Treatment for Panic Attacks in Teen

Hi, my 14 yo daughter has worsening panic attacks. She has had them for a few years but they are becoming more frequent. She used to have them once every 6 months or so in an extreme situation but now they are coming a 2-4 times per month or more. She has some anxiety, social and otherwise, as well as struggling with some self-harm. She is very creative and does well in school etc. She is in therapy at Kaiser but her long time therapist took a new job and she has not adjusted well to the new one yet. At this point I am considering looking outside Kaiser and/or considering getting a psychiatric consultation at Kaiser. Possible avenues include homeopathy (going to try that  very soon, not super optimistic but there are no side-effects), CBT ( possibly expensive, not sure she will buy into it), medication (worried about side-effects and long-term effects).  She is not open to meditation, yoga, etc. I would love to hear any advice or recommendations from this community. Thank you!

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My daughter used to get very severe panic attacks during her middle school years. We initially took her to therapy. But as a freshman in HS, she almost couldnt funtion because of the panic attacks. When she started missing school, we decided to take her to a psychiatrist as well who put her on meds. Those meds were adjusted over time by her doctor. Now my daughter is doing fine, is well adjusted to her life in college while still on her meds.

I totally can relate to your reluctance to try meds for anxiety, and in our case too we used it as a last resort. But these meds did have a positive impact and helped us tremendously. My daughter was able to live up to her full potential because of it. The side effects are not too bad, and the doctor adjusted the dose so she felt fine taking the meds. Best Wishes..

I commend you for looking for treatment for your daughter. She is suffering. I think that Biofeedback and Neurofeedback are very helpful for anxiety. They can help kids become more aware of and change their physiological states.  Also, you could consider talking with your daughter's doctor about a beta blocker medicine, which is fast acting and I do not think creates dependency nor side effects. That would be different than an SSRI or benzodiazepine. Good luck!

I'm not sure what her Kaiser therapist has done already but I'm an MFT Intern and I'd be looking at giving her tools for managing the symptoms and de-escalating them followed by CBT to help her figure out what the thoughts/beliefs are that are driving her to feel anxious and try to recognize and change unhelpful thinking patterns. 

I think for therapy to work it's really important that she sees someone she feels comfortable with and has confidence in. So maybe shopping around outside Kaiser is a good idea. You could try Psychology Today and look for therapists locally who use CBT. 

Good luck.

Has your daughter had a full thyroid panel done, as well as a complete blood panel?
Her hormones could be off. One of the symptoms of Hashimoto's Thyroiditis is severe anxiety.
Does she have other less obvious falling out or thinning, brittle nails, digestive problems, hoarse voice,
tired all the time, weight gain. That's an easy blood test  at least to rule out (I'd insist on a full thyroid panel rather then the typical TSH the Drs tend to do).

Does your daughter eat a lot of processed foods? The chemicals in processed foods can cause mood changes and anxiety.
Does she drink diet sodas....artificially sweetened, processed meats and snacks?  You might try a gluten free diet for a month and see
if that makes a'd be surprised.
Another easy-ish thing to clean up to rule things out.

My son had severe anxiety when he was young. A gluten free diet and high doses
of Omega 3 Fish Oil made a huge difference.
My view is to look at a cause rather then treat a symptom.
It was frustrating working with Kaiser since they typically treat a symptom.
If  you decide to go out of Kaiser I can recommend a great naturopathic doctor who works with teens.

Wishing you the best.

My young adult daughter recently started a Yoga program at Kaiser that specifically targets panic attacks and anxiety.  It gives the participants tools to recognize & reduce anxiety.  I believe it is a 6-week class, once a week.   Not sure if the age group is inclusive for teens, but maybe they have a similar program?   She also recently started on Wellbutrin through Kaiser, and it seems to be helping, without any side effects.

Fragrances can cause panic attacks.

Use unscented detergents, personal care products, cleaning products, etc. Open windows for cleaner air. Get houseplants. New carpet and paint can also cause problems. 

It will take awhile for the toxins to clear from her body, but she should feel better in several months. 

We've used CBT for this, and it was very helpful for our daughter.  Ilyana Romanovsky is her therapist.  It is expensive, but Ilyana is very results-oriented, and it was definitely some of the best money we've spent.  Good luck!

CBT is very effective for panic attacks. I recommend looking for a therapist who specializes in CBT and who has a large part of his/her practice with teens. This will take some research but would be well worth it if you could find a good match. I would ask what percent of their practice is teens, how long they have worked with teens, and what training and experience they have had with CBT. There is no "correct" answer to these questions, but I would look for answers that show a lot of experience, continuing education, and an interest in understanding what you need.