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What is panic disorder?

Panic disorder is a specific kind of anxiety disorder. Kids with panic disorder have sudden attacks of anxiety that come with intense feelings of dread and physical symptoms that can feel like a heart attack. These episodes are called panic attacks. Sometimes, the child might feel like they are dying during the panic attack.  

Panic attacks also involve a strong desire to escape from the situation. Fear of having another panic attack can trigger a new one. Kids with panic disorder often avoid places where they have had an attack. 

Panic disorder is rare in young children but often begins during the teenage years. 

What are the symptoms of panic disorder?

Signs that a child or teenager might have panic disorder include: 

  • Anxiety attacks that come with intense physical symptoms, including racing heart, chest pains, trouble breathing, dizziness, nausea and sweating 
  • A sudden and terrible fear of death or losing control 
  • A feeling that the world is not real 
  • A strong desire to escape from wherever they are 
  • Repeated anxiety attacks that come on fast and reach their worst point within about ten minutes  
  • Intense fear of experiencing more attacks 
  • Avoiding places where they have had panic attacks in the past or places that would be hard to escape, like crowds or enclosed spaces  

How is panic disorder diagnosed?

To diagnose a child with panic disorder, an expert will rule out other possible causes of the panic attacks. These other causes could be medical, or they could be psychiatric disorders that share some symptoms with panic disorder, like post-traumatic stress disorder (PTSD) or obsessive-compulsive disorder (OCD).  

Once other causes are ruled out, the professional will diagnose panic disorder if: 

  • The child has experienced several panic attacks 
  • The child worries a lot about having more attacks 
  • The child fears what will happen to them if they have another attack, including feelings of dying or “going crazy” 
  • There is a big change in the child, like avoiding places where they have had panic attacks or even places that reminds them of panic attacks 

How is panic disorder treated?

There are very effective treatments available for kids with panic disorder. Treatment often involves a combination of therapy and medication. 
Cognitive behavioral therapy (CBT) is aimed at lessening the fear that causes kids to avoid situations that remind them of panic attacks. Over time, changing that behavior can ease their anxiety.  

Another common treatment is called exposure with response prevention. This therapy helps lessen anxiety by gently and slowly exposing kids to situations that remind them of panic attacks. 
Drugs called antidepressants have been shown to successfully prevent panic attacks in some children. If those don’t work, anti-anxiety drugs like Xanax are sometimes prescribed instead. 

This guide was last reviewed or updated on December 12, 2023.