What is PTSD?
Post-traumatic stress disorder (PTSD) is a serious mental health condition that might develop after people experience or witness a traumatic event. It might also develop when people hear that close friends or family have experienced a traumatic event.
PTSD symptoms can develop immediately after the traumatic experience or not until weeks, months or even years later. And PTSD symptoms are severe enough to interfere with people’s daily lives.
PTSD can happen after a single traumatic event, several events or an ongoing experience.
What’s the difference between post-traumatic stress and PTSD?
PTSD and post-traumatic stress are both reactions to a traumatic event. But people with post-traumatic stress experience anxiety or other symptoms for only for a few weeks afterwards. Then their symptoms gradually disappear. If the symptoms continue for more than a month, it might be PTSD.
What is a traumatic event?
Traumatic events are sudden, unexpected and shocking experiences that make people feel scared, distressed or overwhelmed. These events might include bushfires, car accidents, actual or threatened physical or sexual violence, or serious injury.
Not everyone who experiences or witnesses a traumatic event develops post-traumatic stress or PTSD.
How to recognise PTSD symptoms in children aged under 6 years
Your child might have PTSD if they’ve experienced, witnessed or heard about a traumatic event, and:
- they’re experiencing one or more symptoms from each of the lists below
- their symptoms have been going on for at least one month
- their symptoms are affecting their health, daily activities or relationships
- their symptoms aren’t caused by medicine or a medical condition.
Distressing thoughts about the event
Your child has unwanted, distressing and recurring thoughts, memories, nightmares or flashbacks related to the traumatic event. They might express these by reliving the event during play.
Other changes in thoughts or emotions
Your child:
- feels strong emotions like fear, sadness, anger, guilt or shame more often or more intensely than usual
- doesn’t want to play or do things they usually enjoy
- doesn’t want to be around friends and family
- isn’t as happy as usual.
Avoidance behaviour
Your child:
- avoids activities, places or people that remind them of the event
- doesn’t want to talk about the event.
Other changes in behaviour
Your child:
- is irritable or angry for no apparent reason
- is constantly looking out for danger
- is easily startled
- has difficulty concentrating
- has sleep problems.
How to recognise PTSD symptoms in children and young people aged 6-18 years
Your older child might have PTSD if they’ve witnessed, experienced or heard about a traumatic event, and:
- they’re experiencing one or more symptoms from each of the lists below
- their symptoms have been going on for at least one month
- their symptoms are interfering with their health, daily activities or relationships
- their symptoms aren’t caused by medicine or a medical condition.
The symptoms of PTSD in older children and young people might present differently from the symptoms in younger children.
Distressing thoughts about the event
Your child has unwanted, distressing and recurring thoughts, memories, dreams, nightmares or flashbacks related to the traumatic event.
Other changes in thoughts or emotions
Your child:
- can’t remember an important part of the event
- keeps having negative thoughts like ‘I’m bad’, ‘No-one can be trusted’, or ‘The whole world is bad’
- keeps blaming themselves or others for the event
- feels strong emotions like fear, anger, guilt or shame more often or more intensely than usual
- loses interest in or doesn’t want to do activities they usually enjoy
- feels distant from people around them
- can’t feel emotions like happiness or satisfaction.
Avoidance behaviour
Your child:
- tries not to think or talk about the traumatic event
- avoids people, places, conversations, activities, objects or situations that remind them of the event.
Other changes in behaviour
Your child:
- is irritable or has angry outbursts
- behaves in risk-taking, reckless or destructive ways
- is constantly looking out for danger
- is easily startled
- has difficulty concentrating
- has sleep problems.
If your child says anything about suicide or self-harm – like ‘I wish I was dead’ or ‘I don’t want to wake up anymore’ – or you’re concerned they’re having these thoughts, you should take this seriously. Seek professional help straight away. Contact your GP or your local child and adolescent mental health service, or ring Lifeline on 131 114. You could also call 000 and ask for help or go to the nearest emergency department.
Why professional help for PTSD is important and where to get it
If you’re worried that your child has PTSD symptoms, it’s important to get professional help as soon as you can. The sooner your child gets help, the sooner your child can get a diagnosis. And when your child has a diagnosis, they can start PTSD treatment that will help them feel better and recover.
Who can help your child with PTSD?
- Your GP
- Your child and family health nurse
- A psychologist
- A school counsellor
- Your local community health centre
- Local mental health services
- Child and adolescent mental health services
- The National Domestic Family and Sexual Violence Counselling Service
How is PTSD diagnosed?
To diagnose PTSD, a mental health professional will do a thorough assessment.
The assessment will include talking with your child and might include using psychological questionnaires or tests. It can also include talking with you about what you’ve noticed about your child’s thoughts, emotions and behaviour.
The health professional will want to rule out other conditions that can look like PTSD, including anxiety disorders, depression in children, depression in teenagers, obsessive compulsive disorder, ADHD, brain injury and complex PTSD.
PTSD is not your child’s or your family’s fault.
How is PTSD treated in children and teenagers?
Trauma-focused cognitive behaviour therapy (TF-CBT)
This type of CBT is recommended for treating PTSD in children and teenagers.
TF-CBT can include:
- relaxation techniques like breathing and muscle relaxation
- strategies to identify feelings and understand and respond to emotions
- strategies to recognise, monitor and change unhelpful thinking
- gradual exposure to trauma-related triggers
- creative activities like drawing, painting, clay-making, writing, and playing with toys
- a focus on the future.
Children usually do TF-CBT with psychologists, counsellors or social workers, either one-on-one or together with their parents.
Eye-movement desensitisation and reprocessing therapy (EMDR)
EMDR is also recommended for treating PTSD in children and teenagers.
EMDR can include:
- gentle guided eye movements, taps or sounds while focusing on upsetting or traumatic memories
- help to process memories so they feel less upsetting or scary
- strategies to cope with strong emotions linked to upsetting or traumatic memories
- strategies to build confidence, calmness and positive self-beliefs.
Children usually do EMDR with psychologists, counsellors or social workers, either one-on-one or together with their parents.
Medicine
Medicine isn’t recommended as a first line of treatment for PTSD. But if your child has depression as well as PTSD, their doctor might suggest antidepressants.
Your child might be able to get Medicare rebates for up to 10 sessions with a mental health professional each calendar year. To get these rebates, your child will need a mental health treatment plan from a GP or a referral from a psychiatrist or paediatrician.
How to support your child with PTSD
If your child has PTSD, they’ll need your love, understanding and support. It’s best to talk with your child’s doctor or therapist about how best to support your child.
Ideas for supporting your child
- Talk with your child about the traumatic event.
- Be available if your child wants to talk about the event or problems they’re having. This could mean staying at home with your child, taking time off work, or picking your child up from school.
- Show affection in a way that works for your child. For example, your child might like hugs, or they might prefer high fives or fist bumps.
- Do regular physical activities with your child like walking, bike riding, dancing or playing ball games.
- Make time to do things your child enjoys and finds relaxing, like cooking or listening to music.
- Try breathing for relaxation, muscle relaxation or mindfulness exercises with your child.
- Help your child practise helpful thinking. For example, you could create helpful self-talk messages or a positive collage about the future.
What does recovery from PTSD look like?
Recovering from PTSD takes time. It’s not always straightforward.
The recovery process will usually involve some ups and downs. Many young people who experience PTSD will have some symptoms again in the future. This might happen if they’re going through a stressful time or they’re exposed to media coverage of traumatic events.
No-one is to blame for a setback. Keep giving your child as much support as you can, even during the difficult times.
You can work with your child and their therapist to help your child find new ways to recover.
It’s important to look after yourself too. If you’re meeting your own needs, you’ll be better able to meet your child’s needs.