printable pdf Most people have experienced a sense of panic at some time in their life. This is a normal reaction to a life-threatening situation e.g. a house fire, road accident or assault. Panic usually takes the form of an extreme feeling of fear and dread and the overwhelming desire to escape the situation. The physical feelings are very uncomfortable and can include:
- A pounding and racing heart, even palpitations (feeling your heart is stopping or missing beats).
- Shortness of breath or a feeling of choking.
- A tremor which can be as bad as violent shaking.
- Tingling or numbness in your fingers and toes.
- Feeling sick, dizzy and sweating.
- A feeling of losing control of your bladder and or bowels. This can cause temporary incontinence.
- A fear that you are about to die.
- A sense that you or things around you are not real.
- Feeling you are losing control of your mind even that you are going crazy.
- Feeling aggressive towards anyone who gets in your way of escape.
These symptoms of extreme anxiety are very necessary and are an instinctive reaction to prepare our minds and bodies to escape or fight for our lives. The symptoms of panic usually disappear gradually after the frightening event has passed.
Unfortunately panic sometimes happen when there is no immediate threat to life. These are often called 'panic attacks'. Panic attacks are one of the most common psychological problems in the Western World, affecting 2-3% of the population in any one year. Fortunately many people get over this with no need for treatment and when treatment is required, it is usually short and often successful.
A young person experiencing these distressing feelings and thoughts is often not fully aware of why they are feeling so frightened. If the panic attacks happen regularly they can start to interfere with their normal daily activities like school and social life. This can add to their distress and lead to them avoiding similar places and situations to those in which they had the panic. This avoidance can be called agoraphobia, school phobia or social phobia depending on which area of their life is affected.
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In trying to understand why a child or young person may be having panic attacks, ask yourself the following:
- Do you know if this young person worries a lot or has low confidence?
- Do you know if they have recently experienced bereavement or divorce?
- Do you know if they have experienced any trauma in the past?
- Do you know if they are under any stress at school, for example approaching exam time, changing schools or being bullied?
When trying to respond helpfully to a young person it is useful to understand what they might be feeling. Also that they may have no immediate explanation for these feelings and behaviours and that your calming presence, thoughtful advice and reassurance can help with both the immediate panic and its longer term resolution.
As well as dealing with the panic attacks, the young person often has to deal with the fear of having further attacks, the embarrassment of their behaviour during an attack and teasing from other young people.
Children and young people can be put under stress by having to avoid certain situations and having to make excuses to avoid situations or trying to explain irrational fears and behaviours to parents, teachers and other young people.
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Panic attacks are very frightening to those experiencing them and to those around them. By their nature, the young person has lost control of their emotions and can be very unpredictable. Remaining in control yourself is extremely important to an individual having a panic attack. It will be unsupportive to respond to a panic attack with anger, anxiety or attempts to belittle the young person’s feelings. It is important to be aware of your own feelings and attitudes.
For more information, see section on being aware of yourself and your own response.
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- Remember that the young person is feeling a sense of uncontrollable and irrational terror that they may not understand the reasons for.
- Stay calm and try to look relaxed as the young person will pick up your tone of voice and body language and be calmed by this.
- Be confident and reassuring but don’t shout or slap them.
- Explain that you understand how anxious they are.
- Ask them if there is anything obvious that is frightening them but don’t interrogate them about why they are feeling so afraid.
- Use affirming language: "you will be alright", "I will keep you safe", "you are not having a heart attack".
- Explain that their symptoms are not uncommon and not life-threatening.
- Help them to leave the situation that is provoking the attack and to go to somewhere quiet and relaxing.
- Try to distract them by talking about normal things. For more information, see section on counselling techniques.
- Get them to concentrate on slow deep breathing, in through the mouth and out through the nose.
- Talk the young person through relaxation techniques.
- If they feel dizzy get them to sit or lie down in a safe position (follow your organisation's first aid procedures).
- Give them a drink to sip on, but not drinks containing caffeine.
- Stay with the young person until they have calmed down because people in a panic are not always able to judge risk properly, for example they may run across roads without looking.
- Explain the situation to classmates etc and ask them not to question, tease or fuss over the young person.
- Talk to the young person about their panic attacks and reassure them that their feelings are normal and that you respect them.
- If appropriate, gently enquire what they think might be causing them to panic. For more information, see section on counselling techniques.
- Try and find out how often the panic attacks occur, how much they interfere with their normal life and if they are receiving help from a specialist.
- Enquire if there are any obvious stresses in their life e.g. exams, family problems, bullying etc. For more information, see section on counselling techniques.
- Explain the physical symptoms of anxiety to the young person to help them understand that the feelings they get when they panic are a normal reaction.
- Suggest they practice relaxation either through self-help reading, relaxation training tapes and CDs or by attending relaxation/yoga classes.
- Suggest they reduce their intake of stimulants like tea, coffee and cola.
- Suggest they take up exercise to expose them to the normal sensation of increased heart beat and shortness of breath.
- Ask them about their ways of coping with stress and worry. For more information, see section on solution-focused techniques.
- With the young person's permission, inform and educate key people about the young person’s anxiety, for example their teacher or parent.
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- If the young person feels faint or experiences chest pain, difficulty breathing or has palpitations, it is advisable to have their general health examined by a doctor.
- If you or the young person are concerned about their physical health.
- If the panic attacks happen more than once and are causing the young person concern and distress.
- If the young person’s life is being inhibited by panic attacks, i.e. they avoid certain situations.
- If the panic attacks occur in combination with other worrying behavioural or psychological problems, e.g. self-harm, depression, sleep disturbance, deterioration in school performance, etc.
- If you discover serious issues that you lack the necessary skills and experience to deal with e.g. sexual abuse.
Fortunately, persistent panic attacks often respond very well to treatments such counselling, relaxation training and cognitive-behavioural therapy. These treatments are usually available through local mental health services.
You should get in touch with your local health centre or hospital to obtain a contact number for the appropriate children and young people's mental health specialists.
Remember - you can contact your local mental health specialists for a number of reasons, for example:
- For advice on how to make a referral about a named child.
- For advice about whether or not to make a referral (it is normal practice to seek this advice without naming the child in the first instance).
- For advice about what to do (once again there should be no necessity to name the child).
By not naming the child you are protecting their right to confidentiality. This method of seeking advice also has the advantage that you do not need to get anyone’s consent in advance of your contact phone call.