Post-Traumatic Stress Disorder (PTSD) in Children: Symptoms, Causes, and Treatment

Post-traumatic stress disorder (PTSD) in children is a serious and very real condition that can occur when children experience severe stress, such as the death of a loved one, violence, or injury. While not all will get PTSD as a result, the reality is that 3% to 15% of girls and 1% to 6% of boys who have gone through trauma will develop the condition [*]. This may interfere with their relationships and daily life as they grow older, especially if unresolved. Here, we’ll discuss PTSD in children, including the symptoms, causes, and treatments that can help.

What is Post-Traumatic Stress Disorder (PTSD) in Children?

Post-traumatic stress disorder is a mental health problem that affects people of all ages, including children. Kids may have experienced childhood trauma and have frightening thoughts and memories of past events. They may find these events terrifying, whether physically or emotionally. Childhood PTSD may be accompanied by depression, anxiety, and other conditions in children.

What are the Signs of PTSD in Children?

The symptoms of PTSD may start soon after a stressful event. However, they may also appear much later after the event has passed; it can take 6 months or even longer for symptoms to appear after the traumatic event. Children may feel emotionally numb for a long time, and in many cases, it may become a long-term (chronic) problem.

There are many signs of PTSD in children, including the following:

• Feeling emotionally or physically distressed when exposed to situations that remind them of the traumatic event
• Reliving the trauma over and over again
• Having nightmares or disturbing memories during the day
• Having trouble sleeping
• Feeling depressed or grouchy
• Having trouble being affectionate
• Being more aggressive than before, even violent
• Feeling jittery, nervous, alert, or watchful
• Losing interest in things that used to bring joy
• Feeling detached or numb
• Unresponsive
• Staying away from certain situations or places that bring back memories
• Having flashbacks, such as images, feelings, sounds, or smells
• Having issues with focusing in school
• Losing touch with reality
• Worrying about dying at a young age
• Acting younger than their age (e.g., thumb-sucking or bedwetting)
• Having physical symptoms, such as stomachaches or headaches

Some of these symptoms are also signs of childhood trauma in adults.

What Causes PTSD in Childhood?

Traumatic events may cause PTSD in childhood [*]. These include neglect, abuse, terrorism, natural disasters, the death of a loved one, or community and school violence. Childhood traumatic stress occurs when these events overwhelm a child’s ability to cope.

Traumatic events that trigger PTSD in children may be something that happens to the child, something that happens to someone else close to the child, or something the child saw.

Children may develop PTSD after experiencing any of these traumatic events:

• Natural disasters, such as earthquakes or floods
• Manmade tragedies, such as war and bombings
• Animal bites
• Invasive medical procedures
• Accidents, such as car or train wrecks
• Violent personal attacks, such as mugging, torture, rape, or kidnapping
• Physical or sexual abuse
• Emotional abuse
• Bullying
• Neglect

Which Children Are at Risk for PTSD?

Children who are at risk for PTSD are often affected by the following:

• How close they were to the traumatic event
• How bad the event was and how long it lasted
• Whether the event happened more than once
• How resilient the child is and how well they cope
• Support from the child’s family and community after the event
• How much violence the child experiences in the community or neighborhood

How is PTSD Diagnosed in Children?

Not all children who experience a traumatic event will get PTSD. This condition is only diagnosed if symptoms persist for over a month and negatively affect the child’s daily life and functioning. For children with PTSD, symptoms will often start within three months after the traumatic event. However, symptoms can also surface months or years later.

Mental health professionals, such as child psychiatrists, can diagnose PTSD. The first step is to speak to one of these experts and arrange a mental health evaluation for your child. Because the event was distressing, the child may not want to talk about the event. It is important to get a professional who is highly skilled in speaking with children and families.

After the diagnosis, the utmost priority is to minimize the chances of another traumatic event happening to the child. This entails getting support from family, friends, and the child’s school to make the child feel safe and secure.

How is PTSD Treated in Children?

While there are ways to heal from childhood trauma, PTSD doesn’t typically go away on its own. Getting help and treatment can make all the difference. Mental health professionals such as psychologists and psychiatrists can provide therapy and medication to manage the most pressing symptoms of PTSD, such as anxiety, mood problems, and sleep issues.

There is a specific type of therapy for children with PTSD called trauma-focused cognitive behavioral therapy (TF-CBT). This type of talk therapy uses talking and learning activities, such as play, drawing, and storytelling. Some therapists may use tools like trauma worksheets to make therapy more engaging. Parents or caregivers are allowed to be present during this type of therapy to provide comfort and safety for the child.

TF-CBT can help children who have gone through any type of trauma, not just those who are diagnosed with PTSD. Going to therapy soon after a traumatic event helps children cope well.

How to Help Prevent PTSD in Children

It can be difficult to prevent traumatic experiences from happening to children, especially if they are outside of your control. But these measures may help prevent the development of PTSD in children:

• Teaching kids that saying “no” to someone who makes them uncomfortable is okay
• Encouraging and getting involved in prevention programs in your community
• Practicing disaster response drills at home or in schools

Researchers are still trying to figure out why some children develop PTSD after stressful and traumatic events while others do not. However, preventing the risks for trauma and reducing the impact of unavoidable stressors on children can help protect them from PTSD.

Tips for Helping a Child Live with PTSD

As a parent, caregiver, or guardian, you play an essential role in your child’s treatment. Here are some things you can do to help.

• Learn about the condition. Knowing as much as you can about the details of PTSD can keep you informed and help you understand what your child needs. You can look up resources on YouTube, read the best books on childhood trauma, or simply consult a professional to learn more about what you can do. Psychoeducational digital resources can also help your child learn coping skills to manage their PTSD symptoms.
• Face reality. It is important to admit that the event happened. Pretending that everything is normal will not help your child.
• Attend counseling with your child. Be supportive and attend counseling sessions with your child. They may be resistant at first, but it is necessary to recover from the traumatic event.
• Get support. Work with your child’s school and a mental health professional to create a treatment plan. It also helps to reach out to local community services and get in touch with other parents who may have a child with PTSD.
• Take depression and suicide seriously. If your child is showing symptoms of depression and suicide, then it is crucial to get treatment immediately. Suicide is considered a health emergency.
• Help your child feel safe. For a while, your child may feel the need for extra time, comfort, and care from you. Help them feel safe and secure.
• Do things you and your child enjoy. Trauma can make it more difficult to feel positive emotions that naturally help children recharge. Make time for playing, enjoying nature, making music and art, or cooking. Such activities will help reduce stress and build your child’s resilience.

When to Seek Professional Help

Some signs will indicate that it is time to seek professional help. These include but are not limited to:

• Feeling extreme depression, anxiety, anger, or fear
• Expressing thoughts of self-harm
• Feeling out of control
• Hearing voices
• Seeing things
• Not being able to sleep for days
• Exhibiting behavior that concerns family, friends, or teachers

If your child shows any of these signs, get help from your healthcare provider immediately.

The Bottom Line

PTSD can feel like an insurmountable obstacle for your child. But there is hope. When treated early, there is a higher chance that kids can manage their symptoms and grow up to live normal, fulfilled lives. As the childhood trauma quote goes, “The paradox of trauma is that it has both the power to destroy and the power to transform and resurrect.” Let your child know that they have the power to build their life despite having gone through trauma. Soon, they may grow to believe it too, and beat PTSD.

Explore our collection of trauma worksheets for engaging exercises and education to support kids in trauma treatment.

References:

1. US Department of Veterans Affairs. How Common is PTSD in Children and Teens? 2024.
2. Mann S & Marwaha R. Posttraumatic Stress Disorder. 30 January 2023.