The Difference Between Meltdowns, Tantrums, and Panic Attacks

In my work and personal life, I have come across a lot of confusion around whether a person or child who is neurodiverse is having a meltdown, tantrum, or a panic attack since they can look similar. As someone who cares for that person, it can be hard to watch and nerve-racking trying to figure out how to help. 

I experienced all three growing up, and what to give some insight into these three emotional phenomena. 

Since at the heart of these three events emotions lie at the center and cause these three phenomena to occur. 

MELTDOWNS 

Meltdowns occur when there is a flood of emotion that overwhelms all the systems in the body. They often appear as crying or breakdowns. It is the body trying to cope with the flooding of emotions and crying is often the only way it knows how to let out the excess emotions it cannot deal with. This phenomenon would occur during a highly emotional event, a breakup or a death, but it would occur when I would feel many emotions at once, during arguments or bittersweet moments, because my brain had a hard time processing how I was feeling. 

How to Help: 

Often times I needed a hug, other times I needed to scream into my pillow. I also just needed to be by myself for a while and other times I needed to know that there was someone close by. I hated it when people would want me to talk to them when I was having a meltdown because I was too flood to focus on my words and what I was feeling too. It did help when someone would verbalize the feelings I was having, upset and angry when dealing with a breakup or excited and scared when going off to college. It gave my brain the cue to deal with the emotion since it then understood what I was feeling. 

TANTRUMS

Tantrums occur when the emotions of rage, anger, and frustration overwhelm the body. The behavior displayed often is categorized as noncompliance and defiance. There is often property destruction and aggression towards people and objects. I would break objects, like hairbrushes, when I would tantrum. I would tantrum because in that moment I was flooded with emotion, thoughts, and sensory input.

How to Help:

Give space is the most important step you can take to help during a tantrum. Remember to keep yourself and animals safe if the person is coming aggressive. For me, it hurt so much more when I knew that I hurt someone when I would tantrum. 

Afterward, while debrief try to push away judgment, I would already be putting myself down a lot with very negative self-talk, so using judgment words, like should, make the person worse and doesn't help when talking to us. 

Teaching self-regulation skills help when we are calm and can prevent tantrums from escalating. 


Panic Attacks 

Panic attacks happen when there is an overwhelming flood of anxiety. It is often accompanied by fear of loss of control/death, sense of impending doom/danger, rapid heart rate, sweating, shaking, chills, shortness of breath, nausea, stomach cramps/pain, pain in the chest, hot flashes, headache, dizziness/faintness, numb, feeling of unreality/detachment. 

For me it occurs in 4 stages: 

1) Trigger – Something happens that causes me an uncontrollable sense of anxiety

2)    2)  Perseveration on the anxiety – All I can focus on is the thoughts brought about by the trigger

a.       This is when I would get symptoms like shortened breath, rapid heart rate

3)    3)  Disassociation from my body – I feel like I am looking down on myself at that moment

a.       This is when I would feel numb, dizzy, loss of control

4)    4) Black Out – My memory did not form a connection to what I was doing, my brain was so
                        overwhelmed that it did not create a memory.

a.       This is the scariest part for me because I had no idea what I did/was doing during that time. 

b.       Afterward  I would feel a headache, nausea, sometimes cramps and chest pain

How to Help:

If you are watching someone in a panic attack it is best to take your cues from the person. Often times I would say what I needed without knowing that I was, it was my body's automatic response to the stress. If they say leave them alone it is best to leave them alone.

Afterward, they may not be in the space to talk or even understand what happened. It is best to describe the situation and what happened, please give as much detail as possible. I was more willing to talk when I was able to process the whole situation. 

Recap

Meltdowns occur when there is a flood of emotion that overwhelms all the systems in the body. Typically the person can only breakdown and cry. Tantrums occur when the emotions of rage, anger, and frustration overwhelm the body. Panic attacks happen when there is an overwhelming flood of anxiety that occurs in four stages, for me at least. 1) Trigger 2)  Perseveration on the anxiety  3)  Disassociation from my body and 4) Black Out. To help the person going through any of these emotional phenomena it is so important not to judge, be understanding, and take the lead from the person going through the emotional phenomena.