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Mental Health PTSD Stress Trauma

Can Teens Have PTSD?

Post-traumatic stress disorder (PTSD) is often associated with combat veterans and victims of sexual assault. It is a widespread condition with a spectrum of symptoms brought on by any form of trauma at any age. So, what about teens? Can teens have PTSD too?

Nearly 7 percent of adults experience PTSD at some point in their lives, and women experience PTSD more regularly each year (5.2 percent) than men (1.8 percent). However, among teens alone, about 5 percent experience PTSD any given year (8 percent among girls, 2.3 percent among boys). Children can experience PTSD as well, usually in response to abuse or the loss of a parent. PTSD symptoms appear a little different in children and teens than they do in adults.

Recognizing the signs of PTSD can help parents and friends get their loved ones the care they need and minimize the chances of long-term recurring mental health problems, such as high levels of stress and anxiety, recurring depressive thoughts, and even suicidal ideation.

What is PTSD?

Post-traumatic stress disorder is a type of stress disorder or anxiety disorder caused by trauma. Whereas other anxiety disorders may also figure in a traumatic or harrowing experience as part of its causes, PTSD can usually be directly attributed to a single event or series of events, such as a natural disaster, death of a loved one, or habitual family abuse. PTSD is triggered by a traumatic event but does have genetic causes. Some people are more likely to develop PTSD symptoms in response to trauma than others.

PTSD Symptoms in Teens and Children

In addition to being a mental health issue, PTSD has physical symptoms. The brain changes in response to trauma, sometimes being “locked” into a state of hypervigilance or awareness. Children, teens, and adults with PTSD have marked differences in the way their brain processes startling stimuli. As a result, people with PTSD are more prone to entering fight-or-flight, are more easily startled, and may be much more irritable and on-edge than others.

PTSD has several characteristic symptoms that can be categorized as either remembering/re-experiencingavoidanceunwanted thoughts, or physical and emotional changes, such as heightened anxiety, difficulty controlling emotions, recurring depressive episodes, insomnia, jitters, nervousness, restlessness, and an uncontrollable startle reflex.

Can Teens Have PTSD? How Does it Differ from Adults?

Post-traumatic stress disorder is not a simple condition, and symptoms can vary depending on the nature of the trauma, the severity of the condition itself, and the age of the person. Children and teens will usually experience PTSD differently than adults.

In general, teens are more prone to anger and irritability after a traumatic experience. Teens with PTSD have a harder time with emotional regulation and will be more emotionally unstable as a result of their condition. They are more likely to turn towards violent actions against themselves or others following a traumatic experience and more likely to experience outbursts of anger, either against themselves or others. Teens are also likely to “retaliate” to abuse by engaging in self-harm, high-risk behavior, sexual behavior, or substance use.

Children and PTSD

Aside from greater emotionality and irritability, symptoms between teens and adults are mostly the same. Children, on the other hand, are more likely to incorporate elements of their trauma into play as part of their “flashbacks” or re-experiencing symptoms. A child under the age of six may re-experience their trauma through roleplaying or reenactments with toys. They are also more prone to nightmares and other frightening dreams that incorporate elements of their traumatic experience.

Time-Skewing and Omen Formation

Two other unique elements in pre-adolescent PTSD are time-skewing and omen formation. In other words, children are more likely to mess up the sequence of events in which their trauma took place, among other memory problems. They will have a harder time remembering exactly in what order things happened to them, perhaps due to the way their brain prioritizes the severity of the event over its chronological order.

Omen formation refers to the way children will attempt to understand what happened to them through pattern recognition. They may pick random signs that occurred prior to the trauma as predictive factors for a repeated event. In this way, they will try to stay alert for anything that might signal another traumatic experience, even if it had nothing to do with their abuse or trauma.

As with older teens and adults, children experience cognitive trouble and memory problems because of untreated trauma. They may do worse in school, and symptoms can continue for years after the event.

PTSD vs. Other Anxiety Disorders

PTSD can be classified as an anxiety disorder because its characteristic symptoms center around a nervous response to a traumatic event, and this can reinforce existing feelings of insecurity and anxiousness or create new ones.

Teens and adults with PTSD are also more prone to social and generalized anxiety (growing feelings of worry, despite no direct cause), panic attacks, and depressive symptoms, including overwhelming feelings of guilt and self-blame, and resulting episodes of self-harm or suicidal ideation.

However, most other anxiety disorders are not directly linked to a single event or traumatic cause. Anxiety disorders like social anxiety disorder or generalized anxiety usually develop independently of any event, with the most common age of onset being adolescence.

How is PTSD in Teens Treated?

Some medications can help teens with PTSD manage stress symptoms and depressive symptoms, such as antidepressants and anti-anxiety medication, but the bulk of a teen’s treatment relies on therapeutic methods, such as cognitive-behavioral therapy (CBT), dialectical behavior therapy (DBT), and eye movement desensitization and reprocessing (EMDR).

These therapies approach PTSD in different ways but ultimately circle back to helping teens work through their trauma, overcome, and deconstruct misattributed feelings of guilt or shame, and develop healthy coping skills to manage future stressors and lead a symptom-free life.

Specialized treatment may be needed in cases where PTSD is coupled with another diagnosis, such as substance use disorder or major depressive disorder. Co-occurring mental health conditions can complicate treatment and require an approach that addresses multiple issues concurrently through a lens of holistic mental care.

Finding Treatment for PTSD in Teens

It’s important to treat and address PTSD in teens to prevent other long-term mental health issues. If you suspect your teen of experiencing PTSD, contact us today.

Visions Treatment Centers is focused on treating teen mental health needs using specialty clinic modalities by licensed clinical psychologists. We also offer teen residential treatment programs and much more.

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Mental Health Trauma

7 Signs of Trauma in Teens (And how to cope)

Traumatic experiences can alter a person’s psyche dramatically, weighing on them both consciously and subconsciously, and changing their decision making, their thought processes, and their behavior. These changes can alter personalities and continue to affect a person even long after they’ve “made peace” with the past. And like adults, teens can also experience trauma or a trauma disorder too. But what are the signs of trauma in teens? How are these signs recognized? And how does one cope?

In teens especially, trauma can lead to emotional and psychological maladjustment, presenting difficulties in achieving independence in adulthood, communicating with others, retaining and understanding information, and engaging with people socially.

To understand why and how trauma can affect teens, we need to understand the effect trauma has on the brain, and why treatment can be difficult.

What is Teen Trauma?

Traumatic experiences are subjective, meaning an event that traumatizes one person might not necessarily traumatize the other, even if they were both present that day.

But nearly all traumatic experiences are characterized by their shock and horror – usually, events involving mass death, abuse, violence, cruelty, long-term neglect, or forces of nature. Trauma may be caused by an acute event or a period of horror.

When trauma occurs, the mind is affected in a way that isn’t typical of stressful situations. We are equipped to deal with stress, and we learn through both negative and positive reinforcement. But there’s a difference between “one of life’s lessons” and an event so impactful that it leaves an unwanted mark on our way of thinking for years to come. The latter is a traumatic event. Trauma is characterized by intrusive thoughts and emotions, changes in mood and cognition, jumbled or lost memories, and more.

Teens experience trauma similarly to adults, with a few key differences. The biggest is a greater tendency towards impulsive, risk-taking, self-destructive, and violent behaviors. Teens are more likely than adults to turn towards self-harm, dangerous sexual behavior, and drug use after a traumatic event.

Now, let’s look at some of the signs of trauma in teens and their effects.

Recognizing Signs of Trauma in Teens

Psychologically, trauma is understood as an open and unhealing wound in the mind. The mind may respond in a few different ways, which brings us to the telltale signs of post-traumatic stress. These include:

  • Hyperarousal/hypervigilance, such as overreacting emotionally and physically to certain stimuli, like unexpected touch or a loud noise.
  • Depersonalization/dissociation, such as remembering trauma as something that happened to someone else, or completely forgetting/burying the event.
  • Extreme avoidance of potential triggers.
  • Development of phobias, or extreme fears related to the event.
  • Unwanted or intrusive thoughts, including memories or flashbacks, panic attacks, and frightening thoughts.
  • Changes in mood and cognition, including memory problems, having a harder time retaining information, not enjoying things as much as before, being more depressed, feeling down more often for no discernable reason, and a more negative worldview.
  • Irritability and aggressive thoughts/behaviorespecially in teens.

1. Hyperarousal

Hyperarousal is one of the primary symptoms of post-traumatic stress disorder. Hyperarousal can be recognized through constant overarching anxiety, always being “on edge”, being easily startled, bouts of insomnia, and an elevated fight-or-flight response.

2. Dissociation

Dissociation and its similar symptoms usually involve some sort of distortion in the perception of a traumatic event to avoid the pain associated with it, whether by forgetting it completely, only remembering vague memories, or associating it with someone else.

A teen who is dissociating from their trauma is still heavily affected by it, and may experience hyperarousal and hypervigilance, as well as strong anxiety symptoms.

3. Avoidance

Avoidance is a normal response to something awful, but avoidance symptoms in the context of trauma may go to extreme lengths, such as never stepping foot inside an elevator again, avoiding cars for years, or developing maladaptive coping mechanisms to avoid and forget, including binge drinking and other forms of drug use.

4. Phobias and Panic

Trauma can lead to the development of phobias and frequent unexplained panic attacks. These may include a phobia of crowds, a phobia of certain animals, or even a phobia of men.

In contrast to other fear or anxiety-based symptoms, phobias represent an overwhelming, constantly present fear, to the point the thought of the danger can cause panic even when the danger itself isn’t present.

5. Intrusive Thoughts

Unwanted and intrusive thoughts can range from flashbacks to violent or unwanted fantasies, morbid thoughts, and frequent unwanted thoughts or daydreaming about violence, violent circumstances, and so on. These thoughts are oppressive and difficult to overcome. They can fuel maladaptive coping mechanisms, such as drinking, as a way to block them out.  

6. Mood and Cognition

Signs of trauma can be recognized in a teen’s mood and way of thinking after a traumatic event. Trauma can leave a person feeling less enthusiastic about things they used to enjoy, even to the point of anhedonia, or joylessness.

It can also impact a person’s cognitive and creative abilities, slowing them down, affecting memory and critical thinking, and making them less sure of themselves.

7. Aggression, Risk-Taking, and Self-Harm

In teens, trauma will more often accentuate impulsive feelings and feelings of self-harm or shame, and resulting behavioral changes, such as more risk-taking, greater promiscuity, higher likelihood of frequent substance use, and self-destructive or self-harming behavior.

Coping With Teen Trauma

Stress disorders, or post-traumatic stress, as well as other anxiety disorders, may develop because of a traumatic experience. Teens can still function relatively well after trauma but may develop greater signs of mental instability the longer their trauma goes unaddressed.

This is especially true if they begin to seek maladaptive ways to cope with their post-traumatic stress, such as addictive substance use or self-harm.

Healthy coping mechanisms are one of the most important aspects of a good treatment plan for a trauma disorder, including creative endeavors, support groups, family or friend group therapy sessions, sports, and self-care. These coping skills help teens reduce stress levels, manage their stress after traumatic triggers, and help avoid or ignore intrusive thoughts.

Mental Health Treatment for Trauma

Mental health treatment remains the crux of any teen trauma treatment plan. Professional one-on-one or group therapy is the first line of treatment for trauma disorders, helping teens identify and overcome negative and unwanted thoughts associated with their trauma. Trauma-specific therapeutic interventions include:

  • Eye movement desensitization and reprocessing
  • Cognitive processing therapy
  • Prolonged exposure therapy
  • Somatic therapy
  • And more.

Working with a therapist you can trust is important. Trauma disorders are disabling and difficult to overcome. The road ahead may be quite long. It’s important to establish a strong bond with your therapist of choice.

Trauma Disorder Treatment at Visions Treatment Centers

Is your teen struggling with trauma? Reach out to Visions Treatment Centers today. We can help.

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Cognitive Behavioral Therapy (CBT) Trauma

What Is Trauma-Focused Cognitive Behavioral Therapy?

Trauma-focused cognitive behavioral therapy (TF-CBT) is a form of cognitive-behavioral therapy (CBT) designed to assist in the treatment of families, children, and teens who have survived a traumatic event. Therapists trained in trauma-focused cognitive behavioral therapy have had greater success in treating children and teens with trauma-related mental health issues, from induced anxiety and clinical depression to post-traumatic stress disorder.

Understanding Trauma-Focused Cognitive Behavioral Therapy

Trauma-focused cognitive behavioral therapy is a short-term treatment option that usually lasts about 16 sessions or less. Over 80 percent of teens treated via trauma-focused CBT see notable improvements in symptoms within this period. This form of therapy is also used to help families navigate post-traumatic stress and the symptoms that follow, particularly by arming them with the necessary tools to manage stress, anxiety, and depressive symptoms better through healthier coping mechanisms, thought experiments, and self-reflective methods. Individuals treated through trauma-focused cognitive therapy learn to identify and differentiate errant and intrusive thoughts, disarm them more effectively, and develop the tools to improve their perspective. Some of the most crucial elements explored through trauma-focused cognitive behavioral therapy through its program include:

  • A safe and stable treatment environment. Outpatient or residential treatment establishes an environment that assures the patient that they are safe and taken care of.
  • Affect regulation. Taking charge of your own emotional state.
  • Cognitive trauma processing and trauma narrative. Working through the events of what happened, while providing therapeutic exposure to traumatic memories, and recontextualizing them into tools to overcome trauma.
  • Child-parent sessions. Helping parents better understand what their child is going through while demonstrating how trauma-focused therapy works and helping them arm themselves with the tools to help support their loved one in the long term after therapy.
  • Focusing on future development. Because this therapy is often short-term, a large focus is placed on the effectiveness of future treatment options, and the transition towards long-term treatment via an established support system continued therapeutic support and other mental health resources.

A Short History of Trauma-Focused Cognitive Behavioral Therapy

Trauma-focused cognitive behavioral therapy was developed through the clinical work of Anthony Mannarino, Judith Cohen, Esther Deblinger, and other researchers. They worked together to establish a form of cognitive-behavioral therapy that centered on the treatment of traumatized children and adolescents, by incorporating family therapy and centering on specific core elements of cognitive-behavioral therapy that were most effective for children and teens. Once the basic framework for trauma-focused cognitive behavioral therapy was established, it was followed by five different randomized controlled trials, the golden standard of scientific testing. The result was an explicitly proven efficacy for children and teens with traumatic experiences, proven again multiple times by other researchers.

How Does TF-CBT Differentiate Itself From CBT?

The main differences in trauma-focused cognitive behavioral therapy versus traditional cognitive behavioral therapy include:

  • A focus on establishing a safe day-to-day environment for the treated child or teen.
  • Revisiting their trauma in treatment.
  • Incorporating family therapy to ensure their continued safe development.
  • Centering on treatment elements that resonated best with children and teens.

What Does TF-CBT Treat?

Trauma-focused cognitive behavioral therapy is most often used for the treatment of post-traumatic stress disorder in children and teens. Children and teens experience and display signs of PTSD differently from adults. Children re-experience trauma more often through play, while teens are far more likely to struggle with irritability and outbursts of rage following a traumatic experience. TF-CBT helps them avoid destructive behaviors, identify, and push back against intrusive thoughts, and overcome trauma. TF-CBT is specifically used to treat individuals between ages 3-18, for both single traumatic events and recurring trauma. TF-CBT has also been used in the treatment of teens with complicated grief, as well as stress-induced anxiety and depression.

Should I Speak to My Therapist About TF-CBT?

It’s never a bad thing to express an interest in a certain treatment method or modality. If you are interested in exploring the applications of trauma-focused cognitive behavioral therapy in your own treatment, it isn’t a bad idea to talk about it with your therapist. Ultimately, your mental healthcare provider is the best person to advise you on any treatment you should or shouldn’t try, as well as where or when to try them. Treating individual cases of a mental health issue is vastly different from reading about them, or providing textbook examples of illnesses and treatments.

Case-by-case details greatly affect how efficacious any given treatment might be, and you should always defer to a professional who has spent time working with you and your issues and knows best how you process certain activities and modalities. It also helps to understand that there are distinct limitations in both the application and usefulness of trauma-focused cognitive behavioral therapy. For example, this form of therapy may not be suitable for children or teens who have had severe conduct or behavioral problems before their trauma. Their therapist might instead focus on helping them overcome these conduct issues before addressing their trauma.

Both substance use and suicidal ideation might be contraindicative of trauma-focused therapy as well. The keyword here, however, it might. Because such a core tenet to trauma-focused cognitive behavioral therapy is gradual and frequent exposure, both suicidal ideation and drug addiction can be amplified by this type of treatment. But by modifying exposure frequency and taking a dialectical approach to address factors such as suicidal ideation and self-harm, trauma-focused cognitive behavioral therapy can still be a useful modality in cases with these issues. Otherwise, teens with these issues may be better served with a different treatment approach that tackles both their addiction or severe depression and trauma appropriately, and effectively.

If you have questions about the treatment options offered to you by your therapist or mental health professional, be sure to ask as many of them as possible. It’s important to be on the same page with your treatment provider and to understand how and why certain treatment modalities might work better for you than others. Patients are encouraged to be involved with their treatment, always – and to have a better understanding of both how their condition is affecting them, and how their treatment is helping them overcome that.

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PTSD Trauma

Recognizing Trauma and Stressor Related Disorders in Teens

Trauma and stressor related disorders, sometimes commonly referred to as post-traumatic stress disorder (PTSD), can be characterized by aberrant symptoms following a period or event of extreme stress, with various recurring reactions, behaviors, thoughts, and other symptoms ranging from restlessness jitters to panic attacks, extreme irritability, and more.

PTSD symptoms differ from age group to age group. The condition can occur at any point in a person’s lifetime. The only prerequisite for PTSD is trauma – while there is a genetic component in how likely PTSD is to occur after a harrowing event, anyone can be affected by PTSD.

When a teen develops PTSD or trauma and stressor related disorders, their stress response system is no longer functioning the way it should. This can lead to several issues during everyday situations, such as being hyperaware and constantly on-edge, or dissociating from life and reacting seemingly cold or emotionless.

While PTSD used to be considered a type of anxiety disorder, it has since been recategorized as a trauma disorder due to trauma and stressor related disorders having their phenotype characteristics, including dissociative symptoms and extreme irritability.

However, teens with PTSD are also more likely to struggle with comorbidity in the form of depression and anxiety. They may be more susceptible to co-occurring substance use disorders and high-risk behaviors such as self-harm. Recognizing trauma and stressor related disorders in teens is essential because specific symptoms can be mistaken for “normal” teen behavior.

What Does PTSD in Children and Teens Look Like?

Children and teens can react differently to trauma than some adults do. In younger school-aged children, PTSD symptoms may include reliving or re-engaging in traumatic experiences through play (either with toys or virtually). It is thought that younger children have a more challenging time recalling the order of traumatic events.

Teens are more likely than children and adults to react aggressively after trauma and are more likely to develop impulsive behaviors as part of their PTSD. From here, signs and symptoms vary wildly. Some of the signs of PTSD in children and teens include:

    • Avoidance of certain situations or events
    • Nightmares and flashbacks in older children
    • More impulsive behavior
    • Frequent nervousness, restlessness, being on-edge
    • Acting numb or distant
    • Trouble focusing on tasks and academics

The DMV-5 utilizes eight sets of criteria with their symptoms to define and diagnose PTSD in individuals, further providing information about how the disorder might manifest. These criterion sets include:

    1. A significant stressor/traumatic event(s)
    2. Intrusive symptoms (unwanted thoughts, flashbacks, and nightmares)
    3. Avoidance symptoms
    4. Adverse changes in mood and memory (i.e., trouble remembering things)
    5. Changes in arousal and reaction (greater aggression, easily startling, hypervigilance)
    6. Duration (symptoms lasting more than four weeks)
    7. Functional significance (symptoms must create distress and impact social life, school life, work, etc.)
    8. Excluding other reasons (symptoms cannot be explained by medication, other illnesses, substance use)

Some of these signs may be more obvious than others. It is also understood that there are dissociative variants of PTSD (where the primary characteristic is a “disconnection” from reality) or other trauma and stressor related disorders.

Defining Other Trauma and Stressor Related Disorders

A traumatic experience is one that leaves a lasting negative impression. Ultimately, many of us experience traumatic events in our lives. Losing a loved one, witnessing a natural catastrophe or accident, or being the victim of a crime can leave a lasting and significant impact. However, each person processes trauma in different ways.

In some cases, the damage can be so severe that it lingers for months and bleeds into every waking moment. Flashbacks, avoidance symptoms, and hypervigilance are just some of how the mind tries to cope with an event or horror that has left an impression too great to overcome without help and therapy. Some of the other ways in which trauma can leave a lasting impact include:

Acute Stress Disorder

Acute stress disorder (ASD) shares many of the same symptoms as PTSD. Still, its onset is almost immediately after a traumatic event, lasting for at least two days and less than a month. Sometimes, ASD develops into PTSD if symptoms persist past a month.

Adjustment Disorders

Adjustment disorders are defined as adverse changes in thought or behavior in a teen following a traumatic event, usually below the threshold for a PTSD diagnosis.

Reactive Attachment Disorder

Reactive attachment disorder (RAD) is characterized by withdrawn behavior. It is typically caused by extreme neglect or social deprivation. A teen with RAD may display limited or lacking emotional responses and low empathy or remorse.

Disinhibited Social Engagement Disorder

Disinhibited social engagement disorder (DSED) is characterized by a lack of inhibition when interacting with strangers. Children and teens with DSED may be overly friendly or welcoming towards people they don’t know, for no apparent reason. It’s a different form of response to extreme neglect and social deprivation.

Other Dissociative Disorders

Dissociative disorders, such as dissociative identity disorder (DID), dissociative amnesia, and depersonalization disorder, are often the result of an extreme stressor or traumatic experience, causing a person to separate themselves from the experience of reality itself.

Grief-Related Trauma

The loss of a loved one causes bereavement disorders. While it’s normal to be in pain when we lose someone we love, specific symptoms – such as intense grief over a year after the death, significant impairment due to distress, preoccupation with the deceased, etc. – may indicate a disorder.

Treating Trauma and Stressor Related Disorders in Teens

Treatments for trauma and stressor related disorders depend on the severity of the condition and the types of symptoms present. Talk therapy is an integral part of the treatment process, and therapists may leverage specific techniques to help teens better process their emotions and regulate responses or gradually approach and confront particular events. Trauma-specific treatments meant to address stressors include:

Eye Movement Desensitization and Reprocessing (EMDR)

This approach to treatment utilizes guided eye movements to change how a person reacts in response to triggers.

Exposure Therapy

Although it sounds drastic, exposure therapy encompasses several different therapy types to overcome their fear or trauma in a safe environment.

Cognitive Therapy

This type of talk therapy aims to help patients become aware of the relationship between their thoughts, behaviors, and mood and recognize patterns in thinking and behavior associated with their PTSD. Identifying these patterns can help in slowly altering them over time.

Treating PTSD in teens is difficult at any age, under any circumstances. Trauma is powerful, and it takes time and support to overcome these emotional and physical responses slowly. However, with consistent therapy and help from friends and family, long-term treatment can significantly reduce symptoms.

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PTSD Trauma

Recognizing the Symptoms of PTSD in Teens

Post-traumatic stress disorder (PTSD) is a serious and potentially underreported issue among teens. Sources of trauma are varied and can include both acute and chronic causes such as child abuse, school shootings, gang violence, and automobile accidents. Left undiagnosed or inadequately treated, PTSD can lead to several comorbid mental health conditions, a much higher rate of suicide, and trouble with social interaction.

Among children and teens, about 14-43 percent experience a type of trauma. Roughly 3-15 percent of young girls and 1-6 percent of young boys are diagnosed with PTSD. Among teens identified with PTSD, 47 percent were recorded to struggle with depression as well. Diagnosed teens were more likely than their peers to engage in high-risk behaviors and self-harm, and had trouble adjusting to and interacting with peers without PTSD.

While it’s a condition that affects millions of Americans, PTSD (and trauma in general) can often be misunderstood. It’s important to recognize the early symptoms of PTSD in teens and children, in order to seek help as early as possible.

Defining Trauma

Trauma and traumatic events are two separate concepts. Trauma is a personal emotional response to a severe event, or a chronic accumulation of overwhelming stressors. Not all traumatic events cause trauma in a person, and not all instances of trauma lead to a disorder. Trauma is, despite its terrible nature, a normal response. We go through emotional and physical shock after a sudden loss, assault, or other type of traumatic event.

Similarly, being exposed to upsetting situations repeatedly can also cause trauma, such as with first responders to mass casualty events, social workers, medical professionals, soldiers, and police officers confronted with violent cases. Like a buzzer, some of these examples can eventually cause shock to run through our system. In rare occasions, a traumatic response can leave the buzzer on almost permanently.

Rather than being in a state of shock and denial for a few days to a few weeks, the symptoms and feelings of trauma might persist for months and years. When the personal response to a traumatic event is particularly severe or long-lasting, it becomes a disorder. While the main cause of PTSD is trauma, there are factors that make it more or less likely for teens to develop PTSD. Recurring trauma increases the chances of PTSD, for example, as does a history of anxiety and traumatic stress in the family.

Being left alone or having no system for support or recovery after trauma can also cause it to linger for much longer and develop PTSD. PTSD can cause a change in the brain’s reaction to stress, especially anything reminiscent of the trauma, and one aspect PTSD is that it causes the body’s fight-flight-freeze response to go haywire.

The Three Main Symptoms

When trauma lingers and develops into PTSD, it continues to leave a mark on a person’s life in one or more ways, usually along the lines of three basic symptoms:

    • Re-experiencing: Symptoms people usually think of when they think of PTSD tend to be forms of re-experiencing – flashbacks, bad dreams, sudden images and intrusive thoughts, and unwanted recollection. Sometimes, symptoms of re-experiencing are triggered by outside reminders. At other times, they can occur out of nowhere.
    • Avoidance: Some people develop emotional numbness to anything associated with the trauma. They avoid or grow distant towards people, places, and things. Avoidance in PTSD can be extreme and may even include signs of dissociation or disconnection from oneself or reality.
    • Agitation: These are symptoms of extreme alertness and arousal. Someone who is excessively jumpy, easily angered, and struggles with sleep may be experiencing symptoms of agitation.

Most symptoms of PTSD fall within the three major categories of symptoms and represent intense unresolved fear and unconscious attempts at coping with that fear. Due to PTSD’s effects on the brain and the way we perceive stress, teens diagnosed with PTSD may be more likely to develop comorbid mental health conditions and are more susceptible to things like substance use disorder.

Common Signs and Symptoms of PTSD in Teens

Some of the signs of PTSD in teens include:

    • Panic attacks
    • Recurring nightmares after the fact
    • Restlessness and insomnia
    • High irritability
    • Easily startled
    • Emotionally numb or distant
    • Isolating oneself from friends and family
    • Avoiding places and things
    • Struggling at school or work
    • More open to high-risk behavior
    • More likely to react violently towards others (this is more common among teens than children or adults)
    • Struggling to maintain a relationship
    • Openly discussing suicidal ideas
    • Reacting viscerally to traumatic triggers (heart rate hikes, hyperventilation)

Researchers find PTSD symptoms differ slightly between children, teens, and adults. For example, children are likely to incorporate elements of their trauma into play, because they are reliving their trauma by re-enacting it. Teens tend to display more violent behavior if exposed to violence versus children or adults.

PTSD vs. Acute Stress Disorder

Acute stress disorder (ASD) is a different condition that arises in the first month after a traumatic event. When someone is exhibiting severe symptoms similar to PTSD immediately after a horrific event, they are generally experiencing ASD. These symptoms become PTSD when they last longer than a month.

Another difference is that PTSD symptoms can and do sometimes occur with a delay – a teen can survive a tragic accident or terrible assault and be “fine” for weeks and months, and then begin displaying symptoms of PTSD months after the event occurred. Extremely rare cases have even recorded PTSD onset occurring a year after trauma.

Seeking Help

A diagnosis of PTSD is not made lightly. It is normal to feel shaken up after a traumatic event. But it is equally important not to dismiss what might be a mental disorder. PTSD can leave its mark on the brain and turn every day into a nightmare. Seeking help as early as possible can help reduce the impact PTSD has on a teen’s life. Consider seeking a diagnosis from a psychiatrist or take a screening test and bring the results to a mental health professional.

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Recovery Trauma

Awareness—Rape Culture and Addiction

Rape isn’t a new problem. Everyone in the world knows about someone in their family, a friend, or neighbor that has been affected by an incident of sexual assault. Acts like rape ruin lives, and it has to stop. When we think about rape victims, many people don’t quite understand that everything stops and nothing is ever the same for them. Victims of rape are at the highest rate for alcohol and substance abuse, where addiction and self-isolation—that delicately toes the line for suicide—takes hold of their world and makes them a prisoner to the unsafe place that is now their home.

The Brock Turner Case Issue

The case of the State vs. Brock Turner isn’t a case we can think of where justice has been served, but where the justice system has fallen short once again. For those victims of rape, thoughts about what it felt like are refreshed with this injustice. For men and women, young teens and children all over the world that have experienced something like this, we know there is nothing that can be done to reverse what’s happened in the past.

No life sentence can change the way you feel when someone invades your personal space, the difficulty you have when trying to engage in romantic activity with your partner, or how you feel about yourself throughout your lifetime. What justice does, is bring awareness to the issue.

Building awareness about rape and the problems that come flooding into the lives of the victims is what needs to happen now. The issues that come up about people of color and white privilege come to the surface. To stop rape from occurring as well as the snowball of social, mental and physical health problems that ensue from it, we must teach our children to care for one another and to know what’s right from wrong. We can’t allow people to think it’s okay or that it’s something minor and that a person should be more careful because this isn’t the issue. We cannot ask victims if they egged someone on or if they are sure they didn’t allow it to happen. Think before you put someone down and discount their struggle with rape. It’s never okay.

We at Visions Adolescent Treatment Center understand that every voice must be heard, and therapy is essential to rebuild, in some capacity, a safe and comforting space. Therapy helps victims understand why they react the way they do from physical touch and anything sensory.

We encourage our clients to speak out and inspire others to do so as well. When we come together and bring awareness to the world, the chances for rape to occur and for victims to isolate is reduced. When we say it’s not okay, that’s when we can lift the veil and help people deal with their broken worlds.

If you or a loved one suffers from addiction and struggles with sexual assault, call Visions Adolescent Treatment Center today at (818) 889-3665.

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Mental Health Recovery Trauma Treatment

In Recovery, We Lean In to Let Go

Being in recovery from mental illness, substance abuse, alcoholism, eating disorders, behavioral issues, et cetera, require that we lean into some things that make us uncomfortable. Let me tell you, “leaning in” isn’t easy. Our brains like pleasure and revile pain. In fact, finding ourselves in rehab tells us that our habitual patterns of trying to put an elementary salve on a gushing wound weren’t working very well. It means that drinking, drugging, stealing or lying our way out of our feelings doesn’t work — at least not permanently. Frankly, none of these “solutions” ever work. Not in the long or short term.

By suggesting that we lean into our difficulties instead of leaning away, I am asking for you to embrace your courage. I am also asking you to trust in your exemplary clinical team, your support team, and in your own ability to do this difficult work while you are in treatment and beyond. Positive thinking or praying for it all to magically go away are both examples of temporary, feel-good actions that don’t provide a long-term solution. It’s wise to also recognize that the recovery process often requires legitimate, clinically supported psychological care.

Recovery is about change. It’s about shifting perspectives and learning how to redefine and revise old paradigms in order to create healthy ones. When we face our old thought patterns and old ideals, we offer ourselves the opportunity to let go. We often find ourselves able to walk through our issues not around them, recognizing that while they are present, ready and willing to make us miserable, we don’t have to take the bait. When we begin to look at our issues with some awareness and compassion, their negative influence has a chance to dissipate.

Our ability to recognize the negative for what it is allows us to invite the positive experiences and influences into our lives. In our recent blog, “How do You Stay Motivated,” I quoted Dr. Rick Hanson, Ph.D., who addresses this very thing: “The remedy is not to suppress negative experiences; when they happen, they happen. Rather, it is to foster positive experiences – and in particular, take them in so they become a permanent part of you.”

Negative experiences do not have to own us; in fact, they can be part of the landscape without being part of our foundations.  This is emblematic of recovery.

The process of recovery is not something you have to do alone. In fact, you can’t. There are support groups, clinicians, treatment facilities, therapists, et cetera, as available resources to you. Yes, there are things you may have to face and work through, but coming to an understanding that you don’t have to ride through that storm alone is a welcome relief.

Categories
Feelings Mental Health Recovery Self-Care Trauma

Acknowledging and Honoring Grief

With addiction and mental illness comes something that we often don’t want to look at, which is grief and the deep sense of loss that arrives when we or a family member steps into recovery. Drugs and alcohol and/or mental illness are often viewed as the villains in the aftermath of addiction. But the underlying weight of grief often gets shoved to the side or bypassed entirely.

 

The truth is, grief can be crippling. It can take the wind out of us and make us feel like we’ve landed flat on our faces, gasping for air. When we ignore it, or devalue the importance of the grieving process, we suffer more.

 

Mental illness and/or addiction may have ripped your family at the seams. It may have poked holes in your belief system, and placed a shadow on your hopes and dreams for your family. The truth is, everyone suffers: the one with the disease and the ones close to them.

 

I grew up with a parent mired by the tragedy of her own childhood, which was fraught with a mentally ill mother and a stoic father. Now, I see this same parent as an adult and it affords me the opportunity to recognize the untended grief and loss she’s endured and the great suffering that has resulted. A large portion of our existence in a scenario like this revolves around survival and learning how to endure the shame and fear associated with our circumstances. It’s not uncommon for the grief we feel to be ignored or for us to feel as though it is something to endure.

 

How can we stand tall in the midst of suffering while honoring our grief?

 

Talk about it. Develop a relationship with someone you trust that can help you process your feelings. It could be a counselor, a therapist, a psychologist, a good friend. What we hold onto holds onto us. Processing grief is part acknowledgement and part letting go. It evolves and becomes something we can hold with care instead of treating it like a hot stone.

 

Practice self-care. Take walks, meditate, do yoga, surf, get a massage, take a bath. Indulge in yourself. Healing is hard work; it’s important to nurture ourselves in the process.

 

Lean toward your difficulty. As counterintuitive as that may sound, this is ultimately the way out. That which we fear, can hold us back. We have to find a way to feel our feelings, touch our own hearts with kindness and compassion, and begin the process of finding acceptance and letting go. Take baby steps here. You don’t have to take on the high dive just yet.

 

Grief is present all around us. In adolescence, we grieve the loss of childhood and the inference of responsibility. In recovery, we grieve the person we were, the things we missed, and the damage we did. We also grieve the perceived “fun” guy/gal we thought we were. Be patient: recovery will afford you many more fulfilling ways of having fun.  This list goes on, but it doesn’t have to be daunting.

 

My experience has shown me that when I lean toward the thing I fear, the fear lessons. When I acknowledge the shadow side and hold the difficulties with compassion, the light starts to trickle in. I suffer when I turn away, and when I ignore the suffering, it becomes more unbearable.  The work in recovery teaches us that we can walk through difficulties with grace, we can begin to feel our feelings and we can crack open the barriers around our hearts. With our feet planted on the earth, and our minds open to possibility, the plight of suffering has a place to fly free.

Categories
Adolescence Communication Mental Health Parenting Recovery Therapy Trauma

Healthy Boundaries Make for Healthy Teens

© sarit z rogers

What steps can you take to ensure that you aren’t in violation of someone’s boundaries? For example, not everyone enjoys being hugged, nor is it always appropriate to express that level of touch. From the perspective of a teacher or a therapist, one must understand the innate power differential that exists between teacher and student or therapist and client. One is looking to the other for advice and pedagogic elucidation, and one is holding the power to elicit such information. We therefore need to be thoughtful in our approach to employing touch in these situations.

 

In a therapeutic environment such as Visions, we address more than substance abuse and mental illness; we are facilitating the excavation of trauma and creating safe boundaries. It’s important to maintain awareness around our own sense of boundaries and how execute them. Asking ourselves these questions and contemplating the answers through talking to our peers and writing them out will help you discern where you may need some work, and where you are strongest:

 

  1. What does it mean to set boundaries?
  2. Is it hard to say “no”? If so, what does saying “no” feel like?
  3. How do I feel when my boundaries are crossed?
  4. What is my reaction internally and externally?
  5. Am I afraid to set boundaries? Why?
  6. What is my history around setting boundaries?

 

As clinicians and teachers, it’s imperative that we know and understand where our weak spots are so we can work on them. For some people, it’s not uncommon to wait until someone pushes us to our edge before we set a limit. The desire to please others or to be liked plays a part here, and our own backgrounds and upbringing will also effect how we interact with others. Perhaps we come from a family where hugging and touch is part of the norm. It may be natural for us to reach out and hug someone when they are suffering, but it’s not always appropriate.

 

Hugging a client may be a violation of a boundary, but if the client has been traumatized in some way, they may not know how to set that boundary. Likewise, if a client persistently tries to hug you, you have to maintain a firm boundary so they learn to understand what is and what is not appropriate. I was volunteering at my son’s school recently, and a kid came up and hugged me, not wanting to let go. It was a child I don’t know and it was a clear violation of my boundaries and the school’s rules. I gently moved away and held a boundary with this child until he moved on. Teens look to us as examples to learn from and to emulate. If we don’t show strong, safe boundaries, they won’t be able to either. Understand that the boundaries we create encourage freedom to be who you are while creating a safe container for healing and recovery.

Respecting boundaries applies to parents too. If the family dynamic has been compromised, parents have to work to rebuild a healthy and safe family structure. Creating solid boundaries is key in that process. Adolescents love to push buttons and stretch boundaries; they are smack dab in the center of their individuation process. That doesn’t mean you, the parent, have to give in. Remember: “No” is a complete sentence, and when it’s said with certainty and conviction, it makes all the difference. A wishy-washy, non-committal “no” may as well be a “maybe” or a “yes.” Poor limits leave room for negotiation where there shouldn’t be.

We all have a part to play in creating safe limits whether we are parents, teachers, or clinicians. Kids, in their infinite wisdom and testing behaviors, demand strong limits, whether they admit it or not. Boundaries create safety. They provide defined parameters in which to develop and grow. So as much as a teen may push, inside, they really do respect a firm “No” and a defined environment.

Categories
Feelings Mental Health Recovery Self-Care Trauma Wellness

Helpful Tools for Self-Regulation

Calm Lake (Photo credit: Moyan_Brenn)

Developing tools for self-regulation allows us to tap into our internal resources so we can be less reactive. Self-regulation will increase our ability to navigate difficult situations or work in challenging environments.  Self-regulation requires us to tap into our mind and body connection. When someone is dysregulated, they are disconnected. One of the steps to self-regulation is learning to connect with our physical sensations and our bodies. Think of it this way: When we are dysregulated, we are reactive rather than responsive. Likewise, when we are self-regulated, we are responsive rather than reactive.

 

Often times, parents have a tough time regulating their emotions. Imagine this: your child has done something infuriating—perhaps he’s lied, or she’s ditching school or doing drugs—and you respond by yelling. You are frustrated, and perhaps even triggered. You are dysregulated. At this point, you are ineffective in your parenting and your kids are apt to be dysregulated as well. You are essentially communicating with metaphorically closed fists. Stress and trauma both send the sympathetic nervous system into the fray.  However, self-regulation will engage the parasympathetic system, which is the body’s natural way of applying a salve. Your action here is to take a time out. Get yourself to a quiet space so you can begin to self-regulate.

 

The three main tools of self-regulation are:

Grounding, Resourcing, and Orienting.

 

Grounding allows you to reconnect with your emotions and physical sensations. Paying attention to your feet on the floor, or placing your hands on something solid can help you get back into your body. Taking deep breaths while you are doing this can help you track the sensations mindfully. Taking a time out when you are dysregulated is the first step to getting grounded.

 

Resourcing is the way in which you ground. We all have resources within us or outside of ourselves. Resources are tools with which we can reconnect with ourselves. For example, breath can be a resource. Your hands on your belly or lap can be a resource. Your pet can be a resource. A resource is something that helps you feel good when everything around you is dismal.

 

Orienting is a way of checking in with your surroundings. When we are not self-regulated, we check out. It can be a very disembodying experience–one that feels determinedly unsafe and out of control.  So when we orient, we do so by consciously noticing our surroundings: looking around the room, noticing where we are, where we are sitting, et cetera.

 

All of these tools help us self-regulate and all of these tools can be taught to our kids regardless of their age or stage of development. In very young children, it starts with self-soothing and bringing awareness to feelings. As kids get older, the language can shift and become more detailed. Being a teen is frightening developmental state; they experience life more intensely because of where they are developmentally. Teens can learn to slow down. Count to 10 before you respond to something provocative, or take a deep, mindful breath. You may find that what you thought you had to say changes. You may discover that what you need to say comes out softer and kinder. Using your breath this way is a means of grounding and resourcing. When we do this, we are developing skills to be in relationship with our impulses and feelings. By reinforcing this awareness, we gain opportunities to change.  Self-regulation is a doorway to self-care. In caring for ourselves, we can more aptly care for others.

 

Parents, you can act as the conduit for this shift. Your kids want to learn from you, even as they push away. By developing these self-regulating tools yourself, your kids may follow. Teach by example, not by hard hands. By doing so, you will no longer communicate with closed fits; you will communicate with open palms and an open heart.

Read this for inspiration:

Getting to the Root of it All – Hala Khouri, M.A.

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