Post-traumatic stress disorder

Post-traumatic stress disorder (PTSD) is an anxiety condition brought on by exposure to a traumatic event. While all children can be expected to be upset after a very disturbing experience—such as witnessing or being a victim of violence, physical or sexual abuse, a natural disaster, an accident, or extreme neglect— children with the disorder don’t bounce back. They develop a pattern of behaviors that includes dreams about the event, play that reenacts the trauma, difficulty sleeping, irritability, and detachment. PTSD can develop months after the event, and may seem oddly disconnected from it. Though PTSD-like symptoms are common among children and adolescents exposed to trauma, the disorder is rare in young people.

If your child has experienced a traumatic event, it’s normal for her to be anxious.  You might worry about PTSD if she becomes distant, recreates her trauma during playtime, regularly has nightmares about it, or experiences difficulty falling asleep. Young children may begin wetting the bed, become overly clingy with their parents, or even forget how to speak.  Some children with the disorder will also develop separation anxiety disorder.  Adolescents with PTSD may display self-destructive behavior and guilt. 

PTSD is brought on by closely witnessing or experiencing a traumatic event that puts the child or loved ones in danger of serious injury or death. Stressors can include neglect, violence, physical or sexual abuse, bullying, bad accidents, and natural disasters.  While it is common to be upset after experiencing a traumatic event, in people with PTSD that response becomes impairing. Experts don’t know why this happens, though susceptibility appears to be familial in some cases, either through genetics or by learning unhealthy responses to trauma from parents with PTSD.  The disorder is diagnosed in girls four times as often as in boys, though the actual prevalence is unknown.

Any child exposed to trauma may express horror, become agitated, or exhibit mixed-up behavior.  But in kids with PTSD, this reaction continues and they can become emotionally numb and detached. For this reason, PTSD isn’t diagnosed until a few months or longer after the initial trauma occurs, allowing a practitioner to better understand the response, although symptoms may manifest earlier or even several years later. PTSD symptoms are commonly grouped in three areas: intrusive memories, such as bad dreams and play that reenact the event; avoidance and numbing, such as difficulty maintaining relationships, difficulty concentrating, and disinterest in formerly significant activities; and increased arousal, such as irritability, guilt, trouble sleeping, or fearful behavior. Children with the disorder often have stomachaches and headaches. The symptoms will cause significant impairment to ordinary functionality.

Many practitioners recommend a combination of behavioral therapy and medication. As some PTSD symptoms are often found in young people who don’t develop the full disorder, a careful evaluation is necessary before a clinician decides how to intervene.

 

Behavioral: PTSD therapy sessions aim to create a safe and supportive environment for your child.  Psychotherapy that helps children speak, draw, play, or write about their trauma has been successful. In other cases, your child’s clinician might recommend behavior modification techniques and cognitive therapy to teach your child to cope with his or her fear instead of addressing the trauma directly. Therapy sessions for children almost always involve a parent, a family member, or another caregiver.

 

Pharmacological:  Medication may be prescribed to help alleviate fear and anxiety, starting with antidepressants and anti-anxiety drugs.  If you child has persistent bad dreams, a drug used to treat hypertension called Prazosin has proven effective in curbing them.

Is it dangerous?
If left untreated PTSD frequently leads to a variety of dangerous behaviors. Depression, risk-taking, and a variety of anxiety and behavior disorders can all follow. Young people with PTSD may also begin using substances in an attempt to self-medicate. Severe cases are at risk for suicide.
Do medications help?
Yes, medications have been used to successfully treat feelings of fear and anxiety in children with post-traumatic stress disorder along with psychotherapeutic interventions. Your child may be prescribed antidepressants or anti-anxiety medication in combination with behavioral therapy.
What causes it?
Exposure to a traumatic event or series of events that a young person believes has put her or her loved ones in danger of serious injury or death can cause post-traumatic stress disorder. Some children may be more susceptible to PTSD, lacking resilience that allows others to bounce back from a disturbing experience.
My child experienced a traumatic event. Will he develop PTSD?
Most children will not develop PTSD. Children who have a history of mental illness are more susceptible, as are those who have experience trauma for an extended period, those who have a close relative with PTSD, or those with little social support after a traumatizing event.
Can I prevent post-traumatic stress disorder?
Researchers don’t know exactly what causes PTSD, but some children are more susceptible. Fortunately, there are some things you can do to reduce the risk of developing PTSD. If your child has experienced a traumatic event, make sure family and friends help him feel safe and protected. If you’re worried about her reaction, consider having her evaluated by a professional.