<p>D1 (14) arrived home last night from an evening out with friends looking not her usual self. She sat down and was soon in tears, saying she thought she’d had some sort of claustrophobic attack in the car: she said she felt panic-y, her throat felt like it was closing up and her chest felt tight. She didn’t tell her friends how much it affected her, and the dad who was driving didn’t even notice, but she was obviously shaken. </p>
<p>From what I can tell, several things seem to have triggered this- nothing major, but perhaps they all added up–</p>
<p>She was exhausted. They stayed at the mall hours longer than she’d thought they would. </p>
<p>She’s not a big fan of cars in general, and often gets carsick</p>
<p>Her friend (maybe even both of them) was goofing around and leaning on and over her and refused to stop when asked. This seems to be most what triggered it. Am guessing she felt overwhelmed and out of control. This was a good friend just goofing around - no bullying or malice. Don’t know if the dad even noticed – D is a mellow (almost passive) kid, and not the kind to ask for help. I was glad she actually sat down and talked to me about it. </p>
<p>Mostly she seems scared that it happened, and scared that it could happen again – almost like a “fear of fear itself” situation. Intend to remain non-alarmist, but definitely will ask her pediatrician for advice. Anyone else out there with similar experience? Thanks</p>
<p>Klonopin. It works wonders. You take it a few times when you feel panicky, and it immediately calms you down. Eventually (or hopefully), your D will get to the point where the drug is no longer needed, as its physical presence and availability is enough to ward off any potential panic attacks. </p>
<p>I was involved in a similar type of situation a few years ago. Wasn’t familiar at all with these kinds of things (I had never even heard of an anxiety attack). Got the klonopin, took it for about a week, and I haven’t had an issue since.</p>
<p>Maybe it was a simple claustrophobic response and nothing to get too concerned about since most people feel claustrophobic at times, especially when placed in the situation you describe. It might not have been what people generally refer to as an anxiety attack at all. I wouldn’t jump to taking a drug for something like this too quickly or make more out of this one event than necessary.</p>
<p>I experience something similar to this when I am in a crowded place, like a bus or subway car, or another small space (I had a lot of trouble getting an MRI). I think it may be mild claustrophobia–for me, it’s definitely worse when there are people crowding around me. I find that it usually helps to get some fresh air. Perhaps she could try opening the car window if it happens again.
Lots of people have mild phobias like this that don’t impact them very often (like fear of heights, for example). If it begins to interfere with what she wants to do, then she may need more help, or medication. I think it makes sense to ask the pediatrician about it, though.</p>
<p>Get her in to see a therapist for evaluation, and then maybe a psychiatrist if the therapist thinks it’s an actual panic attack, or if it recurs. Klonopin is great stuff, but it’s a benzodiazepine, which means that it’s habit-forming, and it’s little better than taking a good belt of rum (which also works wonders for anxiety, incidentally). I got nervous taking Klonopin on a regular basis, since the work I do is life-critical and I don’t need to be mellowed out on benzos at work, but it was reassuring to have it around in case I felt a panic attack coming on. It was like keeping a life jacket around for those times when I felt like I was drowning.</p>
<p>Anxiety can often be triggered by small things, but it may not be just the local event (in the car, tired, feeling claustrophobic) that caused the panic attack. Attacks can be a result of a big life change or a major life event that would have occurred even several months before the first attack. When I first started having panic attacks, they would be at work while I was sitting quietly at my desk listening to calming music! My doctors ran EKGs and did echocardiograms and stress tests to figure out what was wrong-- I didn’t even consider that it might’ve been the stress of maintaining a long-distance relationship, watching my parents go through a divorce, caring for my sick mother, planning a wedding, starting a new job, and moving cross-country… Which definitely would’ve done something wacky to any normal human being.</p>
<p>Carrying Klonopin around and taking it PRN wasn’t quite enough for me, but counseling and a low-dose SNRI have helped SO much, and they don’t affect my concentration whatsoever. It’s nice to not have to worry about another attack happening. Make sure your daughter nips this in the bud, right now, because the longer something like this goes unaddressed, the more likely it is to come back later… I left mine unaddressed for quite a while.</p>
<p>Good luck to you all. Panic attacks are scary when uncontrolled but very, very manageable with the resources available in this day and age.</p>
<p>I would suggest pursuing something like Klonopin as a last resort. It is in a class of frequently abused substances, so it’s a bit of a danger to have around the house with teens coming and going. It also isn’t really something I’d want to add to a very young person’s medical records unless it was absolutely necessary. Perhaps most importantly, it’s better to exhaust all of the more natural possibilities first. Panic attacks are not uncommon, and it is very possible that your child’s solution will be a more simple one.</p>
<p>A child’s pediatrician is a great first stop to discuss this matter. He or she could offer a referral to a counselor who specializes in treating a propensity for panic attacks. Just a few visits could tease out what happened, identify trigger factors and early warning signs, provide an opportunity to learn about the biology of panic attacks, and get some good coaching on avoidance techniques or breathing responses for the future. Having good information, preparation, and a solid game plan for what to do if it happens again may work wonders.</p>
<p>I want to second the above poster’s comment that this matter should be addressed immediately. Panic attack’s are treatable, but they are terrible things to experience.</p>
<p>Do you know if she had any caffeine? Caffeine is also associated with panic attacks. I had several as a young woman before I learned that it was (at least in my case) the trigger.</p>
<p>Now I avoid coffee if I’m going to be in a stressful social situation.</p>
<p>Good point about caffeine.
Could hunger/faintness have been a factor, too?–after hours at the mall, the claustrophobia and tiredness, plus tending toward carsickness–hers seems like a reasonable reaction.
I wouldn’t worry about it unless it happens again. I think claustrophobia is normal–most people have it to one degree or another.</p>
<p>I was trapped in an elevator once, it was hot/dark and I started to panic, --was pregnant at the time–but just took some deep breaths and talked myself into waiting patiently knowing that someone would get me out eventually. . .I was able to get in an elevator the next day without a problem–but I always check where that emergency/call button is when I get in elevators! H got trapped in an MRI (old, small, portable one) and it affected him terribly (I almost start to panic just thinking about it. . .) After that he has panicked during dental work, of all things–just can’t stand to have something/one in his face. He feels uncomfortable getting on planes now, too–but still flies a lot.</p>
<p>It might help her to practice what she’ll do if she starts feeling that way. She can keep a granola bar in her bag, call you to pick her up if she’s starting to feel way overtired, calmly but forcefully tell her friends to stop and that it’s a joke. </p>
<p>If the attack comes anyway, she can do things like tell herself, “I am safe. I am in no danger. My brain is just misfiring a ‘fight or flight’ reaction.” while controlling her breath. I find that talking to myself also helps the time pass because while panic attacks are typically not that long, with nothing to focus on they seem very, very long.</p>
<p>She didn’t tell her friends how much it affected her, and the dad who was driving didn’t even notice, but she was obviously shaken.
refused to stop when asked</p>
<p>Rather than the actual physical response- this is what I would be most concerned about</p>
<p>What kinds of friends don’t stop annoying you when asked?
Not the kind you need IMO</p>
<p>Oh, man, caffeine is a huge trigger for me.</p>
<p>So far as using relaxation techniques to control the panic attacks, I learned to do that long before I really knew what the panic attacks were, and now I’m able to take almost a clinical, detached view of them… “Oh, here comes a panic attack. Slow my breathing. Concentrate on relaxing my muscles and slowing my heart rate.” Rudimentary biofeedback. I can keep them from getting out of control, I can stop the fear before it begins since I know what they are and I know I can ride them out, but the physiological effects of the panic attacks didn’t stop until I started on medication, and the physiological effects of the panic attacks are unpleasant… Like the aftereffects of sticking a fork in an electrical socket, or right after a monster jumps out from around the corner. Racing heart, coursing adrenaline, shaking, loss of concentration-- the whole deal.</p>
<p>I don’t like being dependent upon medicine, but don’t rule it out as a possibility if the attacks can’t be controlled through other means like relaxation and cutting out caffeine… My quality of life is dramatically improved since I decided to bite the bullet and try it out.</p>
<p>Thanks all -
Have skimmed these quickly and will read them again in detail when I get back later tonight.
The tightness in her chest and throat is what scared her the most. She didn’t want want me to call the pediatrician today, but we will at some point. I’m somewhat leery of medication, esp. since this has just been a one-time thing so far. I was thinking more along the lines of deep breathing, changing focus, meditation, etc. But yes, if it happens again it will be more of an issue, and we will talk to the doctor about it.</p>
<p>I think a lot of factors may have contributed, esp just feeling tired and out of control. I asked her about caffeine, as posters above mentioned, and she said her friend did give her an energy drink (yuk). EK - the dad isn’t anyone she knows well or is comfortable enough with to ask for help, and her friend didn’t realize until later how she felt. I wish D had spoken up. She isn’t feeling too zippy today - sore throat and low fever, as if a bug is on the way. Don’t know if that would contribute or not.</p>
<p>Must run out, but will be back later. Thanks so much for posting</p>
It’s a way you can detect a physical response to an action. For example, if one feels a panic attack coming on they can often feel their heart racing and their anxiety level increasing but if they control their breathing, for example, they can actually feel the heartrate decrease and the anxiety level come down. This is just one example.</p>
<p>I wouldn’t say that I have anxiety problems. I’m not depressed. Every once in awhile though I do get overwhelmed and can panic, which sometimes happens like your daughter describes. What’s worked best for me is to just close my eyes and relax. Long, deep breaths for a few minutes straight (like, really really exaggerate them) work wonders for me. A lot of the breathing and relaxation stuff I do are techniques I picked up in a beginners Pilates class–maybe that would be a good thing for her to try?</p>
<p>On the other hand, I have friends that suffer from major anxiety problems who are not helped by similar techniques. They rely on anti-anxiety meds which work wonders for them. I’m pretty sure relaxing and breathing works for me because mine are triggered by specific incidences and don’t seem to be linked to general anxiety problems. And hey, relaxing and breathing are free and easy–good places to start!</p>
<p>my ex boyfriend used to have anxiety attacks. he would just lay flat and relax for a few minutes and it would go away. it helped to eat a little cracker or something too. maybe that’s just because he was hungry.</p>
<p>I completely agree. This is one time; even if she has a couple of more this year, unless it starts to effect her functioning, I would try other non-medication routes. I also remember D1 having her first one the night before she came down with strep throat, when she wasn’t even a teenager yet. They are very scary, and there’s nothing worse than feeling like you want to help your kid, but you don’t know what to do.</p>
<p>That being said, my two biggest triggers are being overtired to the point of physical exhaustion. I do not do caffeine (well, in small amounts in chocolate every now and then), and I almost religiously have one when I’m about to come down with some sort of illness.</p>
<p>Thanks again, everybody.
She no longer seems shaken up, though has now developed a cold and sore throat instead. Exhaustion and impending illness may have been a factor, but it’s never happened before and obviously she’d prefer it not happen again. Will talk to the pediatrician. D is a sensitive girl, and seems to have a pretty strong emotional/physical connection. Long day, must get to bed. Thanks again!</p>