Post-traumatic stress disorder (PTSD) is a debilitating condition that often follows a terrifying physical or emotional event — causing the person who survived the event to have persistent, frightening thoughts and memories or flashbacks of the ordeal. Persons with PTSD often feel chronically, emotionally numb. PTSD in children usually becomes a chronic disorder.

Whose Is Affected?

Traumatic experiences are not common in the lives of most children. However, approximately 3,000,000 children each year are diagnosed with PTSD. No studies have examined the general population incidence of PTSD specifically in children and adolescents. However, it is estimated to be as high as 40% in violence-ridden neighborhoods.

The event(s) that triggers PTSD may be:

• Something that occurred in the person's life
• Something that occurred in the life of someone close to the child
• Something the person witnessed

A child's risk for developing PTSD is often affected by the child's proximity and relationship to the trauma, the severity of the trauma, the duration of the traumatic event the recurrence of the traumatic event, the resiliency of the child, the coping skills of the child and the support resources available to the child from the family and community following the event(s).

The following are some examples of catastrophic, life-threatening events that may cause PTSD if experienced or witnessed as a child or adolescent:

• Serious accidents (such as car or train wrecks)
• Natural disasters (such as floods or earthquakes)
• Man-made tragedies (such as bombings)
• Violent personal attacks (such as a mugging, rape, torture, being held captive or kidnapping)
• Physical abuse
• Sexual assault
• Sexual molestation
• Emotional abuse
• Neglect

Children are more at risk of exposure to violence at home or on the streets than in school. About 1 million children are confirmed victims of child abuse each year. Of inner-city elementary school-aged boys:

• 87% have seen someone arrested
• 84% have heard guns being fired
• 25% have seen someone get killed

The following are the most common symptoms of PTSD. However, each child may experience signs differently.

Children and adolescents with PTSD experience extreme emotional, mental and physical distress when exposed to situations that remind them of the traumatic event. Some may repeatedly relive the trauma in the form of nightmares and disturbing recollections during the day and may also experience any, or all, of the following:

• Sleep disturbances
• Depression
• Feeling jittery or "on guard"
• Being easily startled
• Loss of interest in things they used to enjoy, detachment, general lack of responsiveness, feeling numb
• Trouble feeling affectionate
• Irritability, more aggressive than before, or even violent
• Avoiding certain places or situations that bring back memories
• Flashbacks or intrusive images (flashbacks can come in the form of images, sounds, smells or feelings, a person usually believes that the traumatic event is happening all over again)
• Losing touch with reality
• Reenactment of an event for a period of seconds or hours or, very rarely, days
• Problems in school, difficulty concentrating
• Worry about dying at an early age
• Regressive behaviors, acting younger than their age (i.e., thumb sucking, bedwetting)
• Physical symptoms (i.e., headaches, stomach aches)

Specific treatment for post-traumatic stress disorder will be determined by your child's physician based on:

• Your child's age, overall health and medical history
• Extent of your child's symptoms
• Your child's tolerance for specific medications or therapies
• Expectations for the course of the disorder
• Your opinion or preference

Treatment for PTSD should always start with a full check-up of the child and their family. The plan might include:

• Talk therapy:  A type of talk therapy called cognitive behavioral therapy can help kids learn skills to handle their worries and feel in control of the situations that caused their PTSD.
• Medicine: Some children might also be helped by medicine for depression or anxiety, which can help them feel calmer.

A child's recovery from PTSD depends on many things, like their own inner strength and ability to "bounce back" from hard times. It's also greatly affected by the support they get from their family. Parents are a huge help in the treatment process.

Prevention

Preventive measures to reduce the incidence or lessen the chance of traumatic experiences in children include, but are not limited to, the following:

• Teach children that it is okay to say no to someone who tries to touch their body or approaches the child in any way that makes the child feel uncomfortable.
• Teach children that it is okay to tell an adult the child trusts right away if someone makes the child feel uncomfortable.
• Provide appropriate support and counseling for children and adolescents who have experienced or witnessed a traumatic event.
• Encourage prevention programs within your community or local school system.