14.Post-Traumatic Stress Disorder

14.1.What Is Post-Traumatic StressDisorder?

Children who suffer from post-traumatic stress disorder (PTSD) are thosewho have been exposed to one or more traumas and develop reactions that persistand effect their daily lives after the event has ended.

14.2.Causes of Post-Traumatic Stress Disorder

PTSD is often thought of as an illness that soldiers get after going towar. We now know that PTSD is much more complicated than that. Any person ofany age may develop PTSD after experiencing other types of trauma such as:

Physical harm or threats of harm

Knowing that a friend or family member experienced a traumatic event

Being a victim of a crime, serious accident or life-threatening illness

Natural disasters or terrorism

Sexual molestation or assault including physical, sexual, or psychologicalabuse and neglect

Sudden or violent loss of a loved one

Family or community violence

A child' or teen’s risk for developing PTSD may depend on how close theywere to the trauma, the severity of the trauma, how long the trauma lasted andhow often it occurred. Not everyone who experiences trauma develops PTSD.Having a strong support system, good coping skills to get through difficultexperiences, and being able to respond and act even when afraid are factorsthat reduce the risk of PTSD.

14.3.Signs and Symptoms

Children and teens with PTSD experience extreme emotional, mental andphysical distress when exposed to situations that remind them of the traumatic event.Some may repeatedly experience the trauma in the form of nightmares andflashbacks.

The following are the most common symptoms of PTSD. However, each child orteen may experience PTSD in different ways, and may have some or all of thesesymptoms:

Trouble sleeping

Depression and guilt

Being on constant alert for trouble

Being easily startled

Loss of interest in things they used to enjoy

Feeling numb and lacking emotions; feeling alone

Becoming angry and possibly violent

Avoiding certain places or situations that bring back memories

Flashbacks or intrusive images (Flashbacks can come in the form of images,sounds, smells, or feelings; a person usually believes that the traumatic eventis happening all over again.)

Losing touch with reality

Acting as if reliving the experience for a period of seconds or hours or,very rarely, days

Problems in school; difficulty concentrating

Worry about dying at an early age

Acting younger than their age (i.e., thumb sucking)

Feeling sick (headaches, stomachaches)

Substance abuse

Thoughts of hurting yourself or someone else

In very young children, symptoms can include bedwetting, acting out thetrauma while playing, being “clingy” with their caregivers, and possibly beingunable to talk.

14.4.Diagnosis of Post-Traumatic Stress Disorder

PTSD is diagnosed only if symptoms persist for more than one month and areadversely affecting the child's life and level of functioning. In those who arediagnosed with PTSD, symptoms usually begin within three months following thetrauma, but can also start months or years later.

The length of the illness varies. Some people recover within six months;others have symptoms that last much longer.

A qualified mental health professional usually diagnoses PTSD in childrenor teens after meeting and talking with them and completing a full evaluation.

14.5.Treatment for Post-Traumatic Stress Disorder

PTSD can be treated. Getting help soon after the symptoms appear is veryimportant and can help reduce the severity of symptoms. Parents should arrangean evaluation with a medical professional as soon as signs and symptoms of PTSDare noticed.

14.6.Specific treatment for post-traumatic stress disorder will bedetermined by your child's physician or mental health provider based on:

Your child's age, overall health and medical history

Extent of your child's symptoms

Your child's tolerance for specific medications, procedures, or therapies

Treatment should always be based on a comprehensive evaluation of thechild and family. Treatment recommendations may include cognitive behaviortherapies or parent training. Some children may also benefit from treatmentwith medications.

Recovery from PTSD depends on the child’s or teen’s internal strengths,coping skills and resiliency (ability to “bounce back”) as well as severity ofthe trauma, frequency of re-exposure of traumatic events and the presence ofother mental health disorders. Recovery is also influenced by the support givenwithin the family environment. Parents play a vital supportive role in thetreatment process.

14.6.Prevention of Post-Traumatic Stress Disorder

Parents cannot prevent all tragedy, but may work to prevent some types oftraumatic events by:

Teaching children that it is OK to say NO to someone who tries to touchtheir body or approach them in any way that makes them feel uncomfortable

Teaching children that it is OK to tell an adult they trust if someonemakes them feel uncomfortable

Encouraging violence-prevention programs within your community or localschool system

Fostering school programs to deal with severe emotional distress