Panic disorder is a health condition that causes the person to experience recurrent panic attacks and persistent fears of having other attacks in the future.
A panic attack is a brief period of intense fear or discomfort accompanied by distinct symptoms. A panic attack typically comes to an end and gradually alone rarely lasts more than 10 minutes.
Symptoms may include heart palpitations, chest discomfort, sweating, nausea, hot flashes or cold, shortness of breath, dizziness, derealization, my fear of losing control or fear of dying.
These symptoms, which seem very real to the person, probably reflects the intention of the body to react to a strong signal "fight or flight" that is beyond the conscious control of the person.
What Is The Panic Syndrome In Youth (Children and Adolescents)?
Unlike mild and occasional concerns that a child often has panic disorder can dramatically affect a child's life, disrupting the normal activities of him or her when a panic episode occurs or when the child becomes frightened and worried about the next panic attacks.
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Some children and adolescents with panic disorder avoid places where they think they can have panic attacks, or have constant fear of being or going to places where there is no help available if there's a panic attack.
This fear of behavior with certain places and avoid them is called agoraphobia. Young people who have panic disorder with agoraphobia often avoid places with large numbers of strangers, as the school amphitheater, large parties and restaurants.
Many children and adolescents have panic attacks isolated, it does not require intervention because they are non-recurring. A small number of children and adolescents develop panic disorder.
The tendency to develop panic disorder involves genetic and environmental factors. Panic disorder affects up to 5% of adolescents and are less common in children.
How Is The Panic Syndrome In Children And Adolescents?
Panic disorder often looks different in young compared to panic disorder in adults because children tend to report physical symptoms that accompany panic attacks just in time to manifest psychological symptoms.
A child having a panic attack can be frightened or angry suddenly, without any clear explanation. This behavior is often confusing to other people.
Sometimes the child having a panic attack explains his symptoms incorrectly, as a response to an external cause (for example, "It started when I saw that dog").
These children, especially if they are too young, may not be able to articulate the intense fears they experience during a panic attack. Already teenagers are better able to describe what they went through, particularly after the panic attack passed.
Panic disorder is different predictable panic attacks. If a child has a predictable fear of a particular situation (such as a meeting with a new person) or predictably panics to see something he or she finds scary (like a spider), the child may have a phobia rather than Panic Syndrome.
Phobias are intense fears predictably triggered by certain situations or objects. Phobias include social phobia (associated with intense fear to be exposed to new people) and specific phobias (associated with intense fear of being exposed to situations or objects).
If left untreated, panic disorder can lead to considerable limitations in other areas of the child's life.
Relationships with colleagues, school performance and family relationships can suffer, and it is possible the child to develop depression.
In some situations, in response to extreme anxiety, social isolation, and limited activities, a child may develop thoughts of self mutilation.
A trained doctor (as with child psychiatrist, child psychologist or pediatrician neurologist) should include information collected at home and at school to make the diagnosis.
At home
Children with panic disorder
Children with panic disorder may feel less pressure at home than at school to hide their symptoms. As a result, they tend to have more symptoms at home, whether the fact the case. Symptoms may include a combination of the following:
Episodes of fear or recurring physical discomfort that appear "out of nowhere" and are brief. Typically, panic attacks reach their maximum at 10 minutes.
recurrent episodes that are accompanied by physical symptoms such as racing heart, difficulty breathing, chest pain, feeling of choking, dizziness or fainting, tremors, nausea, or waves of cold / heat.
recurrent episodes which may include psychological symptoms or concerns, such as fear of losing control, fear of "going crazy" or fear of dying. Other symptoms include secluded feel of a body or feeling detached from reality.
Persistent concern about future panic attacks
The fear of being trapped in places or situations where escape may be difficult or embarrassing, especially if a panic attack. These locations include populated areas, public places (malls, restaurants), bridges or enclosed spaces such as elevators, cars or trains. Stand alone or in a queue can also be distressing.
Avoid places where the child is afraid that an attack may occur or where help may not be available. Some children can go to these places only in someone else's company.
Difficult to explain the unusual behavior. Children with panic disorder may not be able to explain what their symptoms or concerns, or because they feel forced to avoid certain places.
Feeling out of control and frightened by the unpredictability of panic attacks.
Low self-esteem, isolation from colleagues, and reluctance to participate in activities.
Experimentation with alcohol or drugs as a way of reducing suffering. Drugs and alcohol may produce or aggravate the symptoms of panic.
Depression or suicidal thoughts can develop when children mistakenly believe that there are no interventions to reduce the symptoms of panic.
In school
A student with panic disorder may have panic attacks at school, although the child may try to hide the symptoms while at school. As a result, a child may appear to have more symptoms at home than at school.
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The child may also avoid or can not describe the attacks, which can lead to confusion in school about the nature of the child's symptoms.
At school, children with panic disorder may have a combination of the symptoms listed below:
recurrent panic attacks that appear "out of nowhere".
sudden interruption without clear explanation. Children and adolescents may need assistance from an adult to understand and express their symptoms.
Low self-esteem in social and academic activities.
Difficulty concentrating due to persistent concern that can affect a variety of school activities, provided follow instructions and complete tasks to pay attention.
Difficulty separating from parents, home problems of transition to school, reluctance to attend school, or avoid recreation with colleagues.
Other conditions such as Attention Deficit / Hyperactivity Disorder (ADHD), may also be present, adding to difficulties in learning. Also, having a mental health condition does not "inoculate" the child to have other conditions.
Additional anxiety disorders such as social phobia, separation anxiety and anxiety generalizada.Os anxiety disorders can not be recognized either because the children may try to hide the symptoms and because their symptoms occur internally and are not easily seen.
Learning disorders can coexist and should not be forgotten. The difficulties of a child in school should not be presumed to be entirely due to the pânico.Se syndrome children still have academic difficulty after symptoms are treated, an educational evaluation for a learning disorder should be considered. Reluctance repeated to attend school may be an indicator of an undiagnosed learning disability.
Side effects of medications that may interfere with the performance escolar.Uma time that the child is receiving treatment for the symptoms, new changes in mood or behavior should be discussed with the parents, as they may reflect the side effects of medications.
As The Panic Syndrome is Treated?
Panic disorder is treated through ongoing interventions provided by the child's doctor, therapists, school staff and family.
These treatments include psychological interventions (counseling), biological interventions (drugs) and accommodation at home and at school, that reduce sources of stress for the child.
The open and collaborative communication among family professionals, school and treatment of a child optimizes the care and quality of life for children with panic disorder.
Psychological interventions (counseling)
Counseling can help children with panic disorder, and all around you, to understand that panic disorder symptoms are caused by a disease with complex genetic and environmental origins – not failed attitude or personality.
Counseling can also reduce the impact of symptoms on daily life. A variety of psychological interventions may be useful, and parents should discuss the specific needs of their children with your doctor to determine which psychological treatments could be more beneficial for your child.
Individual psychotherapy is usually recommended as first-line treatment for children and adolescents with panic disorder. Children with panic disorder can lead to feelings of failure, as if the disease were their fault. Individual psychotherapy can help reduce the symptoms, and can help young people to be aware and treat her feelings of failure and self blame.
The Cognitive Behavioral Therapy (CBT) can teach young people new skills to reduce anxiety that can lead to panic attacks. In Cognitive Behavioural Therapy, a child or adolescent is encouraged to become aware and to describe negative thoughts, feelings or reactions.
A trained physician guides the child to think of new alternatives, more positive, including techniques to predict and prevent the onset of panic attacks. The young man then gets the opportunity to practice new thoughts, feelings or reactions out of the consultation and discuss their experiences with the doctor later. These methods are based on well-researched practices that have helped many adults with panic disorder.
orientation sessions for parents can help parents control the disease to their children, identify effective skills, learn to live with the family despite the disease, and address complex feelings that can arise when raising a child with a psychiatric disorder. Family therapy may be beneficial when issues are affecting the family as a whole.
The group psychotherapy can be valuable to a child by providing a safe place to talk to other children facing adversity or allow a child to practice social skills and combat skills to the symptoms in a carefully structured environment.
Advice based on the school can be effective in helping a child with panic syndrome meet social demands, behavioral and academic school environment.
Biological interventions (medicines)
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Although psychotherapy may be sufficient to treat some children with panic disorder, the symptoms of other children do not improve significantly with psychotherapy alone. These children may benefit from medications.
ANVISA does not approve specific drugs for the treatment of panic disorder in children and adolescents. However, the drugs approved for other uses and age groups are prescribed for young people with panic disorder. ANVISA allows physicians to use common sense to prescribe medicines for conditions whose medications have not been specifically approved.
The Following Medications are commonly prescribed to children and adolescents with panic disorder:
Antidepressants are commonly prescribed to treat the symptoms of panic disorder. The most commonly prescribed antidepressants belong to a group of medicines called Selective Serotonin inhibitors.
Benzodiazepines. Benzodiazepines may also be prescribed in combination with antidepressants to treat more severe symptoms for a short period of time.
While benzodiazepines usually have effect on the first week, antidepressants generally start to produce results in reducing symptoms after being taken regularly for at least 2 to 4 weeks. A full 12 weeks may be required in order to determine whether the drug will be effective for the individual. Medicines should only be started, stopped, or adjusted under the direct supervision of a trained physician.
There is no "best" medicine to treat panic disorder, and it is important to remember that drugs usually reduce, not eliminate the symptoms. Different medications or dosages may be needed at different times in the life of a child or to combat the appearance of specific symptoms.
Successful treatment requires the use of medications every day as prescribed, allowing time for the medicine to work, and following up to check both the efficacy and tolerance.
The family doctor and school should maintain frequent communication to ensure that the drugs work as expected and to monitor and control the side effects.
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