Why is your child having palpitations or a panic attack?

Palpitations are when your heartbeat is more noticeable than usual, maybe pounding, fluttering or feeling like it's missed a beat.

I’ve deliberately linked palpitations and panic attacks here. That’s because when a child is very anxious about something, they can start to panic about it. Panic shows itself in lots of ways, of course. But the first thing your child might feel is their heart thumping or pounding.

They won’t use the word “palpitation”. But you'll recognise the feeling from your own experience when something scary happens out of the blue. So I’ll use the term here.

If it’s not quite like thumping, your child might say it’s like butterflies in their tummy or their tummy feels funny – this is an earlier feeling of worry and anxiety.

The thing to remember is that, in olden times – really olden times! – we needed those physical responses to danger. Fast!

When faced with danger, we needed a surge of adrenalin… and our heart beat faster. Blood and oxygen was diverted to muscles to give them the energy to run away – or to stay and fight that woolly mammoth dashing towards us.

Modern life doesn’t really have the same kind of threats on a daily basis. Children get frightened, worried and anxious about all sorts of other things – but the body responds in the same way it was designed to in hunter-gatherer days.

That’s why they feel the butterflies, palpitations or panic feelings.

Luckily, we have lots of better ways of dealing with daily life now than running away. So it’s good to take note of what the body is telling your child and then work out what to do about it instead of letting the bodily sensations rule.

How will you recognise your child’s FIGHT, FLIGHT or FREEZE response?

If you can recognise what’s happening, you’re in a better position to know to start a calming activity instead of just telling them off, or even worse – dare I mention it?? – shouting at them angrily (yes, we’ve all done it!).

1 When they’re in FIGHT mode:

They’re possibly yelling and shouting, cross and angry, refusing to do as you say, hitting you or someone else, and possibly throwing toys or other objects onto the floor. Something’s rattled their primitive brain and they’re fighting to survive.

2 When they’re in FLIGHT mode:

You might find your child is simply not listening, or perhaps fidgeting a lot so they don’t have to listen, maybe simply trying to cut off/run away mentally in their highly anxious state, or (see above) panicked and their heart’s palpitating.

3 When they’re in FREEZE mode:

You’ll maybe see your child’s face go white or blank, find them rooted to the spot as if made of stone, sitting very still as if dead to the world, or perhaps unable to think (of course not – their thinking brain is cut off) and possibly saying things like “I can’t” or “No” in a fixated way.

So – when your child is responding from their primitive impulses to something they think is dangerous or worrying – as if they’ve seen a woolly mammoth – you can guarantee they’ve flipped instantly in one of these fight, flight or freeze modes.

Accept it for what it is and bring your own wise owl brain online to help calm them. This means you can then follow the procedures below and help them sort it out.

You need a plan of action!

The first thing you need to do is stop your own panic in its tracks. If our child is suffering we imagine the worst, we fret, we're desperate to stop it.

So keep in mind the difference between anxiety that warrants professional input and anxiety that is more normal and useful but that is bothering your child enbough to give them a panic attack at this minute.

I wrote a blog post on assessing normal vs. serious anxiety here.

When you're happy you're not going to overreact out of love for your child, you can start helping your child recover their balance!

So – at some point when they’re calm – you can find a way of talking with your child about the difference between life-threatening stuff like woolly mammoths, fierce tigers etc and the things they’re worried about that make their heart thump.

You’ll obviously decide how to tackle this according to their age and understanding. But most children will respond to something involving a fun story, or an act-it-out play session to demonstrate your point.

The idea is to make sure they know their body is reacting normally and that there is a way to deal with both the anxious palpitations and the problem they’re worried about.

Once they’re not worried about how their body feels, the palpitations will probably stop, or at least lessen.

First, you need a way to help your child become calm and soothed

Obviously only you know what is suitable for your child. You’re the parent and the expert here – although the real expert is your child! But you do need to deal with the palpitations before trying to talk about them.

The reason is this. When a child is in a worried/anxious state, they won't properly hear anything you say because the brain is on high alert for survival, not thinking. So you need to do something calming first. You can do the “talking about worry” bit later.

So – when your child complains their heart or tummy feels funny (butterflies or palpitations caused by anxiety), casually choose a calming activity before doing anything else.

I say “casually” because it’s important not to make a fuss – that might convince your child there is something wrong with their heart. That’s not the same as ignoring it or playing it down! But there’s no point in upping the anxiety either!

Try doing an appropriate calming activity together:

One of the most helpful calming activities you can help your child to use is deep breathing and progressive muscle relaxation. These are proven methods to bring anxiety levels down. You can find breathing techniques here.

However, "active" activities are good too:

Sort out the kitchen drawer together
Sort and tidy the crayons into colour order
Doodle a scribble design and colour in the sections
Mould some play dough: it's the stroking, smoothing that helps, so it doesn't matter what you make.

When we’re primed to fight off wild animals, we can’t think of anything but escape. We’re not bothered about how to decorate a cave or cook a stew. So any quiet sorting/calming activity like those above will bring the body back into its normal state.

After you've helped your child back to a calm state, they're more likely to be able to chat with you about what’s been happening to their body. You can explain how it's normal to have a reaction to something scary. You can add that it's best to discuss the worry and sort it out.

Chatting without discounting their anxiety or palpitations

We parents love to console and comfort – but if your anxious child has palpitations they need someone to hear them out. Someone who they see as really listening to their worries. Because they’re big worries for them.

I know how irritating it is if I’m worried about something and someone says, “Oh it’s nothing to be scared of.” I get even more uptight!

So the number one trick to starting to solve the palpitations problem is to listen quietly and carefully.

There are special ways of responding to what your child says. But they’re not what we usually say, so here are some examples.

What might your response sound like after you’ve listened?

“You’re really worried about what might happen in school today, aren’t you.”

“It does sound like a problem, doesn’t it? Let’s work out how you can deal with it.”

“Umm, that sounds hard. What do you think X would do if they were worried about it?” [X is whoever they admire, or is a confident friend, or a famous person – anyone you think might capture their imagination here]

“Let’s draw a picture of what your worry feels like. Then I will understand it better. Can you start us off? … What colour is it? … What shape is it?”

The act of calming your child down and talking with them in this way will help you find out what's at the bottom of it.

You can find more information on causes of anxiety here.

Ready for a plan of action?

You can also help your (now calm!) child come up with a plan of action related to what they've told you. A plan empowers them to start dealing with the problem. The palpitations should gradually stop.

Don't worry about making a plan right now if your child needs more "pre-plan" help – more listening, more reassurance, more chatting...

They might find a story book helps them understand their worries better. Here's one suggestion:

Children of 6–11 might find this book helpful:

The Panicosaurus by K I Al-Ghani. It's published by Jessica Kingsley, and I’ve found it very useful with children over the years.

Check your child's diet and physical activity levels to maintain balance

Children like adult can find their body becomes imbalanced if either their nutrition or their physical activity is less than good for their age.

If you're not entirely sure what this is, there's a very helpful pdf here that you can refer to. But you probably know if your child is sneaking into the food store and having too many sugary or unhealthy snacks!

And you'll also recognise if they rarely get outside and run around. Schools have very little decent outside play these days, so do think about physical activity. It helps with overall health and restorative sleep. All of which means your child stays calm more often and can be helped with any anxiety problems.

Build long-term resilience against panic attacks

There are many helpful articles in the blog section. Building resilience and anxiety-containing habits in your child is an ongoing project starting at day one and probably going on into teenage years. But you'll be rewarded by fewer panicky moments and easier calming of those that happen.

TAKEAWAY

Recognise that palpitations in children can be a physical response to anxiety, manifesting as heart thumping or a feeling like butterflies in their tummy.
Be aware of different anxiety responses in children, such as yelling (fight), not listening or fidgeting (flight), and becoming still or unresponsive (freeze).
Distinguish between normal and serious anxiety, and communicate with your child to understand their worries.
Engage in calming activities like deep breathing, progressive muscle relaxation, or organising physical tasks when your child feels anxious.
Listen attentively to your child's concerns without dismissing them, and engage in empathetic and understanding dialogue.
Ensure a balanced diet and adequate physical activity for your child to help maintain their overall balance and reduce anxiety.
Focus on building long-term resilience and anxiety-managing habits in your child to reduce the frequency and intensity of panic attacks.

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