Quick FAQs
Post Traumatic Stress Disorder
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Anxiety Defined: What is PTSD? 2:18
Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after someone experiences or witnesses a traumatic event. It shows up as intrusive thoughts, strong distress, and avoidance that continue long after the event.
Symptoms need to last more than a month and cause real distress. Common signs include intrusive memories or flashbacks; avoiding reminders of the trauma; shifts in mood such as shame, anger, or feeling detached; and physical signs like irritability, being on edge, or trouble sleeping.
PTSD can develop after direct or indirect exposure to trauma. Earlier trauma, childhood neglect, other mental health conditions, and family history can make someone more vulnerable.
A clinician reviews symptoms, medical and mental health history, and trauma exposure. Sometimes physical exams or lab tests help rule out medical causes.
Genetics play a role, contributing to an estimated 30 to 40 percent of the risk. Parental trauma can also influence how stress-related genes function in children.
Some people improve over time, depending on the severity of the trauma and their coping skills. Others need structured treatment. Early intervention often leads to better outcomes.
Evidence-based treatments include cognitive behavioral therapy, cognitive processing therapy, trauma focused CBT, exposure therapy, and EMDR. Group and family therapy can also offer support. Medications may also ease symptoms of PTSD.
Triggers may come from inside, like trauma-related thoughts, or from outside, like certain sights or sounds. Avoiding them can make symptoms stronger because the brain loses chances to process them safely. Limited support or unhelpful coping strategies can also worsen symptoms.
PTSD can lead to avoidance, trouble concentrating, emotional reactivity, physical stress symptoms, or increased use of substances to cope. Relationships may feel strained due to withdrawal, mistrust, communication difficulties, or challenges with closeness.
Start with understanding the condition and being aware of the person’s triggers. Listen with patience, encourage treatment, and support safe social connections. Family therapy, shared coping plans, and gentle encouragement to reduce avoidance can help the whole family move toward recovery.
Understanding Post Traumatic Stress Disorder
The defining characteristic of a traumatic event is its capacity to provoke fear, helplessness, or horror in response to the threat of injury or death.
A child or adolescent who experiences a catastrophic event may develop ongoing difficulties known as post-traumatic stress disorder (PTSD). The stressful or traumatic event involves a situation where one’s life has been threatened or severe injury has occurred. Examples include: being the victim or a witness of physical abuse, sexual abuse, violence in the home or in the community, automobile accidents, natural disasters (such as flood, fire, earthquakes), and being diagnosed with a life-threatening illness. A child’s risk of developing PTSD is related to the seriousness of the trauma, whether the trauma is repeated, the child’s proximity to the trauma, and his/her relationship to the victim(s).
PTSD typically develops immediately after the trauma. In some cases, symptoms may not emerge until years have passed since the event. Additionally, a traumatic incident may cause mild PTSD symptoms in one individual while chronically debilitating another. Duration of symptoms also varies, with some people recovering from trauma naturally in the first 3 months, and others experiencing symptoms for months or years.
Examples of traumatic events include:
- Serious accidents
- Diagnosis of a life-threatening illness
- Bereavement and grief
- Violent personal assault, such as a physical attack, sexual assault, burglary, robbery, or mugging
- Military combat
- Miscarriage
- House fires
- Natural or man-made disasters
- Terrorist attack
- Prolonged bullying
- Childhood neglect
Exposure to traumatic event can happen in one or more of these ways:
- Experiencing the traumatic event first-hand
- Witnessing, in person, the traumatic event
- Learning someone close to the individual experienced or was threatened by the traumatic event
- Being exposed repeatedly to graphic details of traumatic events (i.e. first responder to the scene of traumatic events)
PTSD Experience
The experience of PTSD typically includes three principal areas.
- Re-Experiencing of The Traumatic Event as indicated by intrusive distressing recollections of the event. The person may experience flashbacks, nightmares and overall hypersensitive and exaggerated emotional and physical reactions to triggers that remind the person of the event.
- Avoidance and Emotional Numbing as indicated by extensive avoidance of activities, places, thoughts, feelings, or conversations related to the trauma. The person is likely to have a loss of interest in activities, feel detached from others, and present with restricted emotions.
- Increased Arousal as indicated by difficulty sleeping, irritability, outbursts of anger, hypervigilance and an exaggerated startled response which can look like jumpiness or being on edge.
Children do not exhibit the same reliving of the experience as adults do. The progression of PTSD may initially involve dreams about the traumatic event, that frequently transform into more generalized nightmares about monsters or other threatening situations where they or another person is in danger. It is more difficult for children to express their sentiments verbally. Therefore, it is necessary for parents or other adult observers to recognize behavioral changes such as a decreased interest in activity or an altered sense of the future (i.e., the child now believing that he/she will no longer live to become an adult). Other signs of childhood PTSD may occur in the form of repetitive play if the child begins to recreate the incident with toys or may occur through the emergence of physical symptoms such as headaches or stomach aches.
Impact of PTSD
Following the trauma, adolescents may initially show agitated or confused behavior.
They may also show intense fear, helplessness, anger, sadness, horror or denial. Children who experience repeated trauma may develop a kind of emotional numbing to deaden or block the pain and trauma. This is called dissociation. Children with PTSD avoid situations or places that remind them of the trauma. They may also become less responsive emotionally, depressed, withdrawn, and more detached from their feelings.
A child with PTSD may also re-experience the traumatic event by:
- Having frequent memories of the event, or in young children, play in which some or all the trauma is repeated
- Having upset and frightening dreams
- Acting or feeling like the experience is happening again
- Developing repeated physical or emotional symptoms when the child is reminded of the event
Children with PTSD may also show the following symptoms:
- Worry about dying at an early age
- Losing interest in activities
- Having physical symptoms such as headaches and stomachaches
- Showing more sudden and extreme emotional reactions
- Having problems falling or staying asleep
- Showing irritability or angry outbursts
- Having problems concentrating
- Acting younger than their age (for example, clingy or whiny behavior, thumb sucking)
- Showing increased alertness to the environment
- Repeating behavior that reminds them of the trauma
An individual’s PTSD might include symptoms such as feelings of shame, or less commonly, compulsive or aggressive behaviors, or self-destructive behavior. These cases often interfere with an individual’s personal life and can be associated with certain social patterns such as sexual dysfunction, relationship conflicts, and inability to perform daily activities, such as going to school. There are also strong feelings of guilt and despair that lead to social withdrawal and substance abuse.
Rare cases of PTSD may involve auditory hallucinations, paranoid thoughts, or tinnitus, a constant ringing in one’s ears. Individuals who are experiencing paranoid thoughts are highly guarded and constantly suspicious of being harmed and harassed by those around them. When the trauma involves violent death, symptoms of both complicated grief and PTSD may be present.
Prevalence of PTSD
The lifetime prevalence of PTSD is 5.8% in the 17-18 year old demographic and 6.3% in the 18-29 year old demographic. About 37% of annual cases of PTSD are classified as severe. The average age of onset is 23 years old. Females have about a 20% higher likelihood to be impacted by PTSD than males.
Effective PTSD Treatment
Treatment for PTSD (post-traumatic stress disorder) is most effective when it uses structured, evidence-based approaches that help individuals process trauma and regain a sense of safety and control. Early intervention and strong support from family, school, and caregivers are important, especially for children and teens.
The gold standard for PTSD treatment is cognitive behavioral therapy (CBT) for PTSD, particularly trauma-focused cognitive behavioral therapy (TF-CBT). TF-CBT is an evidence-based trauma therapy that helps individuals understand how trauma impacts thoughts, emotions, and behavior, while building skills to manage distress and improve daily functioning.
A key component of trauma-focused CBT is helping patients safely process traumatic memories. This includes developing coping strategies, improving emotional regulation, and strengthening communication within the family. PTSD therapy for children and teens often includes parent involvement to reinforce progress and support recovery at home.
Exposure-based therapy for PTSD, including exposure and response prevention (ERP), is used to gradually and safely revisit trauma-related memories, thoughts, or situations. Through repeated, supported exposure, individuals learn that distress decreases over time, reducing avoidance and helping to break the cycle of anxiety.
Cognitive restructuring is another core part of CBT for PTSD, helping individuals reframe unhelpful or distorted beliefs related to the traumatic event. This process can reduce feelings of fear, shame, and guilt, and support healthier thinking patterns.
In some cases, PTSD treatment may also include medication to help manage symptoms such as anxiety, agitation, or depression.
Another evidence-based approach is eye movement desensitization and reprocessing (EMDR), a form of trauma therapy that helps individuals reprocess traumatic memories using guided eye movements or other forms of bilateral stimulation.
At Anxiety Institute, our specialized PTSD treatment program integrates CBT, trauma-focused therapy, exposure-based approaches, and family support to help children and teens recover from trauma, reduce symptoms, and return to daily functioning.
Contact us for a complimentary consultation. Our team will help determine the best treatment for PTSD for your child.
Resources
Newsletter:
Read Anxiety Institute’s newsletter about PTSD.
Blanco, C., Xu, Y., Brady, K., Pérez-Fuentes, G., Okuda, M., & Wang, S. (2013). Comorbidity of posttraumatic stress disorder with alcohol dependence among US adults: results from National Epidemiological Survey on Alcohol and Related Conditions. Drug and Alcohol Dependence, 132(3), 630-638.
Eisen SA, Griffith KH, Xian H, et al. Lifetime and 12-month prevalence of psychiatric disorders in 8,169 male Vietnam war era veterans. Mil Med. 2004;169(11):896–902.
International Society for Traumatic Stress Studies (ISTSS) – A society for professionals to share information about the effects of trauma;
https://www.istss.org/
Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. B. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52(12), 1048-1060.
National Center for PTSD (NCPTSD) – A center established by the U.S. Department of Veteran Affairs to improve the well-being of U.S. veterans through PTSD research and education;
www.ncptsd.va.gov/
National Institute of Mental Health (NIMH) – An organization with the National Institute of health dedicated to mental health research;
http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml
Thomas, J. L., Wilk, J. E., Riviere, L. A., McGurk, D., Castro, C. A., & Hoge, C. W. (2010). Prevalence of mental health problems and functional impairment among active component and National Guard soldiers 3 and 12 months following combat in Iraq. Archives of General Psychiatry, 67(6), 614-623.
Ralevski, E., Olivera-Figueroa, L. A., & Petrakis, I. (2014). PTSD and comorbid AUD: a review of pharmacological and alternative treatment options. Substance Abuse and Rehabilitation, 5, 25.
Stecker T, Fortney J, Owen R, McGovern MP, Williams S. Co-occurring medical, psychiatric, and alcohol-related disorders among veterans returning from Iraq and Afghanistan. Psychosomatics. 2010;51(6): 503–507.
Trauma and the Vietnam War Generation: Report of Findings from the National Vietnam Veterans Readjustment Study.
Kulka RA, Schlenger WE, Fairbank JA, et al, editors. Brunner/Mazel. (1990).
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