Panic Disorder with Agoraphobia, Preschool

You said your child has times when s/he suddenly becomes very afraid. S/he then feels like something terrible is about to happen. S/he may also have unusual physical symptoms (e.g. fast heartbeat, sweating, and shortness of breath). This is called a Panic Attack. Your child has had two or more of these experiences and s/he now worries that it might happen again. Children who have lots of Panic Attacks may have Panic Disorder.

You said your child has had some of the following difficulties:

• A sense that something bad is about to happen
• Racing or pounding heartbeat
• Sweating
• Dizziness or lightheadedness
• Shortness of breath or a feeling of being smothered
• Trembling or shaking
• Feeling of choking
• Chest pain or discomfort
• Nausea or stomachache
• Feeling like things are not real; feeling detached from oneself
• Fear of losing control or going crazy
• Fear of dying
• Numbness or tingling feelings
• Chills or hot flushes

And/or

• Crying
• Temper tantrums
• "Freezing"
• Clinging to parents/caregivers

You reported that your child has the following symptoms of Panic Disorder:

• Two or more Panic Attacks
• For at least 1 month after a Panic Attack your child has:
• Worried constantly about having another attack
• Worried about what will happen when s/he has another attack (e.g. Fears of losing control; "going crazy")

Some children with Panic Disorder start to feel anxious all the time. They may start to avoid situations where they think a Panic Attack may happen. They are afraid of being in places where it might be embarrassing or hard to escape. For example, a child may not want to go to school or be separated from his or her parents. In the worst cases, a child may be afraid to leave home. This pattern of avoiding certain places or situations is called "agoraphobia." Based on your report, your child also has these difficulties. It is likely that your child does not like to go places alone or may even refuse to leave the house. Your child may be very "clingy" and have problems being away from you.

It is uncommon for young children to have Panic Disorder. Those who do may often cry, tantrum, freeze, or cling to parents when having a Panic Attack. They may not want to be separated from their parents for fear of having another attack.

Adapted in part from the American Academy of Child and Adolescent Psychiatry (AACAP) Facts for Families© series (1997), the American Academy of Pediatrics (AAP) Diagnostic and Statistical Manual for Primary Care (DSM-PC) (1996) , and the American Psychiatric Association (APA) Diagnostic and Statistical Manual of Mental Disorders: Fourth Edition (1994) .

There are some things you can do to help your child:

• Practice Relaxation Exercises when your child is calm
• After your child can do these relaxation exercises when calm, help him/her do them when having an "attack"
• Talk your child through the panic attack:
• Once it starts, you can't stop it but it will go away on its own
• Panic attacks always go away
• No one has ever died from a panic attack
• Just because you are having panic attacks now, doesn't mean you will always have them