Brief Answer:
Information

Detailed Answer:
Hello and welcome,

What you are describing are likely to be panic attacks. This is the start of the school year and there may be some underlying stress from school or interpersonal interactions related to school that are weighing on him. Thirteen is a particularly hard age for kids.

As you say this is very out of character for him, I will assume he does not have a psychiatrist or psychologist that he has a past relationship with. For this reason, I'll recommend that you take him to be seen by his primary doctor (family practice or pediatrics). The doctor can talk with him about what has been going on, and may recommend medication or referral to a psychiatrist.

Medications for anxiety fall into two main categories (although there are others that are used less commonly):

Benzodiazepines (lorazepam, alprazolam) which act quickly to calm a person and decrease anxiety. They are short acting and can be used just as needed for immediate relief. However, with frequent use they can be dependency forming.

Antidepressant SSRI medications such as escitalopram (Lexapro). These are taken daily and do not work immediately. They can take a few weeks to kick in (but a benzodiazepine can be used simultaneously as needed until the effects of the SSRI start to help). These prevent or decrease the likelihood of anxiety and panic attacks. They are typically taken for at least 6 months to stabilize the anxiety.

As your son has had 2 panic attack type episodes, it is unclear if they will continue. For repeated or frequent attacks, I would recommend an SSRI (plus the benzodiazepine for immediate help as needed). If the panic attacks were just a one or two time situation, his doctor may want to just try lorazepam or alprazolam for immediate treatment, and consider counseling for any underlying concerns.

I'll share personal experience I had with my child. My daughter, at age 15, was going to travel to a 3rd world country alone with her teacher, who we trusted but was not able to give my daughter much information about the itinerary or accommodations. A few weeks before traveling she began having daily panic attacks - every day during math class (although it was not related to math class, just the time of day). She was sent home from school daily. We tried lorazepam, but it caused excessive sedation for her. Finally she was started on a low dose of escitalopram. By the time she arrived overseas, she was without any further panic and was able to engage in the experience there.

This, of course, is just anecdotal, but I share it because I have been on both sides of treatment for anxiety and can understand how upsetting it can be to see your child suffering like this.

I hope this information helps. Please let me know if I can provide any further information.

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