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:
- A significant stressor/traumatic event(s)
- Intrusive symptoms (unwanted thoughts, flashbacks, and nightmares)
- Avoidance symptoms
- Adverse changes in mood and memory (i.e., trouble remembering things)
- Changes in arousal and reaction (greater aggression, easily startling, hypervigilance)
- Duration (symptoms lasting more than four weeks)
- Functional significance (symptoms must create distress and impact social life, school life, work, etc.)
- 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 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.
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.
Although it sounds drastic, exposure therapy encompasses several different therapy types to overcome their fear or trauma in a safe environment.
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.