Not all scars are visible. A child who once laughed freely now startles at loud noises, clings to familiar faces, or refuses to sleep alone. A past event – something frightening – has taken root in their mind, replaying when they least expect it. This is what PTSD can look like in children. It’s not just fear; it’s a shift in how they see the world and their place in it. In this piece, I’ll walk you through how PTSD manifests in young minds, how to spot the signs, and, most importantly, how we can help them heal.
Post-traumatic Stress Disorder in Children
PTSD is a clinical trauma- and stressor-related disorder, previously classified as an anxiety disorder, characterized by significant behavioral, cognitive, social, physical, and emotional symptoms that can last for more than a month after experiencing or witnessing a traumatic event. Such events may involve sexual abuse, physical abuse, domestic violence, car accidents, or natural disasters.In children and adolescents, the risk of developing PTSD is related to several factors, including the severity and proximity of the trauma, the child's relationship to any victims, and individual resilience and support systems.
What to do?
Reassure safety
Children need reassurance that everything will be alright. Letting them know that you are there to support and protect them can ease their heightened alertness, decrease bouts of fear, and help keep their emotions in check.
Maintain a predictable schedule
Avoid throwing your child off schedule. Sticking to a predictable routine helps reduce stress and anxiety. Make seamless transitions and try to introduce new activities and situations gradually, so as not to overwhelm them. A schedule provides a child with a guideline of what to expect throughout their day and eliminates uncertainties.
Practice good listening
Hear your child out. Give them enough time to express their emotions and feelings. In the case of younger children who are not able to communicate their emotions, pay close attention to any sudden behavior changes, as these will offer valuable clues for you to understand what they could be trying to communicate.
Share information on a need-to-know basis
You need to shield your child from things they do not necessarily need to be exposed to. Only share information that an inquisitive young mind can handle, or answer their questions in a basic and child-friendly manner. Spare any details that are otherwise not necessary to avoid causing further distress. This is also where you would want to limit exposure to media outlets, such as watching the news following a tragic event.
Stay cool and collected
In the event of trauma, everything around a child might seem chaotic. It is crucial, as an adult, to remain calm and reassuring. Children can easily sense fear and helplessness displayed by those they look up to for protection. When a child picks up on negative vibes, it can send them into a spiral of anxiety attacks and emotional distress, further exacerbating a bad situation.
Be vigilant
Signs and Symptoms of PTSD in Children
Days or months after the traumatic event, the child may initially show confused or agitated behavior. They begin to feel intense fear, sadness, anger, and helplessness.
Those who have experienced repeated trauma sometimes develop a kind of emotional numbing called dissociation. Children with PTSD tend to avoid places, situations, and people who remind them of the traumatic experience. They may also become depressed, less responsive, and detached.
Often, children suffering from this disorder may re-experience the event by having nightmares or frightening dreams. They may also have frequent memories of the traumatic event. They may also act and feel like the experience is happening again. They may develop repeated emotional and physical symptoms when they are reminded of the event.
Often, children suffering from this disorder may re-experience the event by having nightmares or frightening dreams. They may also have frequent memories of the traumatic event. They may also act and feel like the experience is happening again. They may develop repeated emotional and physical symptoms when they are reminded of the event.
Other symptoms include being startled and frightened easily, acting younger than their age, lack of concentration and focus, problems staying or falling asleep, and losing interest in many activities.
Symptoms of PTSD in Children can manifest as:
- Reliving the Trauma:
- Intrusive memories: Vivid flashbacks or upsetting thoughts of the traumatic event.
- Nightmares: Recurring nightmares, often related to the trauma.
- Play behaviors: Reenacting the trauma through play, drawings, or stories.
- Physical reactions: Sweating, racing heart, or panic attacks when reminded of the trauma.
- Avoidance:
- Avoiding places, people, or things that remind them of the trauma.
- Withdrawing from social activities or hobbies they used to enjoy.
- Becoming unusually clingy or fearful of being separated from caregivers.
- Negative Thoughts and Moods:
- Feeling sad, depressed, or hopeless.
- Feeling guilty or ashamed about the trauma.
- Difficulty trusting others.
- Loss of interest in activities they used to enjoy.
- Feeling isolated or alone.
- Changes in Behavior and Arousal:
- Irritability and anger outbursts.
- Hypervigilance or being easily startled.
- Difficulty sleeping or staying asleep.
- Changes in appetite or eating habits.
- Self-harm or reckless behavior.
- Additional Symptoms in Young Children:
- Regression in development, such as bedwetting or thumb sucking.
- Difficulty expressing their feelings or thoughts.
- Night terrors or crying out in their sleep.
Note: This list is not exhaustive, and the symptoms of PTSD can vary greatly from child to child.
You may read also: Anxiety Disorders in Children
How is PTSD diagnosed in a child?
Diagnosing PTSD in children can be challenging due to their limited ability to express their experiences and emotions. While it's true that some children may be hesitant to talk about a traumatic event, it's important to avoid assuming all children with PTSD will be silent. Some may readily share their experiences, while others may express their distress through their behavior or play.
Clues from the Child:
- Behavioral changes: Watch for alterations in sleep patterns, eating habits, mood, and overall behavior. For example, a child who used to be outgoing might become withdrawn or easily startled.
- Play: Pay attention to how the child plays. They may use toys or drawings to reenact the traumatic event or depict elements of it, even if they don't verbally express their feelings.
- Nightmares and flashbacks: These are common symptoms of PTSD. If a child has recurring nightmares or seems to relive the traumatic event through flashbacks, it's important to seek professional help.
Family Involvement:
While family members can be valuable sources of information, it's crucial to acknowledge the limitations. Sometimes, families themselves may be unaware of the traumatic event or its impact on the child. Additionally, family members may be hesitant to share certain details due to their emotional distress or fear of blame.
Comprehensive Evaluation:
Therefore, a thorough diagnosis of PTSD in children requires a multi-faceted approach. A qualified mental health professional will use a combination of:
- Clinical interviews: Both with the child and their family members to gather information about the child's experiences, symptoms, and history.
- Psychological assessments: These may include standardized tests and questionnaires to evaluate symptoms and rule out other potential diagnoses.
- Observation of the child: Watching how the child interacts with others and plays can provide valuable insights into their emotional state.
By combining information from various sources and utilizing a comprehensive evaluation, mental health professionals can accurately diagnose PTSD in children and provide them with the necessary support and treatment.
Remember: Early diagnosis and intervention are crucial for helping children recover from PTSD and lead healthy, fulfilling lives.
How is PTSD treated in a child?
Treating PTSD in a child requires a multifaceted (holistic) approach that addresses their unique needs and experiences. Here's a breakdown of the key elements involved:
Psychotherapy
- Trauma-Focused Cognitive Behavioral Therapy (TF-CBT): This evidence-based approach is considered the first-line treatment for childhood PTSD. TF-CBT helps children:
- Understand and process the traumatic event in a safe environment.
- Identify and manage distressing thoughts and feelings.
- Develop coping skills to handle triggers and prevent flashbacks.
- Express themselves and communicate their experiences.
- Other types of therapy: Individual, group, and family therapy can also be beneficial depending on the child's age, preferences, and family dynamics. Play therapy, art therapy, and music therapy offer alternative ways for children to explore and express their emotions related to the trauma.
Medication
In some cases, medication may be prescribed to manage specific symptoms like anxiety, depression, or sleep disturbances. This is typically used in conjunction with psychotherapy.
Family Support
A supportive and understanding family environment is crucial for a child's recovery. Family members can benefit from education about PTSD and learn how to best support the child, creating a safe and stable space for healing.
We need to remember that healing from PTSD in children takes time and patience. All involved parties must be consistent and supportive, providing regular follow-ups with a qualified mental health professional to monitor progress and adjust the treatment plan as needed. This collaborative process, involving the child, family, and healthcare professionals, is key to ensuring long-term well-being.
Early intervention and professional guidance pave the way for effective treatment and positive outcomes, enabling children with PTSD to experience significant healing and lead fulfilling lives.
How to Deal with a Traumatized Child: Parenting A Child Who Has Experienced Trauma
What to do?
Reassure safety
Children need reassurance that everything will be alright. Letting them know that you are there to support and protect them can ease their heightened alertness, decrease bouts of fear, and help keep their emotions in check.
Maintain a predictable schedule
Avoid throwing your child off schedule. Sticking to a predictable routine helps reduce stress and anxiety. Make seamless transitions and try to introduce new activities and situations gradually, so as not to overwhelm them. A schedule provides a child with a guideline of what to expect throughout their day and eliminates uncertainties.
Practice good listening
Hear your child out. Give them enough time to express their emotions and feelings. In the case of younger children who are not able to communicate their emotions, pay close attention to any sudden behavior changes, as these will offer valuable clues for you to understand what they could be trying to communicate.
Share information on a need-to-know basis
You need to shield your child from things they do not necessarily need to be exposed to. Only share information that an inquisitive young mind can handle, or answer their questions in a basic and child-friendly manner. Spare any details that are otherwise not necessary to avoid causing further distress. This is also where you would want to limit exposure to media outlets, such as watching the news following a tragic event.
Stay cool and collected
In the event of trauma, everything around a child might seem chaotic. It is crucial, as an adult, to remain calm and reassuring. Children can easily sense fear and helplessness displayed by those they look up to for protection. When a child picks up on negative vibes, it can send them into a spiral of anxiety attacks and emotional distress, further exacerbating a bad situation.
Be vigilant
Be on the lookout for lingering symptoms of distress often associated with post-traumatic stress disorder. If you notice that your child is regressing, can’t stay asleep through the night, takes longer to fall asleep, is easily startled, or has sudden outbursts of temper tantrums, do not ignore these signs. Seek help!
Finding Help and Support
Understanding and treating PTSD in children requires navigating a complex landscape. The journey may feel daunting at times, but remember you are not alone. A network of resources exists to support you and your child on the path to healing.
General Support:
- National Child Traumatic Stress Network (NCTSN): Offers comprehensive resources, education, and support for families and professionals dealing with childhood trauma. (https://www.nctsn.org/)
- Child Mind Institute: Provides expert articles, tips, and tools to help families understand and support children with mental health challenges, including PTSD. (https://childmind.org/)
For Children:
- The Trauma Toolkit for Kids: https://trauma-informed.ca/wp-content/uploads/2023/04/trauma-informed_toolkit_v07-1.pdf - A downloadable toolkit with age-appropriate activities and resources to help children cope with difficult emotions and understand trauma.
- Sesame Street Sesame Workshop Family Friendly Resources on Emergency Preparedness: https://sesameworkshop.org/resources/ - Offers fun and engaging resources to help children learn about coping with stressful situations and building resilience.
Support Groups:
- National Alliance on Mental Illness (NAMI) Family Support Groups: Connect with other families facing similar challenges and find understanding and support. (https://www.nami.org/Home)
Crisis Text Line:
- Text HOME to 741741 for immediate support from a trained crisis counselor.
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