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Three simple yet effective tools for helping a child through a panic attack

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 anxietyyoutu.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.

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Three women, three MS journeys: How multiple sclerosis looks different for everyone

Gina, Nathalie and Helga share their reactions to being diagnosed with MS and how they stay informed and positive in the face of ever-changing symptoms.

Courtesy of Sanofi

Helga, Nathalie and Gina all have MS, and their experiences show how differently the disease can manifest.

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It’s been 155 years since neurologist Jean-Martin Charcot gave the first lecture on a mysterious progressive illness he called “multiple sclerosis.” Since then, we’ve learned a lot. We know MS causes the immune system to attack healthy tissue, including damaging the brain and spinal cord. Resulting symptoms can be debilitating and include fatigue, blurred vision, memory problems and weakness. Huge advancements in our understanding of MS and its underlying causes, as well as treatment advances, have been made in the past few decades, but MS remains a complex and unpredictable reality for the 2.8 million+ people diagnosed around the world.

Ironically, the only real constant for people living with MS is change. There’s no set pattern or standard progression of the disease, so each person’s experience is unique. Some people with MS have mild symptoms that worsen slowly but sometimes improve, while others can have severe symptoms that drastically alter their daily lives.

All people with MS share some things in common, however, such as the need to stay informed on the ever-evolving research, find various lines of support and try to remain hopeful as they continue living with the disease.

To better understand what navigating life with MS really looks like, three women shared their MS stories with us. Their journeys demonstrate how MS can look different for different people and interestingly, how the language used to talk about the disease can greatly impact how people understand their realities.

woman with horse, woman riding horseGina loves riding her horse, Benita.Courtesy of Sanofi

Gina—Hamburg, Germany (diagnosed with relapsing multiple sclerosis in 2017)

When her youngest son was 4 months old, Gina started having problems with her eye. She’d soon learn she was experiencing optic neuritis—her first symptom of MS.

“Immediately after the diagnosis, I looked up facts on MS because I didn’t know anything about it,” Gina says. “And as soon as I knew what could really happen with this disease, I actually got scared.”

As her family’s primary income provider, she worried about how MS would impact her ability to work as a writer and editor. Her family was afraid she was going to end up in a wheelchair. However, for now, Gina’s MS is managed well enough that she still works full-time and is able to be active.

“When I tell somebody that I have MS, they often don't believe me the first time because I don't fulfill any stereotypes,” she says.

Overwhelmed by negative perspectives on living with MS, Gina sought support in the online MS community, which she found to be much more positive.

“I think it’s important to use as many positive words as you can when talking about MS.” It’s important to be realistic while also conveying hope, she says. “MS is an insidious disease that can cause many bad symptoms…that can be frightening, and you can't gloss over it, either.”

To give back to the online community that helped her so much, Gina started a blog to share her story and help others trying to learn about their diagnosis.

Though she deals with fatigue and cognitive dysfunction sometimes, Gina stays active swimming, biking, riding horses and playing with her sons, who are now 11 and 6.

Cognitive dysfunction is common in MS, with over half of people affected. It can impact memory, attention, planning, and word-finding. As with many aspects of MS, some people experience mild changes, while others face more challenges.

Gina says that while there’s still a lot of education about MS needed, she feels positive about the future of MS because there’s so much research being done.

woman in wheelchair holding medal, woman rowingNathalie is an award-winning rower with multiple international titles.Courtesy of Sanofi

Nathalie — Pennes Mirabeau, France (diagnosed with relapsing-remitting multiple sclerosis in 2002)

Nathalie was a teenager and a competitive athlete when she noticed her first symptoms of MS, but it would take four years of “limbo” before she was diagnosed.

“Ultimately, the diagnosis was more of a relief, than a shock,” she says. “Because when you have signs and you don’t know why, it’s worse than knowing, in the end, what you have.”

However, learning more about the disease—and the realities of disease progression—scared her.

“That glimpse of the future was direct and traumatic,” she says. Her neurologist explained that the disease evolves differently for everyone, and her situation might end up being serious or very mild. So, she decided to stop comparing herself to others with MS.

She said to herself, “We’ll see what happens, and you’ll manage it bit by bit.”

By 2005, Nathalie’s MS had progressed to the point of needing a wheelchair. However, that has not dampened her competitive spirit.

Nathalie began her international rowing career in 2009 and has won multiple world titles, including two Paralympic medals—silver in London and bronze in Tokyo. Now, at 42, she still trains 11 times a week. Fatigue can be a problem, and sometimes hard workouts leave her with muscle stiffness and shaking, but she credits her ongoing sports career for helping her feel in tune with her body’s signals.

“Over the years, I’ve learned to listen to my body, letting my body guide when I need to stop and take breaks,” she says.

Nathalie explains that she used to only look backwards because of the initial shock of her diagnosis. In time, she stopped thinking about what she couldn’t do anymore and focused on her future. She now lives in the following mindset: “Even when doors close, don’t miss out on those that open.” Instead of focusing on what she can’t do, she focuses on the opportunities she still has. Right now, this includes her training for the 2024 Paralympic Games in Paris, where she will compete for another rowing medal.

“I only go forward,” she says. “Well, I try, anyway…It’s easy to say, it’s not always easy to do. But that’s what I try to do.”

woman exiting water after swimming, woman with great daneHelga's Great Dane has become a helpful and beloved companion.Courtesy of Sanofi

Helga—Johannesburg, South Africa (diagnosed with relapsing multiple sclerosis in 2010)

When Helga first started having balance issues and numbness in her feet, she chalked it up to her training as a runner. But when the numbness moved to her face, she knew something was wrong. She never guessed it was MS.

“When I was diagnosed, I felt completely overwhelmed and clueless,” Helga says. “I felt that I had nowhere near enough information. I did not know anything about the disease…I had no idea that it was going to be a process of continually monitoring and adjusting your lifestyle.”

In the beginning, Helga’s symptoms developed slowly, and she didn’t appear ill to others. She was even able to run for a few years after her diagnosis, but she couldn’t do marathons anymore, and she began to fall frequently due to balance issues and right-foot dragging. Then her cognition issues became more problematic, especially in her job as a trainer in a printing company.

“My executive function, decision-making and short-term memory were affected to the point that I was eventually medically unfit for work,” she says. She stopped working in 2017.

However, she didn’t stop living life. Even though she could no longer run, she continued to swim competitively. She got a Great Dane puppy and trained him as a service dog to help her walk. She also serves as vice chair of the patient support organization Multiple Sclerosis South Africa, and she advises others who have been diagnosed to join a patient advocacy group as soon as possible to get reliable information and meet others with MS.

Helga says she is “hopeful” about the future of MS. “I must say that I am so grateful that we have all the new medications available, because my life would not be the same if it wasn't for that,” she adds.

Part of how she manages her MS is by looking at the positives.

“If I could tell the world one thing about MS, it would be that MS is an incurable disease of the nervous system, but it's also the greatest teacher of valuing your health, family, friends, and managing change in your life,” she says. “My life is diversified in a way that I never, ever thought it would, and MS has been honestly the greatest teacher.”

Each MS journey is unique – with each person impacted experiencing different struggles, successes, and feelings as they manage this unpredictable disease. But the common thread is clear – there is a critical need for information, support, and hope. We are proud to participate in World MS Day and share these incredible stories of living life while living with MS. To learn more about MS, go to https://www.sanofi.com/why-words-really-matter-when-it-comes-to-multiple-sclerosis.

MAT-GLB-2301642-v1.0-05/2023

This article was sponsored by Sanofi. Participants were compensated when applicable.

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