Post-traumatic stress disorder (PTSD) is a mental health condition that can occur in children who experience a traumatic event, such as a threat to life, serious injury, or abuse. Sometimes, PTSD can occur in children who hear about trauma that happened to a close family member or friend.

It is normal for a child to show signs of stress after exposure to trauma. If symptoms last for more than a month, your child may have PTSD. For most children, symptoms improve over time. However, some children may continue to have symptoms for years if they do not get treatment.

What are the causes?

This condition may develop when a child experiences a traumatic event.

What increases the risk?

• Children who have experienced a traumatic event, such as:
  • Physical or sexual abuse.
  • Violence or war.
  • A natural or human-caused disaster.
  • An accident or medical trauma.
  • Death of a parent.
• Children with other mental health conditions.
• Children who have a parent with a mental health condition.

What are the signs or symptoms?

In children aged 6 or younger

• Repeating traumatic events through play.
• Reactions as if the trauma were occurring in the present.
• Avoiding people, places, or things that remind the child of the trauma.
• Marked changes in mood or reactions to situations, such as:
  • Aggressive behavior or temper tantrums.
  • Startling easily.
  • Sleep problems.
• Not talking or having trouble talking.
• A change in eating habits.
• Bed-wetting after having been trained to use the toilet.

In children older than age 6

• Omen forming. This is a type of magical thinking where a child believes that if he or she notices some warning sign, he or she can avoid future trauma.
• Time skew. The child recalls an event in a different sequence than how it actually occurred.
• Post-traumatic play. The child acts out some aspect of the trauma during play.
• Trouble concentrating.
• Feeling guilty or ashamed.

In teenagers

• Intrusive symptoms. The teen re-experiences the physical and emotional sensations of the traumatic event, such as:
  • Having distressing memories while awake or distressing dreams.
  • Experiencing intense feelings in response to a trigger that reminds him or her of the trauma.
  • Having physical reactions that are triggered by reminders of the trauma. These may include increased heart rate, shortness of breath, sweating, or shaking.
  • Having flashbacks, or believing he or she is going through the event again.
• Avoidance symptoms. The teen avoids anything that reminds him or her of the trauma. This may also include:
  • Losing interest or not participating in daily activities.
  • Feeling disconnected and avoiding other people.
• Increased arousal symptoms. This is when the teen has physical or emotional symptoms, such as:
  • Being easily startled or nervous.
  • Behaving in a careless or self-destructive way.
  • Having trouble concentrating.
  • Having verbal or physical outbursts of anger toward other people or objects.
  • Having trouble sleeping.
• Negative mood and thoughts. These include:
  • Not being able to remember certain parts of the traumatic event.
  • Being unable to experience positive emotions, such as happiness or love.

How is this diagnosed?

PTSD is diagnosed through an assessment by a mental health professional. You or your child may be asked to describe the experience of the traumatic event. You may be asked to provide your observations about any noticeable changes in your child's behavior.

How is this treated?

• Medicines. Certain medicines can reduce some PTSD symptoms.
• Counseling (cognitive behavioral therapy,or CBT) or exposure therapy with a therapist who specializes in treatment of PTSD.
• Eye movement desensitization and reprocessing (EMDR) therapy. This type of therapy is done with a specialized therapist.
• Play therapy with a mental health professional who specializes in this approach with children.

Some children with PTSD may benefit from a combination of these treatments.

Follow these instructions at home:

Support your child

• Being affectionate and loving.
• Giving your child time to accept what has happened.
• Using simple words to answer your child's questions.
• Talking and listening to your child about his or her experience and feelings.

Manage stress and anxiety

• Help your child find ways to manage stress and anxiety. These may include:
  • Breathing exercises.
  • Meditation or yoga.
  • Listening to music.
  • Organized exercise and play.
  • Spending time with people who make your child feel safe.
  • Finding a support group or family counselor.
• Reduce things that cause stress (triggers), such as family fights, moving to a new home, or changing schools.
• Limit media exposure and news reports about distressing events, especially for young children.

Activity

• Offer your child opportunities to do activities that are healthy for your child's mind and body.
• Plan activities that let your child relax and have fun.
• Create and follow schedules and routines.

General instructions

• Give your child over-the-counter and prescription medicines only as told by your child's health care provider.
• Follow your child's treatment plan carefully.
• Keep all follow-up visits. This is important.

Where to find more information

• Centers for Disease Control and Prevention: cdc.gov/childrensmentalhealth/ptsd.html
• International Society for Traumatic Stress Studies (ISTSS): istss.org/public-resources
• National Center for PTSD: ptsd.va.gov

Contact a health care provider if:

• Your child's PTSD symptoms do not improve.
• Your child has new or worsening symptoms of PTSD.
• Your child seems to be thinking and talking a lot about death.

Get help right away if:

• Your child expresses thoughts of suicide.
• Your child expresses thoughts of harming others.

• 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

• It is normal for a child to show signs of stress after exposure to trauma. If these symptoms last for more than a month, your child may have post-traumatic stress disorder (PTSD).
• PTSD is diagnosed through an assessment by a mental health professional. Treatment is also performed by a specialist in PTSD.
• Treatment may include medicines, various types of therapy, or a combination of these treatments.
• Provide support to your child and help your child find ways to manage stress and anxiety. Contact your health care provider if your child's PTSD does not improve.