Posttraumatic Stress Disorder (PTSD) in Children

Overview

What Is PTSD?

Posttraumatic stress disorder (PTSD) is a mental health condition that can happen after someone goes through or sees a trauma — a very upsetting, scary, or dangerous event. A trauma often causes people to fear for their life or safety. After a trauma, some symptoms can be severe and last a long time.

Therapy, and sometimes medicine, can help kids and teens recover from PTSD. They often also need extra comfort and support from parents and other caregivers.

Top Things to Know

• PTSD is a mental health condition that may happen after a very frightening event.
• Everyone reacts to trauma in a different way.
• Symptoms can include having bad dreams or feeling jumpy, grouchy, sad, or afraid when reminded of the trauma.
• Treatment includes talking to a therapist and sometimes taking medicine.

Signs & Symptoms

What are the Signs & Symptoms of PTSD?

Going through a trauma doesn’t always cause PTSD. But most kids and teens who experience one will feel its effects. It’s normal to react to a deeply stressful event. Sometimes people get past trauma quickly on their own, while others may need extra help to move through the coping process.

Kids and teens with PTSD will often:

• have upsetting thoughts of the trauma
• have nightmares or trouble sleeping
• have bad memories, called flashbacks, that make it seem like the trauma is still happening
• avoid things that may remind them of the trauma
• be more easily startled, scared, or anxious than before
• feel moody, sad, angry, or not enjoy things as much as before
• not remember parts of what happened

Younger children might get more scared and behave like they did when they were littler. They might also act out the trauma while playing.

When kids who have been through a trauma have symptoms that last only days or weeks, it’s called an acute stress reaction. These may begin and end very quickly. When symptoms last longer than 4 weeks, it’s likely PTSD.

PTSD Causes

What Causes PTSD?

PTSD can develop when a trauma makes someone feel overwhelmed, unsafe, and not able to cope in the right way. It may have to do with differences in the brain and the "fight or flight" response (how the body normally reacts to danger). This response triggers the release of natural chemicals in the body, which usually prepares a person to deal with an actual harm. With PTSD, the response is too active and happens even when there’s no danger. This can make it hard for the person to feel safe again.

How severe the trauma was and how quickly a person gets help and support may also affect whether PTSD happens.

People may be more likely to develop PTSD after a trauma if they have:

• less support from people like family, friends, and teachers
• depression, anxiety, or family members with those mental health conditions
• been through another trauma

What Kinds of Traumas Can Lead to PTSD?

Traumatic events that may lead to PTSD can include:

• bad accidents, like some car accidents, or injuries
• physical or sexual abuse, or assault
• military combat
• arrests or evictions
• the sudden death of a parent, caregiver, or close loved one
• seeing or being involved in school or neighborhood violence
• natural disasters, like floods or fires
• shootings
• being the target of hate or threats of harm

Events can be traumatic even if kids and teens didn’t face the danger themselves. Seeing a person get hurt or die can be a trauma and so can learning that someone close died. Grief (deep sadness and loss when a loved one dies) can be intense in these cases and is often called traumatic grief.

How Is PTSD Diagnosed?

Your doctor or a behavioral health specialist (like a psychologist or psychiatrist) can diagnose PTSD. The person will talk with you and your child, ask questions, and listen carefully. Doctors will ask about the trauma and symptoms your child is having. Doctors may also check to see if other health problems may be causing the symptoms.

Treatment & Home Care

How Is PTSD Treated?

PTSD doesn’t usually go away on its own. Getting treatment and help soon after a trauma can make all the difference.

Treatment for PTSD can include therapy and/or medicines to help with anxiety and trouble with mood and sleep. One kind of therapy for kids with PTSD is called trauma-focused cognitive behavioral therapy (TF-CBT). This type of psychotherapy, or talk therapy, involves talking, learning, and relaxation exercises.

For younger kids, TF-CBT includes talking, playing, drawing, and story activities. Parents or caregivers are almost always there during therapy. Their support and comfort play an important role in helping kids learn as much as they can and feel safe.

For teens, TF-CBT often includes:

• building trust and feelings of safety in therapy 
• learning ways to cope, like how to relax and turn negative thoughts into helpful ones 
• growing closer and talking more with loved ones who are helping give support

TF-CBT can help any child who has been through a trauma, not just kids with PTSD.

How Can Therapy Help Kids & Teens Cope with PTSD?

Therapy that focuses on trauma gives kids a way to safely share their feelings, tell their story, and get support. In therapy, kids learn coping and calming skills to help them deal with anxiety and other symptoms after a trauma. This makes it easier to talk about what they’ve been through.

Through therapy, kids learn to change some of their thoughts about the trauma in a healthy way. They may learn to let go of any guilt or shame about what happened to them. Slowly, they learn to face things they may be avoiding and gain more confidence. 

How Can You Help Your Child?

To help your child after a trauma, here are some things you can do:

• Help your child feel safe. Kids may need extra time, comfort, and care from you for a while. Let them know they’ll get through this and that you’re there to help.
• Teach your child to relax. Invite your child to take a few slow breaths with you. Breathe in while you count to 4. Hold your breath for 4 counts and then breathe out while you count to 4.
• Do things together that you enjoy. Trauma can make it harder to feel the positive emotions that naturally help kids recharge. Try to play, laugh, enjoy nature, make music or art, or cook with your child. These activities can reduce stress and build your child’s resilience (inner strengths and skills).
• Talk with your child’s teacher. Explain that your child went through a trauma and may have more trouble with behavior or focusing on schoolwork. If needed, ask for your child to have extra help or more time to do assignments for a while.

When to See a Doctor

If your child has been through a trauma, call your doctor. The sooner you get help, the better.

If you're worried that your child may be thinking about suicide, take it seriously and have a talk right away. You can also turn to these resources for 24/7 help:

• 988 Suicide & Crisis Lifeline: You can call or text 988. You can also contact them through their website.
• Trevor Lifeline for LGBTQ community: Call 866-488-7386 or text START to 678678. You can also contact them through their website.

Staff from these places are trained to help, and the calls are private. If needed, call 911 for help right away.

Other Common Questions

Does my teen have depression?

All teens feel sad or moody at times. But when a sad or bad mood lasts for weeks or longer, and when there are other changes in how a teen acts, it could be a sign of depression. Learn how to tell if your child might be depressed.

How can I help when my child is stressed?

Stress is a normal response to changes and challenges. And life is full of those, even during childhood. Try these tips to help kids cope with stress.

What should I know about taking my child to a therapist?

Many children and teens have problems that affect how they feel, act, or learn. Going to therapy helps them cope better, feel better, and do better. Here’s what to expect at a therapist visit.