Coping with panic attacks: Information for children and young people

This information will give you some techniques that children and young people find helpful to cope with panic attacks.

What is a panic attack?

Panic attacks can happen when your body feels scared or worried. It’s completely normal to feel like this. Children and young people tell us that when they have a panic attack, they can feel scared or worried quickly and sometimes don’t know why they feel scared or worried like this.

Why do we have panic attacks?

When your body feels scared or worried, this causes a fight, flight or freeze response. Some children and young people tell us that this feels like a fast heartbeat, quicker breathing and tense muscles. This is because your brain is trying to keep your body safe by preparing you to fight off the threat or take flight towards safety. Sometimes your body may also freeze.

Everyone’s body reacts differently to feeling scared or worried. Some people may have a panic attack, but some people might not.

If you feel scared and worried a lot, this can make you feel very tired.

What does having a panic attack feel like?

When you are having a panic attack, you might have or feel:

Lots of thoughts
A fast heartbeat
Feel sick
A stomach ache
Legs are shaky and feel like jelly
Feel faint, dizzy or light-headed
Fast breathing
A sharp pain in your chest
Things might not feel real
Sweating, trembling or shaking

When might you have a panic attack?

Panic attacks may happen at different times for everyone. You might notice that you start to feel panic at certain times. For example, some children and young people may have them before coming to a hospital appointment or when they are in a busy place.

What can help when you are having a panic attack?

Children and young people have told us that these things can be helpful to do to cope with panic attacks.

We will tell you more things about these:

Square breathing.
Muscle relaxation.
Grounding.

Square breathing

Square breathing helps you slow down your breathing.

Before you start:

Sit, lie down or stand somewhere comfortable.
Breathe normally for a minute and watch your chest and tummy move up and down as you breathe.
Take deep breaths to watch your chest and tummy move up and down more.

To start

Breathe in slowly through your nose whilst counting to four, and feel the air filling up your lungs.
Hold your breath for four seconds.
Breathe out slowly through your mouth for four seconds.
Repeat this until your breathing is slower.

Muscle relaxation

Children and young people tell us that when they feel scared and worried or have a panic attack, their muscles feel achy and painful.

Progressive muscle relaxation (PMR) can help make your muscles feel less painful and more relaxed.

Before you start

Sit or lie down somewhere quiet and comfortable.
Slow down your breathing and relax.
Tighten the muscle that you want to relax, like your shoulders, for five seconds.
Then relax the muscle for around ten seconds.
When you have finished, stay sitting or lying down for a little while.

Here are some muscles you might like to try this exercise on.

Right hand and forearm	Make a fist with your right hand.
Left hand and forearm	Make a fist with your left hand.
Left upper arm	Bring your left forearm up to your shoulder to “make a muscle”.
Forehead	Raise your eyebrows as high as they will go. Like you are pulling a surprised face.
Eyes and cheeks	Squeeze your eyes tightly shut.
Mouth	Open your mouth as wide as you can. Like you are yawning.
Shoulders	Bring your shoulders up towards your ears.
Chest and tummy	Breathe in deeply, filling up your lungs and chest with air.
Right upper arm	Bring your right forearm up to your shoulder to “make a muscle”.
Hips and bum	Squeeze your bum muscles together.
Right leg	Pull your toes up towards you on your right foot.
Right foot	Curl your toes down on your right foot.
Left leg	Pull your toes up towards you on your left foot.
Left foot	Curl your toes down on your left foot.

Grounding

Grounding helps you to pay attention to what is going on around you, using your five senses: sight, touch, hearing, smell and taste. Grounding can help you to feel calm when it feels like you have lost control.

Look for five things you can see. Say their names out loud. Which one is nearest to you?
Find four things you can touch. Touch them. How do they feel under your fingertips?
Listen for three things you can hear. Can you identify what is making the noise?
Sniff two things that you can smell. Do the smells remind you of anything?
Taste one thing in your mouth. What did you last eat or drink?

Other useful tips and tricks to deal with anxiety and panic attacks

Talk about it

Some children and young people find it helpful to talk to someone. You could talk to a teacher, a parent, your brother or sister, or any adult you trust. It is normal to sometimes feel worried about things that are happening around you. Getting your emotions out can help you to feel better.

Distract yourself

Some children and young people tell us that it can be helpful to distract yourself from your worries. You could play the alphabet game. This is where you name something for every letter of the alphabet in any category or subject. This could be animals, people’s names, foods or anything you choose.

A – ANT
B – BUTTERFLY
C – CAT

You can also try counting backwards in 7’s from 100, or practise your times tables.

You can imagine going for a walk somewhere. It could be anywhere you like. Think about what you might see, hear, feel or smell on your imaginary walk.