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(p. 145) What To Do (and Not To Do) in the Face of Panic 

(p. 145) What To Do (and Not To Do) in the Face of Panic
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date: 10 December 2019

Now that your teen is engaging in various exposures and no longer avoiding situations that make him feel anxious, you may actually notice an increase (for a short time) in the number of panic attacks that he has. It is important, therefore, that you know how to handle a panic attack (or a potential panic attack).

Panic attacks not only feel scary to the person experiencing them, they often look scary to other people. When your teen is in the midst of a panic attack, he may cry, scream, shake, hyperventilate, and say things such as “I think I’m dying!” or “I’m losing it!” or “I think I’m going to faint!” Being in close proximity to such high levels of emotion is enough to make anyone feel anxious or worked up, but for parents to witness such emotion in their own child can be heartbreaking. As stated earlier, one of the most basic parental instincts is to protect your child, so when your teen gets upset, you want to jump in and fix things. However, as you have learned by now, while panic feels (and looks) scary, it is, in fact, harmless. So, while you may want to calm your child down because he looks so distressed, some of the ways in which you may interact with your teen during panic attacks can inadvertently make the situation worse.

Downward Spiral of Panic #1: Mimicking Your Teen’s Panic

The teen starts to panic. (Oh my God, I can’t breathe!) ?

The parent gets upset and responds with strong emotion. (What do you mean you can’t breathe? You need to sit down, you’re white as a sheet!) ?

The teen, feeding on the parent’s alarmed reaction, continues to panic. (I don’t feel right—my heart is pounding, my chest hurts, I can’t breathe!!) ?

The parent, getting more frightened, becomes frantic. (We need to get you out of the store! Maybe we should call the doctor!) ?

(p. 146) The teen, seeing how scared and upset the parent is, becomes even more frightened, and the panic increases. (The doctor?!? Oh my God, I’m dying, aren’t I! I’m having a heart attack!) ?

This cycle of upset continues until the panic attack naturally subsides.

Downward Spiral of Panic #2: Desperately Seeking Calm

The teen starts to panic. (Oh my God, I can’t breathe!) ?

The parent gets upset and tries to calm the teen down. (What’s the matter? Are you hyperventilating? We need to find you a paper bag!) ?

The teen, responding to the parent’s cue that hyperventilating is dangerous, continues to panic. (No, really, I can’t breathe! I do need a paper bag! I need to sit down!) ?

The parent starts frantically trying to get the teen to calm down. (Just try breathing slowly, like this, in and out, in and out.) ?

The teen tries this, but because the panic has already escalated, cannot do so. (I am trying, but I can’t. I can’t catch my breath! Something must be really wrong with me!!) ?

This cycle of upset continues until the panic attack naturally subsides.

Ideal Responses to Your Teen’s Panic

Instead of participating in the downward spiral of panic, we recommend that you stay calm in the face of your teen’s panic. Emphasize that he has the skills to handle the panic and that it is not dangerous. Be empathic—remind him that you know it is uncomfortable, but that it is short-lived and will be over soon. Sometimes, in the very early stages of a panic attack, teens might be able to calm themselves down and prevent a full attack from occurring. Once it has reached a critical point, however, there is just no way to stop the attack from coming, and they need to “ride the wave” of anxiety.

(p. 147) The Ideal #1: Prevented Panic

The teen starts to panic. (Oh my God, I can’t breathe!) ?

The parent remains calm and reassuring. (You’re starting to feel really anxious; that makes sense since this is the first time you’ve been to this mall in a long time. Try to use your skills to calm yourself down.) ?

The teen uses some cognitive restructuring and/or limited relaxation skills and is able to calm down and prevent the panic attack.

The Ideal #2: The Minimized Attack

The teen starts to panic. (Oh my God, I can’t breathe!) ?

The parent remains calm and reassuring. (You’re starting to feel really anxious; that makes sense since this is the first time you’ve been to this mall in a long time. Try to use your skills to calm yourself down.) ?

The teen tries to use the skills, but continues to panic. (I’ve tried everything! I can’t calm down; I need to get out of here!) ?

The parent remains calm, reminds the teen of what he already knows, and tries to focus on a post-panic reward. (OK, so you might have a panic attack. I know you’re uncomfortable, but you’re not in any danger. We can’t leave because, if we do, the panic wins. How about we go sit on that bench over there until it passes? Once it does, we can continue with our quest for the perfect pair of back-to-school shoes.) ?

The teen does have a panic attack, but is able to put it in perspective afterwards. (That wasn’t as bad as some other ones. I was able to remember that it wouldn’t last forever and that I wasn’t going to die.)

Remember that with thoughtful/mindful parenting, you want to consider what message your actions/behaviors send to your teen. If you get frantic, look scared, or desperately try to get your teen to calm down, you further the notion that panic is bad or dangerous and must be stopped immediately. If you remain calm, however, you send the signal that your teen is going to be fine, whether or not he actually panics.