Today, Wednesday 9th March, marks World Panic Day. The mental health charity mind estimates that around 1 in every 100 people in England are diagnosed with Panic Disorder every week. This is a startling figure and, discouragingly, is a mental health condition that is on the rise.
We all experience feelings of anxiety and panic from time to time, in response to stress or significant life events. Panic Disorder, however, is a form of anxiety disorder where an individual will have bouts of extreme anxiety, panic, or intense fear, frequently and seemingly for no apparent cause. It can be extremely frightening for an individual suffering from the disorder and the feeling of being ‘out of control’ can become so overwhelming that a person may avoid certain situations or stop leaving home altogether in an attempt to prevent a panic or anxiety attack. Sadly, this desire to feel more in control can start a negative chain of events that only serves to exacerbate the condition.
Whilst anxiety disorders are the most common mental health condition in childhood, Panic Disorder is rare in young children and, in most cases, begins during the teenage years. This is thought to be linked to changes that are happening in the brain at this key stage of development. Panic Disorder may occur in response to significant life events or extreme stress in a young person’s life. It can manifest in such a way that it causes significant disruption to an individual’s day-to-day life, resulting in panic attacks in response to everyday stressful events, particularly those that place more pressure on a young person, such as exams.
How can I spot the signs of a panic attack?
Symptoms of a panic attack can sometimes be confused with other health-related issues so it is always important to seek help from your GP initially if your child is regularly suffering from panic-related symptoms.
The symptoms of a panic attack might include:
- Breathing uncontrollably or the feeling of not being able to catch a breath
- A racing or pounding heart
- Shaking or trembling uncontrollably
- A tightness in the throat
- Feeling dizzy or light-headed
- Feeling very cold or very hot
- An uncomfortable feeling or pain in the stomach or chest
- A sudden urge to use the toilet
- Ringing in the ears
- Feeling as if your mind is not connected to your body, often described as an odd feeling of being disconnected from your surroundings
How are panic attacks caused?
Very often, individuals suffering from a panic attack can become so distressed that they feel as if they are having a heart attack or might die. It might be surprising then to know that panic attacks, although very frightening, pose no serious threat to our physical health. Once a young person understands this, it can be extremely helpful in controlling the fear that often surrounds them and, in turn, can help to break the negative cycle of thinking that can exacerbate the condition.
To understand this in more detail, let’s take a look at how the brain processes perceived stress:
- The Amygdala, the primitive part of the brain associated with our fear response, is activated. Our Amygdala, the pair of almond-shaped bundles of nerves buried deep in our brain, is responsible for what many of us understand as the ‘fight or flight’ response. It is an important part of our survival instinct that alerts us to danger. When faced with a stressful situation, our amygdala will spark a chain of events in the brain that will help to ensure our survival. It is thought that individuals who suffer from Panic Disorder or panic attacks may have heightened activity in this region of the brain.
- The Hypothalamus floods our bodies with chemicals in response to stress. The hypothalamus is like a command centre in the brain which regulates automatic bodily functions, such as our heart rate, our breathing, and our blood pressure. During a panic attack, in response to perceived stress, this part of the brain will fire off neurons that send messages to our adrenal glands to release stress hormones such as adrenaline and cortisol. The usual, self-regulated bodily functions stop working in the usual way and our bodies’ energy becomes focused on escaping the perceived danger. It is these effects of adrenaline in our bodies that cause the uncomfortable symptoms of a panic attack.
- The Hippocampus stores our subconscious behaviours. Together with the Amygdala and the Hypothalamus, the Hippocampus forms part of the brain that is responsible for our subconscious thoughts and behaviours. The actions we perform day-to-day without thinking, such as walking, riding a bike, or driving to work, are stored in this part of the brain, together with more unhelpful behaviours. For example, our Hippocampus stores our fear-based responses and it is this part of the brain that can keep the cycle of a panic attack going. If we experience a panic attack but still survived, our primitive brain will think it has been helpful for us and so will encourage the same response in the brain again. In this way, we can see that the more an individual might fight or fear a panic attack, the more likely they are to have one because it fires up the fear response in the brain.
How can I support my child if they are suffering from panic attacks?
One of the ways that we can help get panic attacks under control is to lessen the activity in the fear-based primitive part of the brain. Anxiety and panic attacks are some of the main areas that the Youth Fairies help young people with. We do this by supporting young people to gain greater control of the pre-frontal cortex, the part of the brain associated with rational decision-making, positive thinking, and problem-solving. When this part of the brain is exercised, we are better able to develop healthy ways of coping with stress and to better prevent panic attacks from happening in the first place.
This is why grounding techniques, which encourage an individual to focus on the present moment, can be so useful for someone in the midst of a panic attack. It short circuits the neurons that fire off the panic response and forces the intellectual, rational part of the brain to pay attention. When this part of the brain is in control, the primitive responses settle and our parasympathetic nervous system steps in to help (the part associated with rest and relaxation).
Here are a few techniques and strategies you or your child can try the next time they are experiencing a panic attack, or feel one coming on:
This breathing technique stimulates the parasympathetic nervous system, which is the process our body goes through once a perceived threat to our survival or stressful event has passed. It induces feelings of relaxation as our brains release adrenaline when we breathe in and relax when we breathe out. By making the out-breath longer, we signal to our brain that we are calming down.
- Breathe in through your nose for a count of 7, making sure you are doing deep ‘belly breathing.’ Our belly should expand just like a balloon when we breathe in. You can encourage your child to put their hand on their belly to feel it rise and expand on the in-breathe.
- Breathe out through your mouth for the out-breath for a count of 11. This breath should be a long, slow, stretchy breath. If your child places their hands on their belly, they should feel it deflate back to normal.
- Repeat until you begin to feel calm and the panic symptoms ease.
Like all things, this may seem unnatural at first but with more practice, it will become easier. The more your child practises, the easier it will be to draw upon this technique during an episode of anxiety or panic.
Similar to the breathing technique above, Rectangle Breathing encourages a longer out-breath to stimulate feelings of relaxation. The beauty of this is that it has an added visual distraction, is a great one for younger children, and can even be practised at a desk at school.
- You can use anything rectangular for this, like an exercise book or pencil case for example.
- Find a comfortable position and trace your finger along the short side of the rectangle, breathing in as you go.
- Breathe out as your trace your finger along the long side of the rectangle.
- Repeat for the remaining sides of the rectangle, breathing in for the short sides and out for the long sides.
This can be repeated until symptoms of panic have settled.
5, 4, 3, 2, 1
This is a brilliant grounding technique that forces the brain to focus on the present moment. When the brain is distracted by the here and now, it prevents our subconscious panic response from taking over. This is because a different part of our brain, the pre-frontal cortex, is being used instead.
- Look around and notice five things you can see.
- Name four things you can feel.
- Listen to three things you can hear.
- Name two things you can smell.
- Notice one thing you can taste.
This technique can be done anywhere when an individual is having a panic attack to help bring them back to a calm and relaxed state.
The more these techniques, and similar ones, are practised the more likely an individual will be able to use them to prevent a panic attack from taking hold and bring about feelings of relaxation much more quickly.
Create a self-soothe box
Help your child to fill a box with items that soothe them and help them to relax and feel calmer day-to-day before panic attacks occur. For younger children this might include a soft toy or blanket or scented cloth, or for older children it might include a bubble bath, their favourite quote, or a reminder of their favourite music to listen to. The key is ensuring the items are chosen by them and actively encourage your child to feel calm in a way that works for them.
Where can I go for further information and support?
You can contact your nearest therapist at The Youth Fairy if you would like further support for your child to help them find ways of coping better with panic attacks and to help prevent them in the future.
There are also charitable organisations that offer further information and guidance. You can find them at: