Post-traumatic stress disorder (PTSD) is marked by a traumatic experience that leaves you with symptoms similar to anxiety. While the illness is often associated with veterans, it can happen to anyone of any age.

Since a child’s brain is in its prime developmental stages, children may be more vulnerable to PTSD in comparison to adults. Of course, several circumstances must be considered before a diagnosis.

Symptoms of PTSD in Children

Symptoms of PTSD occur after a traumatic event. What’s defined as a traumatic event ultimately depends on a person’s perception. However, common events that lead to PTSD in children include injury, death of a close family member, physical or sexual abuse, and violence. ¹

Child PTSD is multifaceted: no two children will experience the same symptoms or severity. Furthermore, certain symptoms are unique to children and not seen in adults with PTSD. The most common PTSD symptoms in children include:

• Always looking out for potential threats (easily startled)
• Avoids places, people, and objects associated with the traumatic event
• Denial of the traumatic event (feeling numb)
• Doesn’t participate in activities that once interested them
• Feelings of helplessness, hopelessness, and withdrawal from life
• Irritability (angry outbursts)
• Lack of positive emotions
• Playing out the event in their head or through play
• Severe feelings of sadness and fear
• Sleep problems (nightmares)

What Causes PTSD in Children

PTSD can be identified by a single (or multiple) traumatic event(s). Unlike other conditions, it’s not directly linked to genetics or environment. However, since PTSD is a type of anxiety disorder, some are more vulnerable to it than others.

It can be difficult to diagnose a child with PTSD as many symptoms overlap with other conditions, such as attention-deficit/hyperactivity disorder (ADHD). For a diagnosis, one of the following traumatic events has to occur before symptoms arise:

• Disaster (natural or manmade)
• Intense car accident
• Physical, sexual, or emotional abuse
• Seeing a serious illness or death of a family member or close friend
• Witness or a victim of violence or crime

Again, not every child who experiences these events will develop PTSD. In fact, a child is more likely to show signs and symptoms of PTSD if they’re vulnerable to the causes of anxiety. These include:

• Environment – If a child lives in an unruly environment where trauma is regularly present (i.e. abuse), they’re more vulnerable to anxiety. ²

• Genetics – If a family member has been diagnosed with an anxiety disorder, the chances of a child also having anxiety are much higher. ³

• Other Mental Disorders – If a child experiences another mental disorder, such as depression or bipolar disorder, they are more likely to develop a form of anxiety.

• Stress Buildup – If a child experiences a serious health condition or constantly worries about life situations, it can trigger anxiety. ⁴

• Substance Abuse – If a child is misusing drugs or alcohol, they are more susceptible to anxiety. ⁵

How Common is PTSD in Children?

The U.S. Department of Veterans Affairs conducted a review of several studies looking into PTSD in children. It concluded: “Studies show that about 15% to 43% of girls and 14% to 43% of boys go through at least one trauma. Of those children and teens who have had a trauma, 3% to 15% of girls and 1% to 6% of boys develop PTSD. Rates of PTSD are higher for certain types of trauma survivors.”

The same review also looked into reports from child protection services in the U.S. It developed a percentage base of how common specific abuses are among children:

• Neglect – 65%
• Physical abuse – 18%
• Sexual abuse – 10%
• Psychological (mental) abuse – 7%

While this review doesn’t have the most concise data, it gives us an inside look at the most frequent causes of PTSD in children. Not to mention, PTSD’s relevance in the general population of children.

How is PTSD Treated in Children?

PTSD treatment starts with a diagnosis. Medical professionals will seek out a direct traumatic experience that’s led to symptoms. If this traumatic experience isn’t clear, they may misdiagnose PTSD for another mental health condition.

Once a diagnosis is reached, children are asked if they’re safe with their parents/guardians, friends, school, and others around them. This is to ensure there’s little chance of the traumatic event happening again.

When this point is reached, psychotherapies are the most common treatment for children. Psychotherapy will ask your child to discuss, draw, play, or write about the traumatic event. The goal is to help the child identify the thought patterns and triggers surrounding this event and to teach them coping mechanisms. ⁶ You’ll also have the option of group therapy to involve family members or other children with PTSD.

Medications may also be offered to your child to help in symptom management. The most common are antidepressants or anti-anxiety medications. These help calm nerves and give your child a better sense of control. ⁷

Final Word

If you know a child is experiencing PTSD, you must seek out help immediately. When untreated, PTSD can lead to worsened symptoms as the child transitions into adulthood.

Furthermore, you need to create an environment where your child feels safe and protected. We highly suggest speaking to your child’s healthcare provider to get a better idea of their PTSD and what you can do to prevent further attacks.

References

¹ Perry BD, Azad I. Posttraumatic stress disorders in children and adolescents. Curr Opin Pediatr. 1999 Aug;11(4):310-6. doi: 10.1097/00008480-199908000-00008. PMID: 10439203.

² Aktar E, Nikolić M, Bögels SM. Environmental transmission of generalized anxiety disorder from parents to children: worries, experiential avoidance, and intolerance of uncertainty. Dialogues Clin Neurosci. 2017 Jun;19(2):137-147. doi: 10.31887/DCNS.2017.19.2/eaktar. PMID: 28867938; PMCID: PMC5573558.

³ Gottschalk MG, Domschke K. Genetics of generalized anxiety disorder and related traits. Dialogues Clin Neurosci. 2017 Jun;19(2):159-168. doi: 10.31887/DCNS.2017.19.2/kdomschke. PMID: 28867940; PMCID: PMC5573560.

⁴ Pêgo JM, Sousa JC, Almeida OF, Sousa N. Stress and the neuroendocrinology of anxiety disorders. Curr Top Behav Neurosci. 2010;2:97-117. doi: 10.1007/7854_2009_13. PMID: 21309108.

⁵ Smith JP, Book SW. Anxiety and Substance Use Disorders: A Review. Psychiatr Times. 2008 Oct;25(10):19-23. PMID: 20640182; PMCID: PMC2904966.

⁶ Danzi BA, La Greca AM. Treating Children and Adolescents with Posttraumatic Stress Disorder: Moderators of Treatment Response. J Clin Child Adolesc Psychol. 2021 Jul-Aug;50(4):510-516. doi: 10.1080/15374416.2020.1823849. Epub 2020 Oct 13. PMID: 33047981.

⁷ Strawn JR, Keeshin BR, DelBello MP, Geracioti TD Jr, Putnam FW. Psychopharmacologic treatment of posttraumatic stress disorder in children and adolescents: a review. J Clin Psychiatry. 2010 Jul;71(7):932-41. doi: 10.4088/JCP.09r05446blu. Epub 2010 Apr 20. PMID: 20441729.