Childhood Post-Traumatic Stress Disorder: Symptoms And Treatment

We might only realize the impact of our upbringing and childhood once we are well past it. As adults, we may see that how we were raised, our experiences, and what we have lived through can shape who we are now. 

It is often believed that a happy, balanced childhood with loving parents equals balanced, healthy adults. On the other hand, many psychologists believe that children with absentee, critical, or abusive parents may grow up with mental health concerns. One of these is childhood post-traumatic stress disorder which can stem from traumatic events during childhood. 

We may all experience some form of non-traumatic stress during our childhood. Additionally, the same stressful events may be traumatic for one child but not traumatic for another. For example, one individual may find it simple to grieve their parents’ divorce, whereas another person may struggle with the stress of constant imagery, thoughts, or nightmares about their experience. 

Childhood trauma may sometimes feel so overwhelming for a child that they develop post-traumatic stress disorder (PTSD). Children may be particularly susceptible to experiencing PTSD from the divorce of their parents. 

When early childhood trauma leads a child to develop PTSD, they may feel unable to move on from the traumatic event and return to feeling healthy and calm. Instead, their behavior may shift, and they might replay the event(s) in their mind. Children may also experience survivor’s guilt after the trauma occurs.

Childhood post-traumatic stress disorder may be associated with other mental health conditions, such as borderline personality disorder. In some cases, it may even be associated with an increased risk of chronic illness, chronic pain, and other physical symptoms.

Causes of childhood post-traumatic stress disorder

Trauma may depend on a child’s personality, environment, and upbringing. Although what is “traumatic” can vary from child to child, there are several types of adverse childhood experiences that may cause a child to develop post-traumatic stress disorder. These may include:

• Experiencing or witnessing violence, emotional abuse, or domestic abuse 

• Experiencing sexual abuse or incest

• Being physically abused 

• Experiencing human trafficking or kidnapping

• Being impacted by a war

• Being impacted by a natural disaster or witnessing one

• Becoming displaced because of a crisis

• Becoming a refugee or immigrant at a young age

• Living in a neighborhood where violence, drugs, and crimes are present 

• Living through a severe injury or illness (such as cancer)

• Witnessing the death of a loved one through violent or unexpected means

• Experiencing the death of a primary caregiver or parent 

• Being neglected or abandoned 

• Being adopted

• Being in the foster care system, institutionalized, or in group homes 

Often, these causes can be linked. For example, studies show that children who have experienced or witnessed childhood abuse may be more likely to be abused as adults. 

If a child grows up in an unsafe environment, they may be exposed to multiple types of traumas throughout their life, such as dangerous substances, physical abuse, repeated child maltreatment, or other traumatic occurrences. 

Repeatedly being exposed to or going through any of these events may contribute to the development of complex post-traumatic stress disorder. It is not surprising that PTSD in teens is on the rise as children become older. Complex PTSD is a form of post-traumatic stress disorder stemming from repeated traumatic events or complex trauma. The chronic stress of these repeated experiences can have a negative impact on a child’s self-esteem, emotional responses, and overall well-being. 

What are the symptoms of childhood post-traumatic stress disorder?

Recognizing post-traumatic stress disorder (PTSD) in children may be difficult. For example, if a child grows up in an unsafe or hostile environment, the caregivers may not seek care for the child’s symptoms or mental health issues. If the childhood trauma is inflicted upon the child by someone in their family, it may remain unreported.  

Additionally, some of the signs and symptoms of PTSD may be attributed to the hormonal changes of a growing child. In some cases, caregivers or professionals may not believe a child who reports traumatic events. Intervention can be essential in these cases. Learning the symptoms of PTSD and taking them seriously may be beneficial if you care for or have children. 

Adults and children may experience the same type of symptoms of post-traumatic stress disorder. However, children may be more focused on their caregivers to provide support and understanding, as they may not have words for what is going on. Children often express themselves through play for this reason. Pay attention to what kind of games they play, what they roleplay with dolls, or the things they draw. 

Some children may feel afraid to speak up about child abuse if it is inflicted on them by someone they trust. Whether it’s an authority figure, teacher, or parent, they may fear repercussions for speaking out. 

Signs of childhood trauma to keep an eye out for may include the following: 

• Memories and flashbacks of the traumatic event that keep coming back even if the child wants to forget about it

• Having frequent nightmares

• Crying or screaming for no “discernible” reason

• Feeling nervous and “on edge,” especially when faced with something that reminds them of the trauma. For example, a child may become anxious or run away when a particular person enters a room 

• Acting out or drawing out the traumatic events that happened to them

• Having difficulty remembering details of the trauma

• Avoiding any places, people, or things that remind them of trauma 

• Losing interest in activities or interests that used to give them pleasure or joy 

• Becoming detached or isolated from the people around them

• Trouble concentrating at school or home

• Self-blame and guilt about what happened

• Displaying aggression or irritability

• Behaving in an impulsive manner

• Problems with sleeping

• Expressing a general sense of fear or anxiety

• Conduct concerns, such as illegal behavior, substance use, or risk-taking

If you are struggling with substance use, contact the SAMHSA National Helpline at (800) 662-4357 to receive support and resources. Support is available 24/7.

These symptoms may last for years and begin as soon as a few weeks after the traumatic event. They can also take several months or years to first appear. Many children with PTSD may not know they have PTSD until they are adults. 

Some children experience what is referred to as acute stress disorder. This mental health condition refers to a sudden stress response with symptoms lasting from a few days to a month. This may be in response to a stressful or traumatic event. 

Not every child who has gone through a childhood trauma will go on to develop PTSD. Things like mental illness in the family, the type of trauma inflicted, the child’s personality, their support system, and the environment they grew up in may all play a role in whether someone will develop post-traumatic stress disorder.

Diagnosing childhood post-traumatic stress disorder

Because PTSD symptoms may come and go, it might feel easy for a parent to miss the signs. However, at the first signs of PTSD symptoms, it can be beneficial to consult a doctor and mental health practitioner and have your child evaluated. 

A PTSD diagnosis will often be made based on the symptoms exhibited by the child. The doctor may also conduct a few physical and medical evaluations to rule out other illnesses or abuse. 

A diagnosis for PTSD will be made based on the criteria outlined in the DSM-5. Symptoms from four criteria will need to be met for children under six years of age.

They are as follows:

• Criteria A: Exposure to a traumatic event either directly (it happened to the child) or indirectly (they witnessed it)

• Criteria B: The presence of at least one intrusive symptom, like having flashbacks or nightmares of the event

• Criteria C: Displaying symptoms of withdrawal and avoidance of places, people, occurrences, or activities

• Criteria D: Displaying changes in behavior, such as aggression or irritability

If a child has one or more symptoms in each of the four categories and the symptoms have lasted for at least a month, the doctor may diagnose PTSD. For a PTSD diagnosis, a doctor may check to ensure there are no other factors at play (like depression, an anxiety disorder, or physical illness). 

A diagnosis of PTSD may feel scary or upsetting. However, because PTSD is a treatable illness, a diagnosis may be the first step toward getting support for your child or a child you care for.   

Treating PTSD

Children with post-traumatic stress disorder often go through the same kind of treatment as teens or adults who have PTSD: psychotherapy and medication. Receiving appropriate mental health services can be invaluable for a child when it comes to managing and moving forward from traumatic experiences.

Psychotherapy may help the child deal with the trauma, move on from it, and go on to lead a healthy, happy life. Depending on what kind of traumatic event the child endured and what they are going through, therapists—such as psychologists, clinical social workers, counselors, trauma counselors, psychiatrists, or bereavement specialists—may provide support.

A mental health therapist may use various techniques to treat PTSD. The most popular and effective methods used are as follows: 

Cognitive behavioral therapy (CBT)

Cognitive-behavioral therapy (CBT) is often used to treat various mental health conditions and concerns, including PTSD. A therapist specializing in trauma therapy and children may work with the survivor to understand the trauma and how it affected them through talk therapy, behavioral coping skills, and more. CBT is often used to treat children who have experienced sexual abuse. 

CBT may help the trauma survivor understand that they were not to blame for their trauma(s). The process could also encourage them to let go of any irrational thoughts surrounding the traumatic event. Finally, the therapist may provide survivors with any necessary tools to cope with and manage their symptoms.

Play therapy

Through play therapy, a therapist may encourage survivors to communicate what they have gone through by using a creative approach, such as playing games, creating art, role playing, or playing with sensory toys. 

Young children or children who do not yet possess the skills to communicate effectively may be able to communicate through creative means and imagination. Through play therapy, the therapist may help the child process the trauma. 

Eye movement desensitization and reprocessing therapy (EMDR)

EMDR is a form of trauma-focused therapy that is gaining popularity in the mental health field. Studies show that it is a safe and effective treatment for PTSD. 

EMDR may involve combining CBT with eye movement exercises (guided by the therapist) where the survivor talks about what they remember from their trauma(s). The therapist can work with them to address the emotions they experienced during and after the event. This may allow memories to reappear, as it targets both sides of the brain while processing the trauma(s). 

Other trauma therapies 

Depending on the situation and the type of trauma endured by the child, a professional may also recommend support groups, group therapy, family counseling, or another treatment method to help a child understand and cope with what’s happening. 

Medication

In some cases, a mental health professional may also prescribe medication to treat some of the symptoms associated with PTSD caused by childhood trauma, such as anxiety or depression. Managing these symptoms may enable a child to resume normal activities more efficiently. For many, medication is only a temporary solution.  

The effectiveness of PTSD treatment for children

How to support a child experiencing PTSD

A child with a strong support system may feel safer and more open to treatment. You may consider the following tips. 

Validate them 

Make efforts to validate the child’s PTSD symptoms or experiences. Don’t tell them that they’re “bad,” “dirty,” or “dramatic.” Validate their emotions by telling them their experience was traumatic, they didn’t deserve it, and you’re here to support them and help keep them safe. 

Encourage them but do not force a conversation

Encourage the child to talk about their emotions or experiences when ready. Let them know they have a safe place to confide in if they want to discuss it. If they aren’t prepared, do not force them to open up. Studies show that trauma healing can be done without remembering traumatic events. 

Help them with self-care 

Consider boosting a child’s self-esteem and self-confidence by allowing them to participate in activities they are good at, considering their opinions, and allowing them to make decisions. Model healthy self-care by practicing it in your own life. 

Don’t be critical 

Try not to be critical of your child’s behaviors. They may be struggling to deal with difficult emotions related to their trauma. It may take time for a child’s PTSD treatment to feel adequate. Remaining supportive and gentle may allow your child to feel safe in relationships, strengthening a healthy attachment style. 

Getting support related to childhood post-traumatic stress disorder

Suppose you are a parent, guardian, teacher, or loved one of a child who has PTSD. In that case, you may support their treatment by providing unconditional love and support and recognizing they may be passing through a difficult time that could impact their behavior and emotions.  

If you are struggling or have questions about supporting the child after a traumatic experience, consider speaking to a doctor or a therapist. Many parents or childcare workers find themselves too busy to attend an in-person therapy session. If you can relate, support is available online. 

Studies show that online cognitive-behavioral therapy for adults is effective at treating a variety of concerns. In one study, 71% of participants felt that online treatment was more effective than traditional counseling. 

If you’re ready to reach out, consider contacting a counselor on an online platform such as BetterHelp. Many therapists with child psychology experience may be able to support you and your family.