Anxiety, part 3: How to help your child during a panic attack

[Part 1: Understanding your child’s anxiety so you don’t make it worse]

[Part 2: How to help your real life anxious child]

First, you need to know: When a child is panicking, it doesn’t always look like tears and fast breathing. It can look like defiance, rudeness, aggression, or ignoring you. They might scream, hit, shake, run away, or yell orders. Panic is scary, especially for the child experiencing it, but it doesn’t always look like panic. It looks like a child doing whatever they can to get help or get out of a situation, because they truly believe they are in danger. They are trying to survive.

So when it’s happening, your job is not to stop the behavior. It’s to recognize the panic underneath it, and help your child feel safe again.

You’re going to try to move through the same steps we talked about in our post about anxiety, but they need to look a little different.

1. Respond to the panic, not what it makes them do. They think the house is on fire. They're trying to get you out; they're not worried about being polite. You're going to ignore any disrespect, yelling, or bossiness for now. Not because it doesn’t matter, but what needs a response is the panic behind it. You can talk about behaviour later, when they’re calm. Right now, your job is to help them feel safe.

2. Stay calm yourself. This is hard, but it’s crucial. If your child’s panic pulls you into your own state of panic (or embarrassment or helplessness or anger), it’s going to be a lot harder to help either of you. You can’t co-regulate someone if you’re a wreck. You also can’t think clearly about what is possible or helpful if you’re, say, stressed about what all the people around you think of your parenting. And your child will sense your dysregulation and take it as a sign the situation is as scary as they think it is.

Drop your shoulders and your other plans for the next few minutes. Keep your tone of voice steady and calm. Imagine creating a bubble around the two of you, as much as possible. Just you and your child. That’s your whole focus right now.

Let your tone and physicality say: You are not alone. You are not in trouble. I’ve got you.

3, Try to get them to talk about it. 

If your child can talk, ask them to tell you what’s going on. “You seem really upset? What’s happening?” or “What’s going through your head?” The goal is to get them talking. Sometimes even labelling a fear can wind back the panic.

If they can answer, you’re going to use reflective listening: repeat what they’ve said back to them in a warm, calm tone. Not to validate the fear itself, but to validate that you hear them. "You're worried that something on the playground is bad, that something bad is going to happen," or “You feel like you can’t breathe and all your muscles hurt.”

You're not trying to reassure them. You're not contradicting them. You're just repeating what they said, trying to keep them talking. Ask, "Is that right?" For some kids, just hearing it in a nice, calm, grown up voice helps them start to come down. You can add, “That sounds really hard,” even if you know what is worrying them is ludicrous.

If they can’t talk yet, try thumbs up/down questions. “Are you worried something bad is going to happen?” “Would you like to move away from the dogs?” 

If they can’t even give a thumbs-up, validate the panic. “I can see you are really, really scared.” Say, “I want to know what’s going on. Can you try to point to the problem?” Ask if it’s something inside them or in the room, if they want to move away, if they can lead you to the problem. If they really can’t communicate, try something from the tools for calming and sensory reset section below. 

What about reassuring them their worries aren’t true?

The trick is this: your child really thinks there is danger. If they sense that you are skipping to “calm down” before you address their concerns, you’re only going to make them feel more alone and frustrated. Reassure them if it’s something easy and obvious, like, “We left my stuffedy in the diner!” and you can say, “Remember we gave Pokey to dad to take home?” But know that it might not work, and don’t try to convince them now. You’ll get a chance to address the fear itself when their system is calmer.

4. Make sure they know they are not alone.

Panic feels like danger, and it feels like nobody gets it. Show them you’re there (“I’ve got you”). Create that bubble for just the two of you. Use “we” as in “We can handle this” or “We’ll figure this out together.” 

Stay physically close. If they need space, say, “I’ll be right here,” and stay visible. Even if you need to move away for safety, make sure they know where you are, that you are still with them emotionally.

5. Give them a sense of control 

Panic makes kids feel like they have no control, over what’s happening, over their own body, over what might come next. You can offer a little of that back. Ask them: "What would help?" or “What do you need?”

They might yell, “I want to go home!” Instead of arguing, reflect, "You really want to get off the playground." Then, if it's something you can do reasonably, maybe just do it. "We'll go home. Let’s go collect your brother and your sister." Sometimes just hearing they can leave helps kids calm down.

They might say, “I have to get off this plane, right now!” when you are 30,000 feet in the air (not a hypothetical example).

Even if you absolutely cannot do what they want, still reflect, "I understand that you want to get off the plane." Don’t say, “ We can’t do that.” Try “Let me think about some options” or try to keep them talking. Then you work as hard as you can to help them calm without seeming like you’re invalidating the worry.

Tools for calming, sensory reset, and refocusing

Basically, you’re trying to:

• Interrupt the panic loop

• Calm their nervous system

• Pull them back into their “thinking brain

Give them a task "Can you collect everybody’s boots and line them up?” or “Can you count the backpacks and make sure we have 5?” Make the task doable and low-stakes. The goal is to redirect their focus away from the panic.

Take a pause. Often when my kid is in a panic attack, I say, "Okay, let me think." Then I take a deep breath, sloooowly, and I pull off my glasses and very carefully use my T-shirt to wipe down every inch of my glasses while breathing very deeply. And then I put my glasses back on. I exhale. Then I start talking again. 

Just that little pause sometimes disrupts the panic cycle. Offer them a snack and wipe down the tray table in nice, calming circles. Offer to sit next to them, and take a moment to clear the spot.

Or, be explicit. Say, “Oh, that is a hard one. I need thirty seconds,” and then take a deep breath. All that deep breathing calms you for sure, but it can also help co-regulate them.

Try sensory calming or physical touch. Offer to massage their hands, gently scratch their scalp, give them a deep hug. Move to a dark, quiet space, play a favorite song, use a scarf to create that bubble. You can do these things while reflecting their feelings. Always ask first before touching or moving them.

“Trick” them into regulating. Singing is great for this: you cannot sing without regulating your breathing. Some kids tune into a string of endless calm adult chatter, which replaces the chatter in their brain. Or, give them some grounding sensory input. Ask them to lift the heavy bags or squeeze the coats very tightly or stomp their boots on.

Get them thinking logically. Try counting, reading, planning, or building. “Is your heart racing? Let’s see how many times it beats this minute.” “How many kids are on the playground?” “Let’s name all the streets on our way home.” 

Get them into what’s really happening in the present moment. Ask them to name:

• 5 things you can see

• 4 things you can feel

• 3 things you can hear

• 2 things you can smell

• 1 thing you can taste

Ask them to name five parts of their body they can move, to say what parts of them are touching the ground/the chair/the air. These work best if you’ve practiced it when they’re calm.

Get them moving. Running, jumping, dancing, holding something heavy. “Let’s wave our arms and get your brother’s attention.” Get their bodies moving, which gets them breathing and (hopefully) flushes out the stress.

Remind them they’ve survived panic before. Even for kids who know they are having a panic attack, it can feel like they can’t breathe or are in danger just from the attack itself. For kids who don’t know, it’s even scarier. Remind them: "This is a panic attack. It's happened before, and you got through it. You'll get through it today too." 

Tell yourself that too.

When they are calm

After the storm (hours later, even), loop back with some quiet reflection. 

Label it gently. “You had a scary thought, and your brain thought it was real. It got your body super freaked out, and then your thinking brain got overwhelmed. That’s something called a panic attack. It feels awful, but it’s something we can get through.”

The goal is to validate the experience, and help them recognize it next time.

Point out that they got through it. “It was hard, but you did it! You got your brain back online and calmed yourself down.” Again, the goal is to help them remember that next time.

Make a plan. Next time you’re going to be in that situation, or if you think the panic will recur, make a plan. You might know a trigger now, so how can you help in advance? Ask your child what was helpful, what they’d like to try. Give them some ideas and some agency in advance, so maybe they won’t spiral.

Help other adults help your child

Prepare other adults to be most helpful to your child.

• Tell them what happens in an empathetic way: “Poor kid sometimes has panic attacks and gets so worked up she forgets all the rules.”

• Tell them what they might see: “When she’s really scared, she sometimes gets really bossy and yells. She’s not being defiant, she’s trying to communicate her panic.” If they can “catch” the panic early, they might be able to stop the spiral.

• Tell them what to do: “Bring her to a quiet space and talk in a calm voice. Don’t try to reassure her, just listen. Offer to rub her hands or gently guide her into a song.”

One last thing

You’re not going to handle this perfectly. You’re going to say the wrong thing, try the wrong thing. You’ll end up dragging them off the playground, leaving one shoe and six shocked strangers in your wake. You’re going to resort to hissing, “Stop. Screaming. Or I am hucking the iPad. I am not going to be the airplane woman on YouTube today.” (Ahem, also non-hypothetical).

You’re going to be there, though, in it with them, as best as you can. You’re going to make that bubble for them and for yourself and try to stay calm and remember some of these steps.

You’re going to help them learn that even in panic, someone will stay with them, that even in chaos, they can make their way back to calm, and you can get through this together.

You got this.

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