What Is Posttraumatic Stress Disorder (PTSD)?
Someone who is the victim of (or threatened by) violence, injury, or harm can develop a mental health problem called postraumatic stress disorder (PTSD). PTSD can happen in the first few weeks after an event, or even years later.
People with PTSD often re-experience their trauma in the form of “flashbacks,” memories, nightmares, or scary thoughts, especially when they’re exposed to events or objects that remind them of the trauma.
Psychologists, therapists, or psychiatrists can help people with PTSD deal with hurtful thoughts and bad feelings and get back to a normal life.
What Causes PTSD?
PTSD is often associated with soldiers and others on the front lines of war. But anyone — even kids — can develop it after a traumatic event.
Traumas that might bring on PTSD include the unexpected or violent death of a family member or close friend, and serious harm or threat of death or injury to oneself or a loved one.
Situations that can cause such trauma include:
- violent attacks, like rape
- physical or sexual abuse
- acts of violence (such as school or neighborhood shootings)
- natural or man-made disasters
- car crashes
- military combat (sometimes called “shell shock”)
- witnessing another person go through these kinds of traumatic events
- being diagnosed with a life-threatening illness
In some cases, PTSD can happen after repeated exposure to these events. Survivor guilt (feelings of guilt for having survived an event in which friends or family members died) also might contribute to PTSD.
What Are the Signs & Symptoms of PTSD?
People with PTSD have symptoms of stress, anxiety, and depression that include many of the following:
Intrusive thoughts or memories of the event
- unwanted memories of the event that keep coming back
- upsetting dreams or nightmares
- acting or feeling as though the event is happening again (flashbacks)
- heartache and fear when reminded of the event
- feeling jumpy, startled, or nervous when something triggers memories of the event
- children may re-enact what happened in their play or drawings
Avoidance of any reminders of the event
- avoiding thinking about or talking about the trauma
- avoiding activities, places, or people that are reminders of the event
- being unable to remember important parts of what happened
Negative thinking or mood since the event happened
- lasting worries and beliefs about people and the world being unsafe
- blaming oneself for the traumatic event
- lack of interest in participating in regular activities
- feelings of anger, shame, fear, or guilt about what happened
- feeling detached or estranged from people
- not able to have positive emotions (happiness, satisfaction, loving feelings)
Lasting feelings of anxiety or physical reactions
- trouble falling or staying asleep
- feeling cranky, grouchy, or angry
- problems paying attention or focusing
- always being on the lookout for danger or warning signs
- easily startled
Signs of PTSD are similar in both adults and teens. But PTSD in children can look a little different. Younger kids can show more fearful and regressive behaviors. They may reenact the trauma through play.
Symptoms usually begin within the first month after the trauma, but they may not show up until months or even years have passed. These symptoms often continue for years after the trauma. In some cases, they may ease 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 bad memories.)
PTSD also can come on as a sudden, short-term response (called acute stress disorder) to an event and can last many days or up to one month.
People with PTSD may not get professional help because they think it’s understandable to feel frightened after going through a traumatic event. Sometimes, people may not recognize the link between their symptoms and the trauma.
Teachers, doctors, school counselors, friends, and other family members who know a child or teen well can play an important role in recognizing PTSD symptoms.
Who Gets PTSD?
Not everyone who goes through a traumatic event gets PTSD. The chances of developing it and how severe it is vary based on things like personality, history of mental health issues, social support, family history, childhood experiences, current stress levels, and the nature of the traumatic event.
Children and teens who go through the most severe trauma tend to have the highest levels of PTSD symptoms. The more frequent the trauma, the higher the rate of PTSD.
Studies show that people with PTSD often have atypical 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 a big 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.)
How Is PTSD Treated?
Many people recover from a traumatic event after a period of adjustment. But if a child or teen has experienced a traumatic event and has symptoms of PTSD for more than a month, an expert’s help is recommended.
Therapy can help address symptoms of avoidance, intrusive and negative thoughts, and a depressed or negative mood. Mental health professionals who can help include:
- licensed clinical social workers
- licensed professional counselors
- licensed trauma professionals
- bereavement specialists
Cognitive-behavioral therapy is very effective for people who develop PTSD. This type of therapy teaches ways to replace negative, unhelpful thoughts and feelings with more positive thinking. Behavioral strategies can be used at an individual’s own pace to help desensitize him or her to the traumatic parts of what happened so he or she doesn’t feel so afraid of them.
Eye movement desensitization and reprocessing therapy (EMDR) combines cognitive therapy with directed eye movements. This has been shown to be effective in treating people of all ages with PTSD.
In some cases, medicine can help treat serious symptoms of depression and anxiety. Medicine often is used only until someone feels better, then therapy can help get the person back on track.
Finally, group therapy or support groups are helpful because they let an individual know that he or she is not alone. Groups also provide a safe place to share feelings.
PTSD can be very challenging and may require a lot of patience and support. Time does heal, and getting good support from the family can help an individual move forward.