Post-traumatic stress disorder (PTSD) can start after a child sees or is involved in a very stressful event. The event usually involves a real or potential severe injury or the threat of death. It causes feelings of extreme fear, helplessness, or horror. After such an event, children may have trouble sleeping, have nightmares, and feel emotionally numb and cut off from others. For most children, these symptoms stop within a month after the event. When these symptoms continue for a long time, it is called post-traumatic stress disorder.
The stressful event may be:
A child's risk of developing PTSD is related to:
PTSD can occur at any age. If you, or others in your family, have had PTSD or depression, then your child may be more at risk to develop PTSD.
The symptoms usually start right after the event, but they may not start until days or weeks later. When the trauma is a series of ongoing bad events, the symptoms may come on slowly and get worse over time.
Children may feel very fearful, helpless, angry, or sad. They may feel guilty, thinking that they somehow caused the event. They may deny what happened. Children who suffer trauma again and again may dissociate. This means they may not show much emotion and may appear to be "in a trance" or daydreaming. This behavior is most likely when something reminds them of the trauma.
The 3 core symptoms of PTSD are:
Children with PTSD may also:
PTSD is not diagnosed until at least 1 month has passed since the trauma. Symptoms of PTSD usually develop within the first 3 months after the event, but they may not surface until months or even years have passed.
Sometimes it is hard to tell PTSD from other childhood problems like depression, anxiety, or bipolar disorder. Contact a mental health professional who specializes in working with children and teens.
A mental health professional will ask about your child's behavior and symptoms, medical and family history, and any medicines your child takes. Sometimes your child may need lab tests to rule out medical problems like a thyroid disorder.
Along with PTSD, children and teens may have other disorders as well, such as:
Psychotherapy is usually the first and most effective treatment.
Play therapy allows children under 9 years old to act out their fears with toys and people figures. It is often very helpful. Play therapists help children feel more confident and less fearful.
Older children, teens, and adults often do very well with eye movement desensitization and reprocessing (EMDR). In EMDR the therapist helps the child understand the feelings and thoughts they have about what happened. While thinking about the event, the child moves his or her eyes back-and-forth, usually following the therapist's hand or pen.
Cognitive behavior therapy (CBT) helps children learn about PTSD. CBT teaches specific skills to manage fears and negative thoughts about the stressful event.
Other behavioral therapies are also useful. Gradual exposure therapy teaches the child to stay relaxed while being exposed to things that remind him or her of the trauma.
Family therapy may also be helpful. Family therapy treats the whole family rather than just the child. Children often feel very supported when parents and siblings attend therapy with them and work as a group.
Medicines are sometimes needed when the symptoms are very severe. Medicines may help reduce symptoms of anxiety and panic. If your child also has depression, medicines for depression may be prescribed.
It is important to have an experienced professional working with you and your child. Your child may need continuing treatment even after he or she feels better. Symptoms may return if children are exposed to something that reminds them of the trauma.
Anniversaries of the event can often cause a flood of emotions and bad memories.
If children have had PTSD once, then they are at greater risk for future PTSD if they experience another traumatic event.
Most children and teens can get over PTSD with good treatment and family support.
After a stressful event happens, get help as soon as possible. It is very important to help your children feel safe.
If the symptoms have lasted more than 4 weeks, the problem is serious. The symptoms may not go away or they may get worse without professional help.
Get emergency care if your child or teenager has ideas of suicide or harming others or harming him- or herself.
For more information, contact organizations such as:
National Center for Post Traumatic Stress Disorder
Telephone: (802) 296-6300
Web site: http://www.ncptsd.va.gov
National Institute of Mental Health
Telephone: 866-615-NIMH (6464)
Web site: http://www.nimh.nih.gov
Mental Health America (formerly National Mental Health Alliance)
Telephone: 800-969-NMHA (6642)
Web site: http://www.nmha.org