Panic disorder is often described as the fear of fear itself
While many anxiety disorders involve worrying about specific things like tests or social situations, panic disorder is defined by sudden, repeated episodes of intense fear that strike out of the blue.
These are known as panic attacks. For a child or teen, these episodes can be terrifying because they often feel like a medical emergency — as if they are having a heart attack or losing control of their mind — even though there is no actual danger present.
What makes it a disorder, rather than just a one-off event, is the persistent worry about when the next attack will happen and the changes in behavior a young person makes to try and avoid another one.
Common symptoms in kids and teens
Panic attacks usually reach their peak within about ten minutes, but for the person experiencing them, those minutes can feel like hours.
1. The physical storm
A racing or pounding heart
Sweating, chills, or hot flashes
Trembling or shaking
Shortness of breath or a feeling of being smothered
Chest pain or discomfort
Nausea or an upset stomach
Dizziness, lightheadedness, or feeling faint
2. The mental toll
During a panic attack, your child’s mind often races with scary thoughts, such as:
A sense of impending doom or that something horrible is about to happen
Feelings of unreality, as if they are watching themselves from outside their body
An intense fear of dying or going crazy
3. Behavioral changes
After a panic attack, a child may try to avoid where it happened or what led up to it. For example, if your teen had an attack in the cafeteria, they might refuse to eat there. If it happened during a soccer game, they might want to quit the team. This tendency towards avoidance is a major sign that the anxiety has shifted into a disorder.
Why are kids and teens diagnosed with it?
Panic disorder is more common in preteens and teenagers than in younger children. It often emerges during these years as the brain and body undergo significant changes. Here are some of the reasons it might develop:
Biological vulnerability: Just like other forms of anxiety, panic disorder tends to run in families. Some young people have a nervous system that is simply more sensitive to the fight-or-flight response.
Brain chemistry: The brain’s alarm system — the amygdala — might be sending signals when it doesn’t need to. These false alarms can trigger the physical symptoms of panic even when the environment is perfectly safe.
Major life stress: Experiencing a significant loss, a high-pressure academic environment, or a traumatic event can sometimes reset your child’s stress threshold, making panic attacks more likely.
Interpretation of physical sensations: Some kids are highly attuned to their bodies. If they feel their heart race after climbing stairs, they might misinterpret that highly typical sensation as a sign of a heart attack, which then triggers a real panic attack.
The good news is that like most anxiety disorders, panic disorder is treatable. Kids and teens can learn that while panic attacks feel scary, they are not dangerous, and they can develop the skills and strength to ride the waves until they are calm again.