What Causes Panic Attacks and What Can You Do About Them?

Imagine this: your child is sitting on the couch, watching TV, when suddenly their chest tightens, their hands tingle, and they can’t catch their breath. Their face looks terrified, their body goes limp, and they say they feel like they’re dying.

You rush to the ER, certain it must be something serious—maybe asthma, maybe their heart. But after the exam, the doctor looks at you calmly and says: “This was a panic attack.”

If you’ve ever been in that situation, you know how hard it is to believe. How can something that looks and feels so severe be “just” a panic attack?

That’s the mystery I explored in a recent episode of The Pediatrician Next Door: are panic attacks all in your child’s head, or is something real happening in their body?

Panic Attacks vs. Anxiety Attacks: Not the Same Thing

One of the first things I learned (and yes, I was embarrassed I didn’t know this before!) is that panic attacks and anxiety attacks are not the same.

• Anxiety attacks happen when a child is worried or stressed about something specific, and their body reacts.

• Panic attacks can happen completely out of the blue, without any trigger at all. They also leave a lingering fear that it will happen again — which can make kids even more anxious in the long run.

That difference matters, because how we treat and support kids will depend on which one they’re experiencing.

What’s Actually Happening During a Panic Attack

A panic attack isn’t imaginary. It’s a physiological cascade in the body.

Here’s what happens:

• The brain’s alarm system misfires and signals danger.

• Adrenaline floods the system.

• Heart rate speeds up, breathing becomes shallow, blood flow shifts — causing dizziness, tingling, and chest pain.

Your child’s body thinks it’s running from a lion, even if they’re just sitting on the sofa. That’s why panic attacks feel so terrifying and so real.

Why Kids Can’t Just “Snap Out of It”

Parents often try to reason with their child during a panic attack: “Calm down, you’re fine.” But here’s the truth: logic doesn’t work.

When the amygdala (the brain’s alarm center) takes over, the part of the brain that handles problem-solving and reasoning essentially goes offline. Kids can’t talk or think their way out of it.

It’s not stubbornness. It’s biology.

What Actually Helps

If reasoning doesn’t work, what does? The answer is surprisingly simple: co-regulation and body-based techniques.

• Co-regulation means lending your calm to your child. Sit with them, keep your voice steady, model slow breathing. Your presence anchors their nervous system.

• Breath control helps slow the alarm. Try guiding your child to breathe in for four counts, out for six.

• Grounding pulls kids back into the present moment. Ask them to name five things they can see, four they can feel, three they can hear, two they can smell, and one they can taste.

These strategies signal safety to the brain and help the body reset.

The Takeaway

Panic attacks are not “all in your child’s head.” They’re real, physical, and frightening. But they’re also treatable. With practice, families can learn tools to help kids ride out the storm and feel more in control.

If you want to hear more—including pediatrician Dr. Natasha Burgert’s practical strategies—listen to my full podcast episode - linked at the bottom of this page.

And if your child struggles with anxiety or panic, I highly recommend my guest, Dr. Natasha Burgert’s book, Managing Childhood Anxiety for Dummies. It’s full of simple, evidence-based tools that really work.

👉 Your Turn: Has your child ever had a panic attack? What helped you in the moment? Share your experience by writing an Apple Podcasts review or contact me —I’d love to hear from you.