Panic Attack Treatment for Children and Teens
Panic attacks can be frightening and overwhelming for children and adolescents. A panic attack involves a sudden surge of intense fear or discomfort accompanied by physical sensations such as a racing heart, shortness of breath, dizziness, shaking, nausea, chest discomfort, sweating, or feeling detached or unreal. These sensations can feel alarming, and children may worry that they are going to faint, lose control, become seriously ill, or experience another panic attack.
For some children and teens, panic attacks begin to create a cycle of fear. They may become highly focused on physical sensations, repeatedly check how their body feels, seek reassurance, or avoid situations where they worry a panic attack could occur. School, exercise, restaurants, travel, crowded places, being away from parents, or other everyday activities may gradually become more difficult.
The good news is that panic attacks and panic disorder are highly treatable. As a board-certified child and adolescent psychologist, Dr. Diana Bastien specializes in the evidence-based treatment of pediatric anxiety disorders using Cognitive Behavioral Therapy (CBT) and exposure-based interventions. Treatment helps children and adolescents understand panic, reduce fear of uncomfortable physical sensations, and regain confidence in their ability to participate fully in everyday life.
What Are Panic Attacks?
A panic attack is a sudden episode of intense fear or discomfort that is accompanied by significant physical symptoms. Panic attacks can occur unexpectedly or in response to situations that a child has begun to associate with anxiety.
Common symptoms may include:
Racing or pounding heartbeat
Shortness of breath or a feeling of not getting enough air
Chest tightness or discomfort
Dizziness, lightheadedness, or feeling faint
Shaking or trembling
Sweating or feeling unusually hot or cold
Nausea or stomach discomfort
Tingling or numbness
Feeling detached from oneself or one's surroundings
Fear of losing control, fainting, becoming ill, or something terrible happening
Persistent worry about having another panic attack
After experiencing a panic attack, children and teens may begin monitoring their bodies closely for signs that another attack is beginning. Normal changes in heart rate, breathing, dizziness, or other physical sensations can then become frightening themselves, creating a cycle in which fear of panic contributes to additional panic symptoms.
When worry about future panic attacks or avoidance related to panic begins to significantly interfere with daily functioning, a child may meet criteria for panic disorder.
How Dr. Bastien Treats Panic Attacks and Panic Disorder
Comprehensive Evaluation
Treatment begins with a comprehensive psychological evaluation to understand your child's symptoms, identify patterns contributing to panic, and develop an individualized treatment plan.
Careful assessment is particularly important because panic-like symptoms can occur in several anxiety disorders and may also overlap with physical health concerns. Evaluation explores when panic symptoms occur, what your child fears the sensations mean, situations they may be avoiding, reassurance or safety behaviors they rely on, and whether additional anxiety or related concerns are present.
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy (CBT) is an evidence-based treatment for panic disorder in children and adolescents.
Treatment begins by helping children understand the body's natural alarm system and why anxiety can produce intense but temporary physical sensations. Children learn how fear of these sensations can unintentionally amplify them and contribute to the panic cycle.
Therapy may help children and teens:
Understand the connection between physical sensations, anxious thoughts, and panic
Identify catastrophic interpretations of normal bodily sensations
Respond more flexibly to sensations such as a racing heart, dizziness, or shortness of breath
Reduce body checking, reassurance seeking, and other anxiety-driven safety behaviors
Gradually return to situations or activities they have begun avoiding
Build confidence in their ability to experience anxiety without needing to escape from it
The goal is not to teach children that they must prevent every anxious sensation. Instead, treatment helps them learn that uncomfortable sensations can be tolerated and do not need to control their behavior.
Interoceptive Exposure
Interoceptive exposure is a specialized form of exposure therapy used in the treatment of panic. It involves intentionally and systematically practicing safe physical sensations that a child has learned to fear.
For example, depending on the child's symptoms and treatment needs, carefully selected exercises may recreate sensations such as an increased heart rate, mild dizziness, warmth, or changes in breathing.
These exercises allow children to learn through direct experience that physical sensations associated with anxiety are temporary, manageable, and do not necessarily signal danger.
Interoceptive exposures are individualized based on each child's age, symptoms, medical history, and specific fears. Treatment progresses systematically and is designed to help children develop confidence rather than continue organizing their lives around avoiding uncomfortable sensations.
Situational Exposure
Children who experience panic often begin avoiding places or activities associated with previous panic attacks or situations where they fear it would be difficult to leave or obtain help.
Treatment may therefore include gradual exposure to situations such as:
Returning to school or remaining in class when anxious
Exercising or participating in sports
Riding in a car or using public transportation
Entering crowded stores, restaurants, theaters, or other public spaces
Traveling farther from home
Spending time away from parents
Participating in activities previously avoided because of fear of panic
Repeated practice helps children learn that they can remain in situations even when anxiety is present and that panic sensations do not need to determine where they can go or what they can do.
Parent Involvement
Parents play an important role in helping children recover from panic. Understandably, families may begin changing routines, providing repeated reassurance, allowing children to leave situations early, or helping them avoid activities in an effort to prevent distress.
Although these responses can provide immediate relief, they may unintentionally reinforce the belief that panic sensations are dangerous or cannot be tolerated.
Dr. Bastien works closely with parents to help them:
Understand the panic cycle and the role of avoidance
Respond supportively without reinforcing fear
Reduce repeated reassurance and anxiety-driven accommodation
Support exposure practice between sessions
Encourage continued participation in school and everyday activities
Reinforce confidence, independence, and willingness to experience discomfort
Why Early Treatment Matters
When children begin fearing panic itself, their world can become progressively smaller. They may stop exercising, avoid school or social activities, remain close to parents, or increasingly organize their lives around preventing another panic attack.
Early, specialized treatment can interrupt this cycle before avoidance becomes more established. By learning that physical sensations can be experienced without danger and that anxiety can be tolerated without escape, children and adolescents can regain independence and confidence in their ability to navigate everyday life.
Request an Appointment
If your child or teen is experiencing panic attacks, worrying about having another attack, or avoiding activities because of fear of physical sensations, specialized treatment can make a meaningful difference.
Treatment begins with a comprehensive psychological evaluation to better understand your child's symptoms and develop an individualized treatment plan based on their unique needs.
Request an appointment today to learn how specialized, evidence-based psychological care can support your child's recovery.