Three simple yet effective tools for helping a child through a panic attack
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The first time one of my kids had a panic attack, I didn't have any idea what to do. The pounding heartbeat, racing thoughts, shortness of breath, and feeling like you're losing control are disconcerting symptoms for adults to experience, but they're even more alarming for a child who doesn't know why it's happening. As a parent, it's scary not knowing how to help your child when they clearly need help.

The exact cause of panic disorder is unknown, but experts estimate it affects close to 4 percent of the population. Like other anxiety disorders, it also tends to run in families, which appears to be the case for my kiddos. But even people who don't have a full-fledged disorder can occasionally experience a panic attack, and it's good to know what actually helps.

My youngest was around six years old when he had his first bout of panic. It wasn't long after we'd tucked him into bed when he called for me with a shaky urgency in his voice. When I got to his room, he said he couldn't breathe and that his heart was going really fast. "I don't know what's going on," he said through chattering teeth. "My whole body won't stop shaking and I'm freaking out."

I immediately recognized the signs of panic, having gone through it with his older sister, but he was a lot younger than she had been when she had her first episode. Thankfully, the tools we used with her also worked with him.

Here's how we help our kids through a panic attack:


1) Verbalize what's happening to them.

Panic attacks are intense for the person experiencing them and saying something like "Calm down" isn't really helpful. They want to calm down, they just can't.

For our kids, explaining exactly what's happening, what they can expect to happen, and what they actually can control is the first step toward regaining calm. After the first time through it, they don't need this much detail, but here's a basic script of where we started:

"You're okay, even though it doesn't feel like it. You're just having a panic attack. The fear part of your brain is sort of stuck for a bit, and it keeps revving up your body. It's like your brain thinks there's a tiger chasing you, even though there isn't. That makes your heart beat really fast and makes it hard to breathe. You might feel like you're losing control. You might even feel like you're going crazy. But it'll pass soon, I promise. Panic attacks are just temporary glitches. Your brain and body will calm back own, usually within ten minutes or so. Let's work on helping you feel better while it works its way out of your system."

2) Use "box breathing" to help them catch their breath.

Breathing intentionally is one of the quickest ways to reset when your body is in a heightened state. The best technique we've encountered for this is an exercise called "box breathing" or "square breathing." It's actually a tool Navy Seals use to keep calm under stress, but it's so simple even kids can use it.

Slowly draw the shape of a square in the air, starting from the bottom left-hand corner. As you draw the first line upward, have your child breathe in for a count of five. Then have them hold their breath while you draw the top line, then exhale while you draw down the right side. Finally, have them hold the exhale while completing the square with the bottom line. Then repeat—breathe in, hold, breath out, hold. Around four or five seconds for each breath and hold wonders for getting breathing under control, which helps calm the brain and body.

Here's a quick video that shows how it works. (With our kids, I usually draw the box for them while talking them through the breaths and holds at first, then have them start drawing the box with me as they start to calm down.)

Box breathing relaxation technique: how to calm feelings of stress or anxiety youtu.be


3) Ground them in reality with the "4-3-2-1" exercise.

Panic is the brain gripped by a state of fear that doesn't reflect what's actually happening. It's basically the amygdala—the fight or flight center of the brain—wigging out for no apparent reason. The intense fear triggers the fight or flight response, forming a sort of feedback loop, with the body freaking out because the brain's freaking out, which makes the body freak out, and so on.

Getting the brain to focus on the body's physical senses can help break that loop and bring the body and brain back to a state of calm (or at least calmer). For this, we use a simple grounding exercise we call "4-3-2-1." (What we do is a variation of the 5-4-3-2-1 method developed by Captain Tom Bunn to help people cope with a fear of flying. You can see that method here.)

Have the child look for and then name, out loud:

- Four things they can see. ("I see my lamp. I see the cat. I see the window. I see my teddy bear.").

- Three things they can feel. ("I feel my pillow. I feel your hand. I feel the sheets.")

- Two things they can hear. ("I hear cars outside. I hear the heater running.")

- One thing they can smell. ("I smell your lotion.")

I always have the kids say a full sentence for each thing they count, as that reinforces the physical aspect of the exercise. Without fail, my kiddos are always calmer when they get to what they can smell. Super simple, but super effective.

It's important to note that these exercises don't stop an attack in its tracks. Panic usually just has to run its course. What they do is take the edge off, make the attack more tolerable, and help the kiddo wait it out without feeling like they have no control at all while it's happening.

Panic attacks and anxiety attacks (which share similar symptoms and can respond to the same tools) aren't fun for kids or for parents. But when a kid knows what's happening and a parent has tools to help them manage it, they're a lot less scary for everyone involved.

Connections Academy

Wylee Mitchell is a senior at Nevada Connections Academy who started a t-shirt company to raise awareness for mental health.

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Teens of today live in a totally different world than the one their parents grew up in. Not only do young people have access to technologies that previous generations barely dreamed of, but they're also constantly bombarded with information from the news and media.

Today’s youth are also living through a pandemic that has created an extra layer of difficulty to an already challenging age—and it has taken a toll on their mental health.

According to Mental Health America, nearly 14% of youths ages 12 to 17 experienced a major depressive episode in the past year. In a September 2020 survey of high schoolers by Active Minds, nearly 75% of respondents reported an increase in stress, anxiety, sadness and isolation during the first six months of the pandemic. And in a Pearson and Connections Academy survey of US parents, 66% said their child felt anxious or depressed during the pandemic.

However, the pandemic has only exacerbated youth mental health issues that were already happening before COVID-19.

“Many people associate our current mental health crisis with the pandemic,” says Morgan Champion, the head of counseling services for Connections Academy Schools. “In fact, the youth mental health crisis was alarming and on the rise before the pandemic. Today, the alarm continues.”

Mental Health America reports that most people who take the organization’s online mental health screening test are under 18. According to the American Psychiatric Association, about 50% of cases of mental illness begin by age 14, and the tendency to develop depression and bipolar disorder nearly doubles from age 13 to age 18.

Such statistics demand attention and action, which is why experts say destigmatizing mental health and talking about it is so important.

“Today we see more people talking about mental health openly—in a way that is more akin to physical health,” says Champion. She adds that mental health support for young people is being more widely promoted, and kids and teens have greater access to resources, from their school counselors to support organizations.

Parents are encouraging this support too. More than two-thirds of American parents believe children should be introduced to wellness and mental health awareness in primary or middle school, according to a new Global Learner Survey from Pearson. Since early intervention is key to helping young people manage their mental health, these changes are positive developments.

In addition, more and more people in the public eye are sharing their personal mental health experiences as well, which can help inspire young people to open up and seek out the help they need.

“Many celebrities and influencers have come forward with their mental health stories, which can normalize the conversation, and is helpful for younger generations to understand that they are not alone,” says Champion.

That’s one reason Connections Academy is hosting a series of virtual Emotional Fitness talks with Olympic athletes who are alums of the virtual school during Mental Health Awareness Month. These talks are free, open to the public and include relatable topics such as success and failure, leadership, empowerment and authenticity. For instance, on May 18, Olympic women’s ice hockey player Lyndsey Fry will speak on finding your own style of confidence, and on May 25, Olympic figure skater Karen Chen will share advice for keeping calm under pressure.

Family support plays a huge role as well. While the pandemic has been challenging in and of itself, it has actually helped families identify mental health struggles as they’ve spent more time together.

“Parents gained greater insight into their child’s behavior and moods, how they interact with peers and teachers,” says Champion. “For many parents this was eye-opening and revealed the need to focus on mental health.”

It’s not always easy to tell if a teen is dealing with normal emotional ups and downs or if they need extra help, but there are some warning signs caregivers can watch for.

“Being attuned to your child’s mood, affect, school performance, and relationships with friends or significant others can help you gauge whether you are dealing with teenage normalcy or something bigger,” Champion says. Depending on a child’s age, parents should be looking for the following signs, which may be co-occurring:

  • Perpetual depressed mood
  • Rocky friend relationships
  • Spending a lot of time alone and refusing to participate in daily activities
  • Too much or not enough sleep
  • Not eating a regular diet
  • Intense fear or anxiety
  • Drug or alcohol use
  • Suicidal ideation (talking about being a burden or giving away possessions) or plans

“You know your child best. If you are unsure if your child is having a rough time or if there is something more serious going on, it is best to reach out to a counselor or doctor to be sure,” says Champion. “Always err on the side of caution.”

If it appears a student does need help, what next? Talking to a school counselor can be a good first step, since they are easily accessible and free to visit.

“Just getting students to talk about their struggles with a trusted adult is huge,” says Champion. “When I meet with students and/or their families, I work with them to help identify the issues they are facing. I listen and recommend next steps, such as referring families to mental health resources in their local areas.”

Just as parents would take their child to a doctor for a sprained ankle, they shouldn’t be afraid to ask for help if a child is struggling mentally or emotionally. Parents also need to realize that they may not be able to help them on their own, no matter how much love and support they have to offer.

“That is a hard concept to accept when parents can feel solely responsible for their child’s welfare and well-being,” says Champion. “The adage still stands—it takes a village to raise a child. Be sure you are surrounding yourself and your child with a great support system to help tackle life’s many challenges.”

That village can include everyone from close family to local community members to public figures. Helping young people learn to manage their mental health is a gift we can all contribute to, one that will serve them for a lifetime.

Join athletes, Connections Academy and Upworthy for candid discussions on mental health during Mental Health Awareness Month. Learn more and find resources here.

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