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Post-Traumatic Stress Disorder (PTSD)

What is Post-Traumatic Stress Disorder?
Post-Traumatic Stress Disorder (PTSD) is a condition that develops in some people who have experienced a shocking, scary, or dangerous event.

It is natural to feel afraid during and after a traumatic situation. Fear triggers many split-second changes in the body to help defend against danger or to avoid it. This “fight-or-flight” response is a typical reaction meant to protect a person from harm. Nearly everyone will experience a range of reactions after trauma, yet most people recover from initial symptoms naturally. Those who continue to experience problems may be diagnosed with PTSD. People who have PTSD may feel stressed or frightened, even when they are not in danger.

All children and adolescents experience stressful events that can affect them both emotionally and physically. Their reactions to stress are usually brief, and they recover without further problems. A child or adolescent who experiences a catastrophic event may develop ongoing difficulties known as PTSD. The stressful or traumatic event involves a situation where someone's life has been threatened or severe injury has occurred (ex. they may be the victim or a witness of physical abuse, sexual abuse, violence in the home or in the community, automobile accident, natural disaster (such as flood, fire, earthquake), and perhaps they have been 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).

What causes PTSD?
PTSD can occur at any age and is directly associated with exposure to trauma. Adults and children who have PTSD represent a relatively small portion of those who have been exposed to trauma. This difference is not yet well understood, but we know that there are risk factors that can increase a person’s likelihood of developing PTSD. Risk factors include prior experiences of trauma, but there are also factors that may promote resilience, such as social support. This is also an ongoing area of research.

Some factors that could increase the risk of developing PTSD include:

  • Living through dangerous events and traumas
  • Getting hurt
  • Seeing another person hurt, or seeing a dead body
  • Childhood trauma
  • Feeling horror, helplessness, or extreme fear
  • Having little or no social support after the event
  • Dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home
  • Having a history of mental illness or substance abuse

 

What are some symptoms of PTSD?
Re-experiencing type symptoms, such as recurring, involuntary, and intrusive distressing memories, which can include flashbacks of the trauma, bad dreams, and disturbing thoughts. Some other common symptoms of PTSD are:

  • Avoidance – which can include staying away from certain places or objects that are reminders of the traumatic event. A person might actively avoid a place or person that might activate overwhelming symptoms.
  • Cognitive and mood symptoms – which can include trouble recalling the event, and negative thoughts about oneself. A person may also feel numb, guilty, worried or depressed and have difficulty remembering the traumatic event. Cognitive symptoms can in some instances extend to include out-of-body experiences or feeling that the world is "not real" (derealization).
  • Arousal symptoms – such as hypervigilance. Examples might include being intensely startled by stimuli that resemble the trauma, trouble sleeping or outbursts of anger.

 

Do children react to trauma and display PTSD differently than adults?
Children and teens can have extreme reactions to trauma and some of their symptoms may not be the same as adults. Symptoms sometimes seen in very young children (less than 6 years old) include:

  • Wetting the bed after having learned to use the toilet
  • Forgetting how to or being unable to talk
  • Acting out the scary event during playtime
  • Being unusually clingy with a parent or other adult

 

Older children or adolescents with PTSD may also re-experience the traumatic event by:

  • Having frequent memories of the event
  • Having an upsetting or frightening dream
  • Acting or feeling like the experience is happening again
  • Developing repeated physical or emotional symptoms when reminded of the event

 

Can PTSD be treated?
The symptoms of PTSD may last from several months to many years. The best approach is prevention of the trauma. Once the trauma has occurred, however, early intervention is essential. Providers may use one or more of the following to treat PTSD:

  • Support from parents, school, and peers is important. Emphasis needs to be placed upon establishing a feeling of safety
  • Psychotherapy (individual, group, or family) that allows the child to speak, draw, play, or write about the event is helpful
  • Behavior modification techniques and cognitive therapy may help reduce fears and worries
  • Medication may also be useful to deal with agitation, anxiety, or depression

 

Other Common Co-occurring Conditions

 

Transportation
Nonemergency transportation for medical and behavioral appointments is available for Apple Health (Medicaid) members. For more information, visit: HCA.WA.Gov/Transportation-Help.