After a long period of online learning, children recently returned to face-to-face classes in the UAE. This, for some has been a welcome feature while for others, it has exacerbated a feeling of social anxiety. A parent wrote in to us asking about their daughter who has gone back to school only to have panic attacks during lessons. Dr Sneha John, Clinical Psychologist at Medcare Camali Clinic Child and Adult Mental Health, answers:
“Thank you for taking the step to get this addressed. Your daughter’s current emotional state should be viewed in light of the transition she has made from online to onsite learning and any other stressors that the school environment could have brought to her previously. I would encourage you to go through the following tips as you help your daughter process this change:
Your daughter’s current emotional state should be viewed in light of the transition she has made from online to onsite learning and any other stressors that the school environment could have brought to her previously.
Invite her to talk about feelings
“Feelings should be an essential part of your vocabulary as they allow children to learn healthy ways of identifying and coping with everyday situations. Validate their feelings and let them know that whatever they’re experiencing is okay.
“Assure your child that the foundations of her community and learning experience will be strong
“Even if a beloved staff member or principal is leaving, don’t fall into catastrophising with your students or children. Help them see that their experience in school is more than one person, programme or other element.
Direct children to see what they are in control of
“Unwelcome change makes people feel like they don’t have control over their lives. Ask your students or children, “What are you free to choose right now?” and they’ll be reminded of their own power. Teach your child to name five things on her five fingers that she is in control of at a given moment.
Teach your child about panic attacks
“Panic attacks can be frightening, and your child may be concerned about a whole host of things, ranging from worrying that people are laughing at her to worrying that she is having a heart attack or even that she is dying. By teaching your child some of the facts about panic attacks, you can help to dispel some of these worries. Explain to your child that panic attacks are common, and they aren’t dangerous, even though they can feel scary and uncomfortable. Reassure them that panic attacks are brief, and even though they feel like they go on forever, they always end. It’s also important to let your child know that it’s likely that no-one else (other than people they’re close to), will be able to tell they’re having a panic attack, so she doesn’t don’t need to worry about people laughing at her or judging her.
Stay in control during the panic attack
“If your child is having a panic attack, it’s likely that she’ll feel as though she has lost control. It is important for you to stay in control for the duration of the panic attack. Try to stay calm and talk to her in a gentle and soothing voice. Tell her to take deep breaths and reassure her that the panic will be over soon. Once the panic attack seems to be subsiding, give her plenty of time and space to calm down.
“Explain to your child that when she’s having a panic attack, that feeling causes her breathing to become faster, which can make her feel light-headed and dizzy, and cause chest pains. Teach her how to slow her breathing; this can help to reduce the physical symptoms of a panic attack and help the panic attack to pass more quickly. Tell your child to breathe in through her nose for three seconds (she should feel her chest expand when she does this), hold her breath for two seconds before exhaling completely and fully. Your child can then use this breathing strategy the next time she’s having a panic attack.
Encourage your child to face her fears
“If your child has panic attacks in response to certain situations or objects, it’s important to encourage her to face her fears. For example, if your child gets panicky when she is in the car, gradually expose her to this in carefully graded steps such as sitting in a car when it’s parked, before gradually moving up to travelling in the car for very short journeys. This will help your child to realise that her fears are irrational. Give your child lots of praise and encouragement throughout this process and reassure her that she doesn’t have to struggle on her own.
Challenge negative thinking
“The way your child thinks about things can have an impact on her levels of panic. Many of her thoughts will be out of her control and can be negative and unhelpful. Therefore, it’s important to help your child to realise that these are just thoughts as opposed to facts. Even though your child may believe a lot of her unhelpful thoughts during a panic attack, these thoughts should be challenged as they are often based on incorrect assumptions. For example, your child may think she’s having a heart attack when she is are panicking, which can cause her to panic even more. Help her to challenge this thought by reminding her that when she thought she was having a heart attack previously, this wasn’t the case, and her panic attack subsided.
Help your child to shift focus
“It’s likely that your child will be having lots of negative thoughts during a panic attack. You can help to shift her focus from these thoughts by encouraging her to concentrate on something else, ideally something that soothes her or is comforting to her. This might be a favourite toy, a photograph of something enjoyable, or a pet. You could also help your child to develop a ‘happy place’ to go to inside her head. Encourage her to think of a situation or place in which she feels safe and comfortable and tell her to focus on this whenever she feels panicky.
Reassure your child that there are always people there to help
“It’s important to let your child know that she never has to suffer on her own; there will always be someone to help and listen to her. Tell your child’s teachers about her panic attacks, and ask them to step in if your child has one at school. Encourage your child to always speak to someone and be with someone if she feels a panic attack looming.
“Lastly, it is important to identify and reach out to your child’s support system, which would include people who could help her at this time alongside your efforts. This would include a school counsellor, teachers and a psychologist who could see her outside school.”
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