If your child has abrupt, intense fear that comes intermittently, unpredictably, and is recurrent, she might have a panic disorder. A panic attack happens very fast, is intense, and will reach its peak within ten minutes. Panic disorder is not common in young children and affects most people beginning in late adolescence, up to midlife.

Physical Symptoms

In order to be diagnosed with panic disorder your child must experience recurrent attacks with at least one episode that is followed by one month of persistent worry about future attacks. The attacks must be experienced as having an apparent onset and reach a peak in ten minutes. There needs to be a sense of imminent danger as well as four or more of the following symptoms:

• Pounding heart rate or chest pain

• Trembling or shaking and/or dizziness

• Shortness of breath

• Nausea or stomachaches

• Choking feeling

• Fear of losing control or dying

• Numbness or tingling

• Chills, sweating, or hot flashes

• Feeling of unreality

Learning disorders may co-exist with panic disorders and should not be overlooked. If your child is having a hard time with school, it might not be just about his panic. If after you see a doctor and the panic disorder is treated, your child is still upset about going to school, this may be an indicator of an undiagnosed learning disability.

Risk Factors

While 10 percent of children will have at least one panic attack, only 1 to 2 percent will develop panic disorder. However, the experience of panic is so scary that your child or adolescent may live in dread of another attack. He may also go to great lengths to avoid situations that may bring on another attack. This can cause him to want to stay home from school and have anxiety when separated from his parents. Another risk factor is school avoidance. As seen in Chapter 3, school avoidance can be complicated and difficult to treat, so it is best to intervene at the first sign of trouble.

Of those adolescents who continue to have panic disorder as they go into adulthood, many will develop other psychiatric difficulties. Statistics show about half will develop agoraphobia and/or depression, and 20 percent will make suicide attempts, and/or develop alcohol or substance abuse issues. This disorder can also cause your child to believe he is unhealthy, go to the doctor often, and show significant social impairment.

The random nature of panic attacks is powerful and confusing. Since there is no reason outside her body for the worry, your child could start thinking there is something wrong inside her body. Left untreated, this could cause your child to stop most activity, especially outside the home, out of fear the panic will reoccur.