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Posttraumatic Stress Disorder (PTSD)

Medically reviewed by: Shirin Hasan, MD

What Is PTSD?

Posttraumatic stress disorder (PTSD) is a mental health condition brought on by a trauma.

A child or teen may be diagnosed with PTSD if they have gone through a trauma, and if their stress symptoms are severe and last long after the trauma is over.

Therapy can help kids and teens recover from PTSD. Sometimes taking medicines also can help. Kids also need extra time, comfort, and support from caregivers.

What Is Trauma?

Trauma is a serious event that causes a person to fear for their life or safety. Trauma events that can lead to PTSD include things like:

  • bad accidents or injury
  • abuse
  • sudden loss of a parent
  • school or neighborhood violence
  • natural disasters or fires
  • shootings
  • being the target of hate, or threats of harm

Events can be trauma even if the person didn’t face the danger themselves. Seeing someone else be hurt or die from violence can be a trauma. Hearing that someone close died suddenly or violently can be a trauma too.

Does Trauma Always Cause PTSD?

No. Going through trauma does not always cause PTSD. Most kids and teens who go through a trauma will not get PTSD.

But most of them will feel the effects of trauma. It’s normal to react to a deeply stressful event. Most will have upset feelings, thoughts of the trauma, and other signs of distress. This may last for a short while, sometimes days or weeks. With comfort, listening, and support, most can find ways to cope with what they’ve been through.

PTSD develops when a trauma overwhelms a child’s ability to cope. Kids and teens with PTSD need extra help to move through the coping process.

Things that affect whether someone develops PTSD after a trauma include:

  • how severe the trauma was
  • how quickly they get help and support
  • a past history of trauma
  • having depression and anxiety
  • inherited risks like family history of depression and anxiety

What Are the Signs & Symptoms of PTSD?

Most kids and teens with PTSD will: 

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

Younger children may show more fearful and regressive behaviors (returning to a previous level of development) They may re-enact the trauma through play.

When symptoms like these happen in the first days and weeks after the trauma, it may be called an acute stress reaction. Doctors diagnose PTSD when symptoms last longer than a month.

How Is PTSD Treated?

PTSD doesn’t usually go away on its own. Getting treatment and help can make all the difference. Mental health providers (like psychologists, psychiatrists, and mental health counselors) have the experience to work with patients with PTSD.

Treatment for PTSD can include therapy and/or medicines to help with anxiety, mood problems, and sleep issues.

Therapy for kids with PTSD is called trauma-focused cognitive behavioral therapy (TF-CBT). This type of talk therapy uses talking and learning activities, guided by a mental health therapist.

For younger kids, trauma therapy includes talk, play, drawing, and story activities. A parent or caregiver is almost always there during the therapy. Their support and comfort play a big role in helping their child feel safe and do well.

TF-CBT can help any child who has been through a trauma, not just those who have PTSD. Getting therapy soon after a trauma helps kids cope well.

For teens, PTSD therapy often includes:

  • cognitive processing therapy (CPT) activities: to help with thoughts and feelings about the trauma
  • prolonged exposure (PE) activities: to help teens lower anxiety and learn to safely face things they avoid after trauma
  • eye movement desensitization and reprocessing therapy (EMDR): combined cognitive therapy with directed eye movements to reduce the power and pain of the trauma. This helps the brain reprocess memory of the trauma. There are therapists who specialize in this type of trauma therapy.

How Does Therapy Help?

Trauma therapy 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 they feel after a trauma. This makes it easier to talk about what they’ve been through.

Through therapy, kids learn to adjust some of their thoughts about the trauma. They learn to let go of any guilt or shame about what happened to them. Slowly, they learn to face things they used to avoid.

Therapy helps children gain courage and confidence. Kids use their strengths to cope.

How Can Parents Help?

If your child has been through trauma, here are things you can do:

  • Help your child feel safe. They may need extra time, comfort, and care from you for a while.
  • Help your child relax. Invite them to take a few slow breaths with you. Breathe in while you count to 3. Breathe out while you count to 5.
  • Do things together that you enjoy. Trauma can make it harder to feel the positive emotions that naturally help kids recharge. Play, laugh, enjoy nature, make music or art, cook. These activities can reduce stress and build your child’s resilience.
  • Reassure your child. Let them know they will get through this. And that you are there to help.
  • Let your child’s doctor know what your child has been through. Get a referral to a mental health professional (like a psychiatrist, psychologist, or mental health counsellor who specializes in trauma therapy).
  • Tell your child’s teacher that your child went through a trauma. Kids with PTSD may have more trouble focusing on schoolwork. Ask for your child to have extra help or more time to do schoolwork if they need it for a while.
Medically reviewed by: Shirin Hasan, MD
Date reviewed: August 2021