Panic Disorder in Teens and Children

Clear, proven tools to help young people stop fearing panic and get back to life.

What we treat

When fear strikes out of nowhere

A panic attack is a sudden rush of intense fear with strong physical symptoms, like a racing heart, shortness of breath, dizziness, or nausea. Many young people have a panic attack at some point. Panic disorder is when attacks happen repeatedly and a child starts to live in fear of the next one. It is very treatable.

How commonAbout 1 in 43 teens have had it at some point

Typical onsetMost often in the teen years

First-line treatmentCBT for panic, including exposure to body sensations

FormatIn person or telehealth

Understanding panic

What panic looks like in kids and teens

Panic attacks feel frightening, and many kids and teens believe something is medically wrong, like a heart problem, or that they might faint or lose control. They start to watch their body closely and avoid places where an attack might happen, which keeps the cycle going.

During an attack

Pounding heart. Chest tightness or trouble breathing. Dizziness or feeling faint. Shaking, sweating, or nausea. Feeling unreal or detached.

Common fears

Having a heart attack or not being able to breathe. Fainting or throwing up in public. Losing control or going crazy. Being far from help.

What parents notice

Repeated ER or doctor visits with normal results. Avoiding exercise, crowds, or school. Needing a parent nearby. Worry about the next attack.

When to reach out

Your child has had more than one unexpected panic attack
Fear of the next attack has lasted for a month or more
Your child avoids exercise, school, or leaving home
Medical visits have ruled out a physical cause
Your child needs a parent or safe person nearby
Panic is affecting school, sleep, or friendships

Rule out medical causes first

Because panic symptoms feel physical, we recommend a check-up with your pediatrician to rule out medical causes before treatment.

Panic disorder becomes more common through the teen years^[1]. Once medical causes are ruled out, young people can learn that panic sensations are uncomfortable but not dangerous.

How we treat it

Our approach to panic disorder

We use cognitive behavioral therapy (CBT) adapted for panic, the approach recommended for childhood anxiety disorders by the American Academy of Child and Adolescent Psychiatry^[3]. A controlled trial found that CBT for adolescent panic disorder reduced panic severity compared with a control condition^[2].

A thorough evaluation. We learn about your child's attacks, what they fear will happen, and what they have started to avoid.
Understanding panic. Teens learn how the body's alarm system works and why panic symptoms are not harmful.
Rethinking fears. We test catastrophic thoughts like “I'm having a heart attack” against the evidence.
Facing sensations. Through safe exercises like spinning or running in place, kids learn that sensations like a racing heart or dizziness can be tolerated.
Returning to life. Step by step, your child goes back to activities and places they have been avoiding.
Coaching parents. Parents learn to respond calmly, reduce reassurance and accommodation, and support independence.

Working with school: With your permission, we can coordinate with school staff so your child has a supportive plan without relying on leaving class or going home.

The evidence

What the research says

Panic disorder often begins in adolescence, and CBT has research support for helping teens overcome it.

2.3%

of U.S. adolescents have experienced panic disorder at some point, in a national survey of more than 10,000 teens.

Merikangas et al., 2010 [1]

3.3%

of 17- and 18-year-olds have experienced panic disorder, compared with 1.8% of 13- and 14-year-olds, as rates rise through the teen years.

Merikangas et al., 2010 [1]

11 weeks

of CBT for adolescent panic disorder led to greater reductions in panic severity than a self-monitoring control condition.

Pincus et al., 2010 [2]

The AACAP 2020 guideline recommends CBT for children and adolescents with panic disorder^[3].
Learning to face feared body sensations, called interoceptive exposure, is a core part of effective panic treatment^[2].

Research results describe averages across groups of children. Every child is different, and we track your child's progress with standardized measures throughout treatment.

Common questions

Is my child in danger during a panic attack?

Panic attacks feel scary but are not physically dangerous. Still, we recommend a medical check-up to rule out other causes before starting treatment.

What should I do when my child is panicking?

Stay calm, speak slowly, and remind your child that the feeling will pass. We will teach you specific ways to respond that help rather than feed the fear.

Can younger children have panic disorder?

Yes, though it is less common before adolescence. We adapt treatment for younger children with more parent involvement and simpler language.

Does telehealth work for panic?

Yes. CBT for panic works well by telehealth, including practicing body-sensation exercises at home with guidance.

References

Merikangas, K. R., He, J. P., Burstein, M., et al. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: Results from the National Comorbidity Survey Replication–Adolescent Supplement (NCS-A). Journal of the American Academy of Child & Adolescent Psychiatry, 49(10), 980–989. View study
Pincus, D. B., May, J. E., Whitton, S. W., Mattis, S. G., & Barlow, D. H. (2010). Cognitive-behavioral treatment of panic disorder in adolescence. Journal of Clinical Child & Adolescent Psychology, 39(5), 638–649. View study
Walter, H. J., Bukstein, O. G., Abright, A. R., et al. (2020). Clinical practice guideline for the assessment and treatment of children and adolescents with anxiety disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 59(10), 1107–1124. View guideline