they feel safe. Approximately one in three people with panic disorder develops agoraphobia. Agoraphobia does not tend to develop until age 18 or older.
Panic disorder affects approximately 4% of adolescents, whereas panic attacks are relatively common among adolescents (35-65%). On average, one’s first panic attack occurs between the ages of 15 and 19. Panic disorder is extremely rare in prepubertal children. Panic disorder is more common in females than males. Agoraphobia occurs in 2.4% of youth between the ages of 13 and 18 and is more common in females.
Escaping brings quick relief, but it teaches the body to stay on alert:
Symptoms
According to DSM, the following symptoms would suggest Panic Disorder. A. Recurrent unexpected panic attacks; and B. At least one of the attacks has been followed by > 1 month of > 1 of the following:
- Persistent concern about having additional attacks
- Worry about the implications of the attack or its consequences (e.g., losing control, having a heart attack, or going crazy)
- A significant change in behavior related to the attacks
A panic attack is defined as the abrupt onset of intense fear that reaches a peak within a few minutes and includes at least four of the following symptoms:
- a feeling of imminent danger or doom
- the need to escape
- heart palpitations
- sweating
- trembling
- shortness of breath or a smothering feeling
- a feeling of choking
- chest pain or discomfort
- nausea or abdominal discomfort
- dizziness or lightheadedness
- a sense of things being unreal, depersonalization
- a fear of losing control or "going crazy"
- a fear of dying
- tingling sensation
- chills or heat flush
Agoraphobia
Some people stop going into situations or places in which they've previously had a panic attack in anticipation of it happening again. These people have agoraphobia, and they typically avoid public places where they feel immediate escape might be difficult, such as shopping malls, public transportation, or large sports arenas. Their world may become smaller as they are constantly on guard, waiting for the next panic attack. Some people develop a fixed route or territory, and it may become impossible for them to travel beyond their safety zones without suffering severe anxiety.
Red flags to watch for
Some Red Flags that your child might be suffering from Panic Disorder or Agoraphobia are:
- Complains of nausea
- Stomachaches or headaches
- Sweating
- Dizzy, faint, or light headed
- Heart racing or beating faster than normal
- Shaking or feeling jittery
- Avoidance of crowds or far away places or “new” places
- Avoidance of sleepovers
- Anxiety upon separation from a safety person or place because they are worried about having physical symptoms (not because they’re worried they will miss that person or something bad will happen to them if they’re not close by).
Free tools
Finding help
Get treatment with our team
The OCD & Anxiety Institute, founded by Dr. Muniya Khanna, offers evaluation and CBT with exposure for kids, teens, and young adults with anxiety and OCD, in person in Berwyn, PA and by video across Pennsylvania.
Find a provider
Looking for care in person or outside of Pennsylvania? Start with a directory below.
Referral NetworkCoping Cat trained clinicians worldwideSearch by location or specialtyFind a clinician →
If you are unable to find a treatment provider through these or other websites, you can:
- Contact the psychiatry department at a local medical school or a university psychology department.
- Contact your county mental health department, a local hospital, or a community mental health center and ask about mental health clinics or staff psychiatrists.
- Search through your insurance company for local behavioral health or psychiatry providers.
- Search the American Psychological Association provider database.
Disclaimer: We do not endorse the references or providers listed. We list available resources as a service.
Books
Books for kids
A reading list for children and teens, organized by age.
Reading level 4 to 8 10 books
- First Day Jittersby Julie Danneberg. Whispering Coyote Press, 2000.
- Wemberly Worriedby Kevin Henkes. Greenwillow Books, 2010.
- Scary Night Visitors: A Story for Children with Bedtime Fearsby Irene Wineman Marcus, Paul Marcus, & Susan Jesche. Magination Press, 1990.
- I Don’t Know Why…I Guess I’m Shy: A Story About Taming Imaginary Fearsby Barbara Cain & J. J. Smith-Moore. Magination Press, 2000.
- Into the Great Forest: A Story for Children Away from Parents for the First Timeby Irene Wineman Marcus. Magination Press, 1992.
- Night Light: A Story for Children Afraid of the Darkby Jack Dutro & Kenneth Boyle. Magination Press, 1991.
- Cat’s Got Your Tongue? A Story for Children Afraid to Speakby Charles E. Schaefer & Judith Friedman. Magination Press, 1992.
- Outsmart Your Worry Tool Kit for Kids, Ages 5-11by Tool Kits for Kids, LLC, 2008.
- Lions Aren’t Scared of Shots: A Story for Children About Visiting the Doctorby Howard J. Bennett. Magination Press, 2007.
- Sometimes I’m Scaredby Jane Annunziata & Marc Nemiroff. Magination Press, 2009.
Reading level 9 to 12 8 books
- Nobody’s Perfect: A Story for Children about Perfectionismby Ellen Flanagan Burns. Magination Press, 2009.
- What to Do When You Worry Too Much: A Kid’s Guide to Overcoming Anxietyby Dawn Huebner. Magination Press, 2006.
- What to Do When Your Brain Gets Stuck: A Kid’s Guide to Overcoming OCDby Dawn Huebner. Magination Press, 2007.
- Up and Down the Worry Hill: A Children’s Book about Obsessive-Compulsive Disorder and its Treatmentby Aureen Pinto Wagner & Paul A. Jutton. Lighthouse Press, Inc., 2004.
- I Bet I Won’t Fret: A Workbook to Help Children With Generalized Anxiety Disorderby T.A. Sisemore. New Harbinger, 2008.
- Outsmart Your Worry Tool Kit for Kids, Ages 11-18by Tool Kits for Kids, LLC, 2009.
- Kissing Doorknobsby Terry Spencer Hesser. Laurel Leaf, 1999.
- Blink, Blink, Clop, Clop: Why We Do Things We Can’t Stopby E. Katia Moritz. Weston Press, 2011.
For teens 5 books
- My Anxious Mind: A Teen’s Guide to Managing Anxiety and Panicby Michael A. Tompkins, Katherine A. Martinez, & Michael Sloan. Magination Press, 2009.
- Outsmart Your Worry Tool Kit for Kids, Ages 11-18by Tool Kits for Kids, LLC, 2009.
- Free From OCD: A Workbook for Teens With Obsessive Compulsive Disorderby T.A. Sisemore, 2010.
- Perfectionism: What’s Bad About Being Too Goodby Miram Adderholdt & Jan Goldberg. Free Spirit Publishing, 1999.
- Talking Back to OCD: The Program That Helps Kids and Teens Say "No Way", and Parents Say "Way to Go"by John March, 2006.
Books for parents & caregivers
Books to empower those who support children and teens.
Anxiety 11 books
- The Resilience Recipeby Muniya Khanna & Philip Kendall (2021). New Harbinger Press.
- You and Your Anxious Child: Free Your Child from Fears and Worries and Create a Joyful Family Lifeby Anne Marie Albano, with Leslie Pepper. A Lynn Sonberg Book with Avery/Penguin Press, 2013.
- The Coping Cat: Parent Companionby Philip C. Kendall, Jennifer Podell, & Erika Gosch. Workbook Publishing, 2010.
- The Highly Sensitive Child: Helping Our Children Thrive When the World Overwhelms Themby Elaine Aron. Three Rivers Press, 2002.
- Freeing Your Child from Anxiety: Powerful, Practical Solutions to Overcome Your Child’s Fears, Worries and Phobiaby Tamar Chansky. Broadway Books, 2004.
- Freeing Your Child from Negative Thinking: Powerful, Practical Strategies to Build a Lifetime of Resilience, Flexibility and Happinessby Tamar Chansky. Da Capo Lifelong Books, 2008.
- Your Anxious Child: How Parents and Teachers Can Relieve Anxiety in Childrenby John Dacey & Lisa Fiore. Jossey-Bass, 2001.
- Helping Your Child Overcome Separation Anxiety or School Refusal: A Step-by-Step Guide for Parentsby Andrew R. Eisen, Linda B. Engler, & Joan Sparrow. New Harbinger Publications, 2006.
- The Worried Child: Recognizing Anxiety in Children and Helping Them Healby Paul Foxman. Hunter House, 2004.
- Help for Worried Kids: How Your Child Can Conquer Anxiety & Fearby Cynthia Last. Guilford Press, 2006.
- Helping Your Anxious Child: A Step-by-Step Guide for Parentsby Ronald Rapee, Susan Spence, Vanessa Cobham, & Ann Wignall. New Harbinger Publications, 2008.
OCD 3 books
- Freeing Your Child from Obsessive Compulsive Disorder: A Powerful, Practical Program for Parents of Children and Adolescentsby Tamar Chansky. Three Rivers Press, 2001.
- OCD in Children and Adolescents: A Cognitive-Behavioral Treatment Manualby John S. March & Karen Mulle. Guilford Press, 1998.
- What to Do When Your Child Has Obsessive-Compulsive Disorder: Strategies and Solutionsby Aureen Pinto Wagner. Lighthouse Press, 2002.
References
Show 5 references
- Bernstein, G. A., Borchardt, C. M., & Perwien, A. R. (1996). Anxiety disorders in children and adolescents: A review of the past 10 years. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 1110-1119.
- Kessler, R. C., Chiu, W. T., Jin, R., Ruscio, A. M., Shear, K., & Walters, E. E. (2006). The epidemiology of panic attacks, panic, disorder, and agoraphobia in the national comorbidity survey replication. Archives of General Psychiatry, 63(4), 415-424.
- King, N. J., Ollendick, T. H, & Mattis, S. G. (1994). Panic in children and adolescents: Normative and clinical studies. Australian Psychologist, 29, 89-93.
- Last, C. G., & Strauss, C. C. (1989). Panic disorder in children and adolescents. Journal of Anxiety Disorders, 3, 87-95.
- Ollendick, T. H., Mattis, S. G., & King, N. J. (1994). Panic in children and adolescents: A review. Journal of Child Psychology and Psychiatry, 35, 113-134.
