Panic Disorder and Agoraphobia

In addition to having panic disorder, many children and teens may also develop agoraphobia, although these two diagnoses can exist independently so that youth can have panic disorder, or agoraphobia, or both. Youth with agoraphobia experience significant fear of being in at least two locations where escape appears difficult or they might be unable to get help, and therefore will avoid these situations as much as possible. Examples of situations include, using public transportation, being in enclosed spaces, such as in theatres or stores, or riding in elevators; being in open spaces, such as soccer fields or bridges, or being outside the home alone, and more.

Note:
Rates of panic attacks increase in adolescence, and having one does not mean that your child has panic disorder. Panic attacks become a problem when someone worries about having more attacks, or fears something bad will happen because of a panic attack. Also, panic attacks can occur in other anxiety disorders. For example, children or teens with a phobia of dogs might have a panic attack when they are near a dog. In this case, however, the panic attack is expected, and the child is afraid of the dog, not the panic attack. In panic disorder, the panic attacks are unexpected or there is no clear reason for the panic attack to have occurred.

Common Situations or Affected Areas

• School attendance
• Hanging out with friends
• Going on field trips
• Taking public transportation
• Travel
• Reduced independence
• Reassurance seeking

How panic disorder and agoraphobia impacts the child at different ages

Children, especially if they are young, may have trouble describing their symptoms. Instead, they are more likely to talk about their physical symptoms such as pounding heart, upset stomach, chest pain, or nausea, rather than psychological symptoms, such as a fear of “going crazy”. For young children having a panic attack, they may suddenly become very frightened or upset for no clear reason. They may insist something is wrong or that something bad will happen; however, they may be unable to identify exactly what is going to happen. Rather, what you may notice is a change in behaviours such as being unusually clingy, crying, having tantrums, and refusal to do activities that were previously not an issue.

As children mature into adolescence, their skills at describing and expressing their feelings and internal experiences are generally more sophisticated than in young children. Thus, teens may be better at describing a panic attack than younger kids. Furthermore, “panic attack” is a common term used in Western society, so for many youth, they may already be familiar with this term and are able to state, “I had a panic attack,” and provide details. However, despite the shared use of this term, teens might be embarrassed by their symptoms, and may not want to openly discuss what is happening. In addition, not all children and teens are able to recognize that their behaviour is extreme or unreasonable given the situation. Gently supporting your adolescent in having the courage to share with you what is happening may be a good strategy, rather than telling them there is nothing to be afraid of.

Note: If you suspect that your child has Panic Disorder, it is advisable to take him or her to a family physician for a medical check-up. Medical problems (such as diabetes, inner-ear disorders, hypoglycemia, or thyroid problems), excessive caffeine use, or adverse reaction to medication (such as asthma medications) may be playing a role in your child’s anxiety or panic-like reactions.

My Anxiety Plan (MAPs)

MAP is designed to provide children/teens struggling with anxiety with practical strategies and tools to manage anxiety. To find out more, visit our My Anxiety Plan website.