PTSD in children is a complex disorder that affects many children. The effects of trauma are sometimes obvious, but often not, and when left unchecked, can create significant and lasting difficulties in the child’s life. However, when parents are aware of these potential impacts and have the tools and support needed to tend to the trauma responses, healing and growth are more than possible.
What Is PTSD?
PTSD stands for post-traumatic stress disorder and occurs when an individual experiences a traumatic or stressful event and is unable to process it sufficiently to allow their brain and body to metabolize the trauma. Ideally, one’s body and brain can process a traumatic event, make sense of it, and eventually metabolize the stress hormones that are present. But this sequence is disrupted with PTSD, including in children.
In the aftermath of a difficult experience, it is normal for there to be some degree of shock, disruption, hyperarousal, or avoidance of trauma-related reminders (this is true when the trauma is a one-time occurrence, or a prolonged or repeated event or sets of circumstances, such as in the case of abuse or neglect). However, PTSD begins to be considered a diagnosis if these symptoms persist past one month after the traumatic event.
PTSD requires that a person experiences a combination of symptoms that fall into three categories: re-experiencing, avoidance, and hyperarousal. Re-experiencing could take the form of experiencing regular flashbacks or nightmares.
Avoidance might look like going out of one’s way to avoid any sort of loud sound and refusing to drive in certain areas of town because there’s something that reminds you of past trauma. Hyperarousal might mean that you are not able to sleep, you are constantly worried and checking for trauma-related events, and you have an exaggerated startle reaction.
The crux of PTSD is that your nervous system is stuck experiencing the trauma as if it were occurring in the present instead of being able to categorize it correctly as a past event and recognize one’s current safety. Treatment for PTSD often needs to focus on the body’s response to trauma.
PTSD in Children
PTSD in children does occur but is both under and over-diagnosed because children frequently present symptoms of PTSD differently from adults.
There’s a common perception that children are resilient – they’re able to recover from difficult things without the same lasting effects that adults experience. The plasticity of a child’s brain means that they are both able to recover and often thrive if given proper care, but they can also experience lasting damage that influences the rest of their lives.
The studies that have been done on adverse childhood experiences (commonly referred to as ACEs) show that difficult or traumatic childhood events skyrocket the risks of things like depression, anxiety, substance abuse, and other problems in adulthood.
One of the mitigating factors for these harmful effects is what researchers refer to as resilience factors or protective child experiences. A key aspect of these protective experiences is the presence of attuned and responsive caregivers. If a child knows they are loved and experience being supported and cared for during and after an otherwise traumatic experience, it has an enormous protective effect from adverse effects of the traumatic event.
The presence of these protective experiences doesn’t mean that a child won’t experience PTSD, but it does give them a much better chance of experiencing fewer long-term effects from a traumatic event. As parents, and caregivers who care for the children in our lives, it’s important to know that adult presence, support, and care are pivotal to making sure that children can develop and experience resiliency, even after trauma.
There are complex genetic and social factors that influence who gets PTSD and who doesn’t. Just because your child is experiencing PTSD symptoms doesn’t mean that you have failed as a parent or caregiver. There’s a complexity to the brain and nervous system response that is not fully defined. But what we do know for certain is that the presence of compassionate care and attuning to a child’s emotional state absolutely influences the outcome of their state.
PTSD in Children vs. PTSD in Adults
The diagnosis of PTSD in children is based on the same three clusters of symptoms (re-experiencing, avoidance, and hyperarousal). However, some of these symptoms can present differently in children.
Re-experiencing can often happen in a child’s play where they re-enact the same events or themes of the event over and over. It can also take the form of more generalized nightmares that don’t feature specific memories.
Because a young child’s ability to communicate using language is still developing, it can complicate the process of diagnosis. The current criteria for PTSD require the individual to be able to self-assess their internal state, which isn’t a developmentally appropriate task for children, especially younger children. This means that parents, caregivers, and therapists have to be more aware of the other manifestations of trauma in children.
These can include behavior regressions, psychosomatic complaints such as frequent unexplained stomach aches or headaches or other chronic pain, and sudden anxiety. PTSD in children can also manifest similarly to other behavioral diagnoses like ADHD or ADD, so it’s important to be able to track the changes in a child’s behavior and try to understand the origin of symptoms, even if they don’t seem to make sense.
PTSD in Children: How Parents Can Help
One of the most important elements of PTSD treatment is to establish safety for the child experiencing symptoms so that their body and brain are able to feel safe enough to process their past experience. If a parent is themselves traumatized or suffering from the stress of dealing with an event or their child’s behavior, it’s essential that the parent seeks the necessary help for themselves.
Parents and caretakers need to be as well-resourced as possible to create an environment that is conducive to the child’s healing. In fact, parent-related trauma has an increased rate of PTSD, precisely because this task of creating safety becomes difficult in a home where the parent is part of the issue.At a minimum, a parent or caregiver whose child is struggling with PTSD needs to be educated about the symptoms and presentation in addition to learning strategies to regulate their child’s nervous system and help them to stay grounded.
While trauma-focused cognitive behavioral therapy is the most common type of therapy, a growing body of research supports the idea that addressing the nervous system’s response to trauma using more body-based methods is essential.
PTSD in Children – What’s Next
As a parent, it may be scary and overwhelming to consider that your child may be dealing with PTSD, or that the effects of something you could not prevent might be lingering. Rather than stay paralyzed by your own feelings about the situation, we would urge to you seek care as quickly as you can if you suspect that your child is not coping well.
Even if a child doesn’t meet the criterion for PTSD, seeking help early on can be protective in ensuring that an acute stress response doesn’t continue to develop into PTSD. The studies on adverse childhood events can be sobering, but the encouraging research is that the protective effects of supportive caregivers and a child who knows that they are loved and seen are very impactful, as well.
The Bible itself talks often about the effects of hearts that are fragmented and hurting. We know from looking at new research that traumatic experiences cause feelings of isolation, disconnection, and fragmentation that make it more difficult to orient yourself in time and place, but this doesn’t mean that the trauma is the end of the story.
Jesus identified himself as the one who “binds up the broken-hearted” (Isaiah 61) and this is his promise to us. For the people who deal with pain and trauma, he will go into those difficult places with us and with our children. He will bring healing and hope to the darkest parts of our stories.
We would love to come alongside you or your child in this process and hold fast to the truth that there is indeed hope for healing, even in great suffering. Reach out to one of our compassionate counselors today to help your child overcome PTSD.
Kaminer, D., Seedat, S., & Stein, D. J. (2005, June). Post-traumatic stress disorder in children. World psychiatry : official journal of the World Psychiatric Association (WPA). Retrieved May 21, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1414752/
Post-traumatic stress disorder (PTSD) in children. Nationwide Children’s Hospital. (n.d.). Retrieved May 21, 2022, from https://www.nationwidechildrens.org/conditions/health-library/post-traumatic-stress-disorder-ptsd-in-children
Staff), J. S. (P. A. C. E. C. (n.d.). What ACEs and PCEs do you have? PACEsConnection. Retrieved May 30, 2022, from https://www.pacesconnection.com/blog/got-your-ace-resilience-scores
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