|SSM Cardinal Glennon Children's Medical Center|
Posttraumatic Stress Disorder
Posttraumatic stress disorder (PTSD) is the development of characteristic symptoms that occur following direct or indirect exposure to a traumatic or terrifying event in which physical harm was threatened, witnessed, or actually experienced.
PTSD also can occur after the unexpected or violent death of a family member or close friend, or following serious harm or threat of death or injury to a loved one.
Studies show that PTSD occurs in 1%-14% of the population. It can be diagnosed at at any age, and can occur as a sudden, short-term response (called acute stress disorder) or develop gradually and become chronic or persistent.
Most people with the posttraumatic stress disorder try to avoid any reminders or thoughts of the trauma. Despite this avoidance, they often re-experience the ordeal in the form of intense "flashbacks," memories, nightmares, or frightening thoughts, especially when they're re-exposed to events or objects that remind them of the trauma.
Survivor guilt (feelings of guilt for having survived an event in which friends or family died) might also be a component of PTSD.
Causes of PTSD
Traumatic events that can cause PTSD include:
Studies indicate that people with PTSD tend to have abnormal levels of key hormones involved in the stress response. For instance, research has shown that they have lower than normal cortisol levels and higher than normal epinephrine and norepinephrine levels — all of which play an important role in the body's "fight-or-flight" reaction to sudden stress. (It's known as "fight or flight" because that's exactly what the body is preparing itself to do — to either fight off the danger or run from it.)
The severity and likelihood of developing PTSD varies according to the nature of the event, as well as individual factors such as social support, family history, childhood experiences, personality, and any existing mental health problems or stress.
Signs and Symptoms
Symptoms of posttraumatic stress disorder usually develop within the first 3 months after the trauma, but they may not surface until months or even years have passed. These symptoms often continue for years following the trauma or, in some cases, may subside and return later in life if another event triggers memories of the trauma. In fact, anniversaries of the event can often cause a flood of emotions and unpleasant memories.
Sometimes, symptoms are easy to identify — they often resemble symptoms of stress, anxiety and depression. The following signs and symptoms are characteristic of PTSD if they have lasted for about a month or more after the event:
Re-experiencing the event
Persistent avoidance of any reminders of the event
Persistent feelings of anxiety or physical reactivity
People with PTSD often don't seek professional help because they may not recognize the link between their symptoms and the trauma they experienced. They also may want to continue avoiding discussing the problem because it makes them feel anxious.
Many people recover from experiencing a traumatic event after a period of adjustment. However, if your child or teen has experienced a traumatic event and has experienced symptoms listed above for over a month, it's time to get help from a professional.
Your child's teacher, doctor, friends, and other family members who know your child well can play an important role in recognizing PTSD. Other mental health professionals who can help include:
Therapy can be extremely supportive and helpful, particularly if the trauma was unusually severe or life threatening.
Cognitive-behavioral therapy has been shown to be very effective for people who develop PTSD. This type of therapy helps someone to adopt new thoughts (called cognitions) and behaviors in place of destructive or negative ones, while safely revisiting aspects of the trauma.
In some cases, medication may be recommended to help alleviate serious symptoms of depression and anxiety, which can help your child cope with school and other daily activities while being treated for PTSD. You can tell your child that medication is often used as a temporary measure to help until people with the disorder feel better.
Finally, group therapy or support groups can be beneficial because they can help kids and teens understand they're not alone. Groups also provide a safe atmosphere in which to share feelings. Ask the therapist for specific referrals or suggestions for a group.
Helping Your Child
It's helpful to understand that PTSD is an emotional problem and that your child's traumatic experience has left "emotional scar tissue." This means that first and foremost your child needs your support and understanding. It's usually necessary to seek help from a qualified therapist. Family and friends can also play a key role in helping your child recover.
Here are some other things parents can do to support kids with PTSD:
Also, take care of yourself. Helping your child cope with PTSD can be very challenging and may require a lot of patience and support. Time does heal, and getting good support for your family can help everyone get past difficult life events.
Reviewed by: Michelle New, PhD