Post-traumatic Stress Disorder (PTSD) In Children: Symptoms And Management

Nightmares, agitation, and forgetfulness may indicate PTSD.

Medically reviewed by Dr. Anuradha Bansal, MD Dr. Anuradha Bansal Dr. Anuradha BansalMD facebook_iconlinkedin_icon Specialty: Pediatrics and NeonatologyExperience: 13 years
Written by Dr Bisny T. Joseph Dr Bisny T. Joseph
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Post-traumatic StressDisorder

Post-traumatic stress disorder (PTSD) is a mental health disorder that may be induced by exposure to a traumatic incident. PTSD in children may cause them to re-experience or avoid certain things or people associated with the distressing event. If left untreated, PTSD may affect the child’s normal functioning and quality of life.

As per the US National Center for PTSD, around 14–43% of boys and 15–43% of girls may encounter a traumatic episode in childhood or adolescence. Further, around 1–6% of boys and 3–15% of girls have PTSD. Moreover, 65% of PTSD cases are caused by neglect from parents or caregivers (1).

Read this article to understand the symptoms, causes, diagnosis, treatment, and prevention of PTSD in children.

Causes Of PTSD In Children

Witnessing or experiencing traumatic events that may have happened to self or someone close to them can trigger PTSD in children. The following traumatic events may trigger PTSD in children (2).

  • Accidents, such as train wrecks or car collisions
  • Invasive medical procedures
  • Natural disasters, such as earthquakes or floods
  • Sexual abuse and sexual assault
  • Physical abuse
  • Bombings
  • Animal bites
  • Violent personal attacks, such as rape, kidnapping, torture, or mugging
  • Neglect from parents or caregivers
  • Bullying and emotional abuse
  • Death of a close family member or relative

Not all children who experience these events may develop PTSD. The immediacy and severity of the trauma may also play a crucial role. Strong support and encouragement after a traumatic event is a critical protective factor that can help prevent or reduce the risk of PTSD in some children (3).

Signs And Symptoms Of PTSD In Children

Children with PTSD can experience the following types of symptoms (4).

1. Re-experiencing the trauma

Some children may have flashbacks of the traumatic event and often assume that they are going through it again. The following symptoms are common in children re-experiencing the trauma.

  • Having nightmares about the traumatic event or other scary things
  • Hallucinating the smells or sounds from the experience
  • Often narrating the trauma to others verbally or in play

Children with PTSD may not be able to stop thinking about the event, even though it scares them. These sudden and unwanted traumatic memories may often prevent a child from experiencing current events around them.

2. Avoidance

Some children with PTSD may deliberately avoid objects, places, situations, or even thoughts that remind them about the traumatic event. They may also

  • Show numbness to feelings and surroundings as a form of coping mechanism.
  • Have difficulty remembering details of traumatic events.

Emotional avoidance can be a coping mechanism in many children with PTSD. However, in the long run, it may worsen the child’s quality of life and ability to cope with difficult situations.

3. Increased agitation

Some children with PTSD may presume that the trauma or emergency may happen again and show the following symptoms.

  • Trouble falling asleep (insomnia)
  • Unable to concentrate on regular activities and school works
  • Easily frightened or startled
  • Anger outbursts without any provocation

Disruptive and out-of-control behavior, extreme separation anxiety, etc., are seen in young children who cannot verbalize their feelings or thoughts of traumatic experiences. In addition, they can have an extreme fear of being away from parents or caregivers.

How To Prevent PTSD In Children?

The following measures may reduce the incidence of post-traumatic stress disorder in children who have witnessed or experienced trauma (5).

  • Appropriate parental support and encouragement
  • Psychiatric counseling from experts
  • Community and school-level prevention programs
  • Positive reinforcement and other effective parenting strategies

Prevention is not limited to these measures. Talking to your child and assuring them that you will be there for them every step of the way could make a difference in their lives.

When To See A Doctor?

Seek medical care if your child has any symptoms of PTSD. It is recommended to seek immediate care if they experience extreme anxiety or depression, hallucinations, inability to sleep or eat for three days, or display concerning behaviors. Also, seek emergency help if they have suicidal tendencies.

Diagnosis Of PTSD In Children

A qualified mental health professional or a psychiatrist can diagnose PTSD based on a comprehensive psychiatric evaluation of the child. In addition, talking to the child and parents may help them know the symptoms (5).

Not all children who experience trauma develop PTSD. It is diagnosed if a child has persistent symptoms that last more than a month and affect normal functioning.

PTSD symptoms may not be obvious immediately after the trauma. The symptoms may often begin within three months after a traumatic event or may even develop several months or years later in some children.

Treatment For PTSD In Children

PTSD treatment may vary depending on a child’s age, symptoms, severity, and health status. However, early treatment can ease the symptoms and aid in the child’s normal development and improve their quality of life. The following treatments are often recommended for children with PTSD (2).

  • Cognitive-behavioral therapy (CBT) to help a child handle their anxiety and overcome the event that triggered PTSD
  • Medications for children who have anxiety or depression due to PTSD. Psychiatric medications may help them stay calmer.

Children with PTSD may recover within six months, and a few may experience symptoms for a longer time. Recovery may depend on individual factors such as coping skills, inner strength, and family encouragement and support.

How To Help A Child Live With PTSD?

As a parent, you may do the following to help your child cope with PTSD (2).

  • Admit what happened and try to understand your child. Explain the need to move on. Pretending that it is normal may not help them recover.
  • Encourage your child to attend counseling sessions after they have gone through a traumatic event.
  • Never skip scheduled therapy sessions and follow-up visits.
  • Inform teachers and peers about your child’s condition. This may help them support your child.
  • Seek support from local and online sources and parents dealing with the same situation.
  • Take signs of depression and suicidal thoughts seriously and seek emergency support.

Frequently Asked Questions

1. Can PTSD be contagious?

PTSD is not contagious. However, at times, someone may develop PTSD after a friend or family member experiences trauma. In such cases, it may be said that close contact with someone with PTSD may trigger the disorder in a person (6).

2. What happens if PTSD is left untreated in a child?

Untreated PTSD may cause functional impairment in children. To overcome such problems, children may resort to self-medication with drugs such as anxiolytics, or start consuming alcohol or other recreational drugs that may further deteriorate their mental condition. This may result in depression, anxiety, or even suicidal ideation (7) (8).

Parents should not ignore the signs and symptoms of PTSD in children since anxiety and depression could severely impact their life. Also, the right diagnosis and early treatment can help improve their quality of life. Besides giving the prescribed medications, it is important to take them for therapy sessions and support groups to open up about their apprehensions and issues. Lend them an ear and hold their hands, expressing you are with them whenever they need emotional support. A helpful and positive atmosphere will prove helpful in their treatment.

Key Pointers

  • Post-traumatic stress disorder (PTSD) in children is a mental health problem occurring when they experience something traumatic.
  • Accidents, physical abuse, natural disasters, and violent attacks are some causes of PTSD.
  • Children with PTSD may experience hallucinations, nightmares, insomnia, and more.
  • Medicines and therapies may be used to treat the condition.
  • Not missing the counseling sessions, informing teachers and friends, and seeking local support are some ways to help children with PTSD.

References

  1. PTSD.
    https://www.ptsd.va.gov/understand/common/common_children_teens.asp
  2. Posttraumatic Stress Disorder (PTSD) In Children.
    https://www.stanfordchildrens.org/en/topic/default?id=post-traumatic-stress-disorder-in-children-90-P02579
  3. Post-traumatic Stress Disorder Basics.
    https://childmind.org/guide/post-traumatic-stress-disorder/
  4. Post Traumatic Stress Disorder (PTSD).
    https://www.childrenshospital.org/conditions-and-treatments/conditions/p/post-traumatic-stress-disorder-ptsd/symptoms-and-causes
  5. Post-Traumatic Stress Disorder In Children.
    https://www.chop.edu/conditions-diseases/post-traumatic-stress-disorder-children
  6. Post-Traumatic Stress Disorder.
    https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd
  7. Kamron A. Fariba and Vikas Gupta; (2021); Posttraumatic Stress Disorder In Children.
    https://www.ncbi.nlm.nih.gov/books/NBK559140/
  8. Posttraumatic Stress Disorder (PTSD) in Children.
    https://www.ncbi.nlm.nih.gov/books/NBK559140/
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Dr. Anuradha Bansal
Dr. Anuradha BansalMD
Dr. Anuradha Bansal is a highly accomplished pediatrician and neonatologist with 13 years of professional experience. Presently, she is working as Assistant Professor in the Department of Pediatrics at PIMS Jalandhar. She has done her MBBS and MD Pediatrics at GMCH, Chandigarh.

Read full bio of Dr. Anuradha Bansal
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