Dear Teen Parenting Coach

Q: How Can We Teach Our Emotional, Anxious Tween to Calm Herself?

Could the loss of a loved one spark emotional outbursts and runaway anxiety attacks in a tween with ADHD? Here, our Dear Teen Parenting Coach explains how puberty can exacerbate poor emotional regulation, and how parents can help children struggling with scary and overpowering feelings.

Q: “My 12-year-old daughter recently starting having emotional outbursts that turn to panic and anxiety attacks. It’s clear she doesn’t understand what is happening, gets scared and has difficulty calming herself down. We have found that keeping her busy and focused on her passion has allowed her to be focused at school without medication. She recently lost a grandparent and I’m wondering if this is contributing to the recent outbursts.” —CrystalN

Dear CrystalN:

My sincere condolences for your loss. It certainly sounds like your daughter is going through a rough time. Losing a grandparent in the midst of navigating puberty and middle school would be painful for any child. For a girl with attention deficit disorder (ADHD or ADD) whose brain normally struggles with emotional regulation and is particularly sensitive to hormonal changes, it can be downright cataclysmic. It’s no wonder that she doesn’t understand what is happening and feels frightened by it all.

The death of a loved one can be very unsettling for young people. They often lack the cognitive and psychological maturity to process the wide range of feelings that accompany their grief. Of course, this is hard for many adults, too. Kids see their parents’ sadness and feel helpless to make things better. They’re also reminded of the fact that, one day, you too will die. In addition, family dynamics are shifting. While everybody adapts to loss differently, it’s a universally vulnerable time.

Your daughter, like many kids with ADHD, may not be able to articulate what is swirling around inside of her. She may not even be aware of any underlying distress until something sets her off and the floodgates release in the form of a panic attack. Her feelings overwhelm her and, along with vulnerability triggered by her grandparent’s death, seem to be contributing to her recent anxiety.

[Self-Test: Could Your Child Have an Anxiety Disorder?]

The onset of puberty in girls, especially those with ADHD, can also increase reactivity and sensitivity to anxiety since estrogen has a direct effect on the brain’s neurotransmitters. While keeping her busy and involved with her passion may have helped your daughter manage her ADHD challenges until now, it’s possible that her outbursts are showing you that she needs something more now. She definitely needs to develop skills for regulating herself in these moments and for understanding her outbursts’ underlying contributors.

Here are a few ways you can assist her:

  1. Schedule an appointment with her pediatrician to discuss the behavioral changes you’ve been seeing at home. It’s important that her doctor knows what is happening; he or she may have some suggestions for both of you.
  1. Collaborate with her to find ways to deal with her agitation. Given her fluctuating hormones and the recent loss of her grandparent, your daughter can’t expect to stop her big feelings all together. What you can do is create a plan to address those feelings before they actually erupt. Sit down with her and talk about the triggers that you both notice preface her eruptions. Review any signs that indicate something’s changing. What does she notice is occurring in her body? What behaviors does she start to display? Make a list of these observations.
  1. Help her slow down the tidal wave of emotions by reducing her anxiety and panic. Talk about what has helped her in the past when she’s had these intense feelings. What does she think might be useful now? Ask her what you can do (and what you can avoid) that would support her in regaining control in those moments? Connect these ideas to your previous observations. Write a list of her options and post them in your kitchen.

[You’re Not Alone: “What an Anxiety Attack Really Feels Like”]

  1. Despite your inclinations or instincts, try not to reassure her when she’s panicking. You may have already noticed that it doesn’t work anyway. Instead, guide her to follow the list of suggestions that the two of you have created to slow things down and bring about calm. Reassurance teaches kids to rely on other people to make things okay when they really need to learn the tools to soothe themselves. As a burgeoning teen, she will need this skill more and more in the coming years. Instead, remind her of times when she’s been afraid and done something anyway. Be specific and guide her in accessing that resourcefulness now.

If your daughter continues to struggle, consider taking her to see a counselor. Counseling can be extremely useful in assisting kids with ADHD and their parents to understand their triggers, improve their ability to talk about what’s happening, reduce anxiety and panic, and create options when emotions run high.

Do you have a question for ADDitude’s Dear Teen Parenting Coach? Submit your question or challenge here.

The opinions are suggestions presented above are intended for your general knowledge only and are not a substitute for professional medical advice or treatment for specific medical conditions. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your own or your child’s condition.