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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.