Panic disorder is diagnosed when children have panic attacks frequently enough to cause significant impairment or suffering.
Panic disorder is usually treated with a combination of drugs and behavioral therapy.
(See also Overview of Anxiety Disorders in Children and Adolescents Overview of Anxiety Disorders in Children and Adolescents Anxiety disorders are characterized by fear, worry, or dread that greatly impairs the ability to function and is out of proportion to the circumstances. There are many types of anxiety disorders... read more and Panic Attacks and Panic Disorder Panic Attacks and Panic Disorder A panic attack is a brief period of extreme distress, anxiety, or fear that begins suddenly and is accompanied by physical and/or emotional symptoms. Panic disorder involves recurrent panic... read more in adults.)
Panic disorder is much more common among adolescents than among younger children. Sometimes children have separation anxiety Separation Anxiety Disorder Separation anxiety disorder involves persistent, intense anxiety about being away from home or being separated from people to whom a child is attached, usually the mother. Most children feel... read more or generalized anxiety Generalized Anxiety Disorder in Children Generalized anxiety disorder involves excessive, persistent nervousness, worry, and dread about many activities or events. Because of their worries, children with generalized anxiety disorder... read more when they are younger and then develop panic disorder as they go through puberty.
Panic attacks can occur in any anxiety disorder, usually in response to the focus of that disorder. For example, children with separation anxiety may have a panic attack when a parent leaves. Children who fear being trapped in places with no way to escape easily (agoraphobia Agoraphobia in Children and Adolescents Agoraphobia is a persistent fear of being trapped in public situations or places with no way to escape easily and no one to help. Agoraphobia may develop in adolescents, particularly those who... read more ) may have a panic attack when they are seated in the middle of a row in a crowded auditorium. Many children who have panic disorder also have agoraphobia.
Physical disorders, such as asthma Asthma Asthma is a condition in which the airways narrow—usually reversibly—in response to certain stimuli. Coughing, wheezing, and shortness of breath that occur in response to specific triggers are... read more , can also trigger panic attacks, and panic attacks can trigger asthma.
During a panic attack, children feel great anxiety, which causes physical symptoms. The heart beats rapidly. Children may sweat profusely and feel short of breath. They may have chest pain or feel dizzy, nauseated, or numb. Children may feel like they are dying or going crazy. Things may seem unreal to them. Symptoms may be more dramatic (involving screaming, weeping, or hyperventilating) than they are in adults.
Children may worry about having other attacks. Panic attacks and the associated worries interfere with relationships and schoolwork.
In panic disorder, panic attacks usually occur on their own, with no specific trigger. But over time, children begin to avoid situations that they associate with the attacks. This avoidance can lead to agoraphobia, which makes children reluctant to go to school, visit the mall, or do other typical activities.
Panic disorder often worsens and lessens for no apparent reason. Symptoms may disappear on their own, then recur years later. But with treatment, most children with panic disorder improve.
Occasionally, when panic disorder is not treated, adolescents drop out of school, withdraw from society, and become reclusive and suicidal.
A doctor's evaluation
Doctors diagnose panic disorders when children
Have had several panic attacks
Change their behavior to avoid situations that trigger the attacks
Worry about possible future attacks
Do not have a disorder that is causing the symptoms
Thus, doctors usually do a physical examination to check for physical disorders that may be causing the symptoms.
Doctors also check for other mental health disorders (such as obsessive-compulsive disorder Obsessive-Compulsive Disorder (OCD) and Related Disorders in Children and Adolescents Obsessive-compulsive disorder is characterized by recurring, unwanted, intrusive doubts, ideas, images, or impulses (obsessions) and unrelenting urges to do actions (compulsions) to try to lessen... read more or social anxiety disorder Social Anxiety Disorder in Children and Adolescents Social anxiety disorder involves a persistent fear of being embarrassed, ridiculed, or humiliated in social situations. Children and adolescents with social anxiety disorder typically avoid... read more ), which may be the reason for the panic attacks.
Usually drugs plus behavioral therapy
Usually, a combination of drugs and behavioral therapy is effective for panic disorder. In some children, drugs are frequently needed to control the panic attacks before behavioral therapy can begin.
Benzodiazepines are the most effective drugs, but a type of antidepressant called selective serotonin reuptake inhibitors Selective serotonin reuptake inhibitors (SSRIs) Agomelatine, a new type of antidepressant, is a possible treatment for major depressive episodes. Several types of drugs can be used to treat depression: Selective serotonin reuptake inhibitors... read more (SSRIs) are often preferred because benzodiazepines cause drowsiness (sedation), may interfere with learning and memory, and may result in dependence.