Post-traumatic stress disorder (PTSD) is a mental health condition that may develop after seeing or experiencing an upsetting event (trauma). Types of trauma that can lead to PTSD include physical injury, any kind of abuse, violence, or a natural disaster.

PTSD can occur shortly after a traumatic event or may happen weeks later. It can affect how a child thinks and feels for months or years. There are ways to recognize the symptoms and support your child who is living with PTSD.

How to recognize PTSD in your child

In general, signs of PTSD include stress, mood changes, avoidance, anxiety, and distressing memories. Symptoms of PTSD also vary by age.

• Be fussy, clingy, or irritable.
• Have frequent temper tantrums.
• Repeat traumatic events through play.
• Not talk or have trouble talking.
• Have a change in eating habits.
• Wet the bed after having been trained to use the toilet.

• Have trouble concentrating.
• Believe that they notice warning signs to avoid trauma in the future.
• Be frequently sad and withdrawn.
• Have frequent physical complaints, like headaches or stomachaches, heart racing, or feeling tired.
• Have nightmares or trouble sleeping.
• Frequently talk about scary thoughts.
• Go back to early behaviors (regress) like bed-wetting or thumb-sucking.
• Feel guilty or ashamed.

• Talk about the traumatic event frequently.
• Be disobedient and disruptive.
• Have problems in school.
• Show behavior changes, such as:
  • Using drugs or drinking alcohol.
  • Becoming sexually active.
  • Developing eating disorders.
  • Self-harming, such as cutting himself or herself.
• Be frequently sad and withdrawn.

How to support your child

• Do not react with anger. Your child cannot change his or her reactions without working on them.
• Do not punish or scold your child for PTSD behaviors. Instead, be patient. This takes time and understanding.

• Knowing your child's PTSD triggers as a way to avoid them.
• Never using physical punishment.
• Being willing to listen whenever your child talks about feelings or memories of trauma. Do not force your child to talk about these feelings or memories.
• Trying not to let your child see disturbing images in the media.
• Using a night-light in your child's bedroom if your child has trouble sleeping.
• Helping your child practice self-soothing skills, such as breathing slowly, holding a favorite stuffed animal, or snuggling with you.

• Having a regular schedule with consistent mealtimes, school, bedtimes, and activities.
• Helping your child arrive on time to school and other activities.
• Letting your child choose meals or activities to help him or her feel a sense of control. This can help children who often feel helpless.
• Allowing your child to be sad or cry. Do not criticize your child for these emotions.
• Asking your child about his or her feelings and letting your child talk without judging the feelings as good or bad.
• Encouraging your child to express emotions and ideas through drawing or writing.
• Checking in regularly with your child's teachers or other caregivers about how your child is doing.
• Teaching your child activities to manage stress, like listening to music or practicing deep breathing.

Follow these instructions at home:

Eating and drinking

• Give your child foods that are high in fiber, such as beans, whole grains, and fresh fruits and vegetables.
• Limit foods that are high in fat and processed sugars, such as fried or sweet foods.

Activity

• Encourage your child to do his or her normal activities as told by your child's health care provider.
• Ask your child's health care provider to suggest some appropriate activities for your child.
• Encourage your child to be physically active every day.

General instructions

• Do not get angry with your child for behavior changes caused by PTSD.
• Give over-the-counter and prescription medicines only as told by your child's health care provider.
• Make sure your child gets enough sleep.
• Keep all follow-up visits. This is important.

Where to find more information

• Child Welfare Information Gateway: www.childwelfare.gov
• National Institute of Mental Health: www.nimh.nih.gov
• Centers for Disease Control and Prevention: www.cdc.gov
• National Center for PTSD: www.ptsd.va.gov
• International Society for Traumatic Stress Studies: istss.org

Contact a health care provider if:

• Your child's symptoms are more intense or more frequent.
• Your child is having trouble at school or outside the home.
• Your child has new or worsening symptoms.
• Your child is using drugs or alcohol.
• You are having trouble supporting your child at home.

Get help right away if:

• Your child expresses thoughts about harming himself or herself or others.
• Your child talks about death or suicide.
• Your child is:
  • Acting suspicious and angry.
  • Having repeated flashbacks.
• You and your child are having an increasing number of fights.
• Your child says that he or she is very depressed or anxious.

• Call 911.
• Call the National Suicide Prevention Lifeline at 1-800-273-8255 or 988. This is open 24 hours a day.
• Text the Crisis Text Line at 741741.

Summary

• Post-traumatic stress disorder (PTSD) is a mental health condition that children may develop after seeing or experiencing an upsetting event (trauma).
• PTSD can occur shortly after a traumatic event or may happen weeks later. It can affect how a child thinks and feels for months or years.
• Work with your child's health care provider and mental health care provider to learn what behaviors are typical and how to cope with them.
• It is important to help children with PTSD feel safe and supported.
• Check in regularly with your child's health care providers, teachers, and other caregivers about how your child is doing.