"When we can talk about our feelings, they become less scary.
The people we trust with that important talk can help us know that we are not alone.” – Fred Rogers, aka Mister Rogers
Trauma & PTSD
Written by Violaine Guéritault, Ph.D.
Whatever the age of your young person, there is one thing we all have in common — we want to be happy. Your young person wants to feel positive emotions through experiencing happy times and happy events, and they want their life to be filled with happy memories. And life does give them plenty of opportunities to experience the happiness they seek. But experience also teaches us that life is like the weather — it has pleasant days and stormy days. And while some of the pleasant days may mark your young person’s life with memorable happy events, some of the stormy days can affect them and change them to the very core of their being.
Such stormy days can hit a person’s life at any age with harsh repercussions, but when they strike at a younger age, such as during the preteen or teenage years, the consequences can be particularly impactful and sometimes devastating. There are, of course, different kinds of stormy days that life will put on your young person’s path, but the kind of stormy days that will prove to have the most significant effects and long-lasting consequences are traumatic events.
As opposed to what you may think, traumatic events occurring during the preteen and teen years are far from rare. In fact, a recent scientific study shows that 61% of teens aged 13 to 17 have been exposed to at least one traumatic event in their lifetime, while 19% have experienced three or more of such events. Traumatic events during adolescence are unfortunately relatively common.
What is a Traumatic Event?
Do you think your young person may have experienced a traumatic event? Do you wonder how to know if they have? To answer these questions, the first thing that it is good to know is how to define a traumatic event. According to the Center for Disease Control (CDC), a traumatic event is “when an event, or a series of events, causes a lot of stress.” Traumatic events are marked by a sense of horror, helplessness, serious injury, or the threat of serious injury or death.” It is also important to know that traumatic events are not associated only with physical harm. They can also cause emotional, psychological, or spiritual harm. Your young person can experience such harm and distress by being directly exposed to a traumatic event themselves, and they can become just as distressed if they witness the traumatic event when it is happening to another person, or if they learn that the traumatic event occurred to a close family member or a close friend.
The second thing that will help you figure out if your young person has ever experienced a traumatic event is to have a list of what is considered to be a traumatic event. Let’s now look at what you would find on such a list:
1. Physical, sexual, or emotional abuse Such abuse can be perpetrated by a caregiver, community member, a family member, an intimate partner, a friend, classmate, or a stranger (i.e., bullying).
2. Neglect This refers to a failure on the part of an adult to provide for a child’s basic physical, medical, educational, and emotional needs.
3. An unstable or unsafe environment Can include lack of housing, food, medical care, unsafe sleeping, etc.
4. Domestic violence Occurs when a child is the recipient and/or the witness of physical, sexual, or psychological violence by someone in the victim’s domestic circle.
5. Interpersonal violence or victimization When someone is the victim of assault or rape, for example.
6. Community violence Refers to gang violence, riots, or school shootings.
7. Natural disasters Includes events such as tornadoes, hurricanes, and deadly or severe storms.
8. Terrorist attacks A surprise attack involving the deliberate use of violence against civilians in the hope of attaining political or religious aims.
9. Loss of a loved one Occurs when someone is separated from a caregiver or is confronted with the sudden death of a caregiver, a sibling, or a close friend/family member.
10. Accidents or medical trauma Includes severe injuries caused by a car accident, for example, an accident associated with the practice of a sport, or dealing with a life-threatening illness.
11. Divorce Can also be considered a major life event and also can be traumatic for some.
12. Racial trauma – or race-based traumatic stress The mental and emotional injury caused by encouters with racial bias and ethnic discrimination, racism, and hate crimes. It has been observed in numerous Black, Indigenous, and people of color (BIPOC) communities and in people of all ages, including young children.
Like it is the case for most situations in life, when it comes to traumatic events, each person will react differently to the trauma caused by such events. If you have experienced one or more traumatic events in your life, then you know that both the body and the mind are affected one way or another in varying degrees. The same holds true for your young person. They will likely react in a way that is unique to them and it is important to validate their reactions and support them in whatever way their needs may manifest. Let’s go over some of those reactions experienced by the body and the mind when confronted with a traumatic event so you can be aware of them and recognize whether your young person is experiencing anything similar.
It is well documented that the body may react by developing the following problems:
Aches and pains
Muscle tension
Fatigue
Agitation and edginess
Headaches
Nausea/GI discomfort
Being startled easily
Racing heartbeat
Lethargy
Sleep disturbances (e.g., insomnia and nightmares)
Difficulty concentrating or paying attention
Unexplained physical symptoms and increased medical problems such as allergies, skin problems, and auto-immune disorders
As for the mind, it can also be deeply affected by traumatic events in many ways, such as:
Shock, denial, and disbelief
Confusion, difficulty concentrating and/or learning new information
Difficulty in regulating emotions and in knowing and describing feelings and internal states
Social isolation and difficulty relating to others (e.g., mistrust)
Anger, irritability, mood swings
Anxiety and fear
Guilt, shame, and self-blame
Feeling sad and hopeless
Feeling disconnected and numb
Low self-esteem and sense of self-worth
Intense fear that the traumatic event will recur (especially around the date of the anniversary when the event occurred)
Repeated memories of the event or flashbacks
Sustained avoidance of reminders of the events
Substance abuse to numb negative emotions
You should know and always remember that reacting to a traumatic event is a very normalresponse to a very abnormalsituation. However, it’s important to be aware that such a response can become unhealthy if it lingers for too long and if it affects and interferes with everyday life. In some cases, the traumatic stress can be so intense that it triggers a condition known as post-traumatic stress disorder (PTSD).
Not all preteens and teens who have experienced a traumatic event will develop PTSD. However, the more severe the trauma, the higher the chances that they will experience PTSD symptoms. But what is post-traumatic stress disorder (PTSD) exactly? You probably have heard this term before and you know that it has to do somehow with the consequences of trauma, but maybe you are not sure about the specifics of it. Let’s look at what PTSD is in more detail.
What is PTSD?
PTSD is an anxiety disorder that can develop after experiencing or witnessing a major traumatic event. The symptoms associated with this disorder are well-known and well documented, and they usually present themselves in the following ways:
Reliving the trauma – This happens when a person experiences recurring, involuntary, and upsetting memories about a trauma such as vivid flashbacks, nightmares, and intrusive thoughts and images. For example, a teen who was involved in a car accident may keep remembering every moment of the accident: the sound of crushed metal at the moment of the impact, and the images of blood on his or her own body or someone else’s. A person also may find themselves feeling intense distress at real or symbolic reminders of the trauma.
Avoidance – It refers to all kinds of attempts on a person’s part to avoid anything that reminds them of the trauma they experienced. This may include staying away from places, objects, or discussions that remind them of the traumatic event. It may also mean that they are unable to remember details of what happened and that they are feeling emotionally numb or disconnected from their own feelings. It is not uncommon for a person to also feel physically numb or detached from their body, and to feel like they are unable to express affection.
Cognitive and mood symptoms – These symptoms include negative thoughts about oneself, feeling guilty, ashamed, worried, and depressed.
Symptoms of high anxiety or “hyperarousal” – These symptoms can cause sleep difficulties, anger outbursts, difficulties concentrating on a person’s daily activities, and a state of hypervigilance when they feel constantly “on guard” or “on alert” as if something terrible is about to happen at any time. A person may also feel really jumpy and easily startled by any stimuli that bear resemblance to the traumatic event they experienced.
It’s important to note, however, that PTSD is not the only condition that can develop as a result of experiencing intense traumatic stress. PTSD symptoms often coexist with other conditions such as depression, impulsive or aggressive behaviors, self-harm, suicidal thoughts, and substance abuse problems such as drug or alcohol use, especially among adolescents.
Other anxiety disorders can also be found in association with PTSD. Among those, panic disorders are often observed. Panic disorders can come out in different forms such as phobias, or panic attacks that are rather common among preteens and teens who have experienced traumatic events.
With a better understanding of what traumatic events are and their potential consequences such as PTSD, it may be easier for you to identify if you, someone you know, or your young person have experienced some kind of trauma in the past. If you think your young person may have experienced a trauma that you weren’t aware of, or is having trouble processing a traumatic event that occurred, you may be wondering what to do next to help them.
Supporting & Communicating with your Young Person
There are quite a few things you can do to help your young person manage and cope with a traumatic event. What is most helpful for your young person, however, depends mostly on whether they have developed PTSD symptoms or not.
Whether that is the case or not, the very first thing you need to do is: be kind, gentle, and patient with your young person. They may need extra care and comfort from you and the need to feel safe may linger with them for a while. Healing gently is the answer here, try not to push your young person, let them lead and simply support them. Trying to power through trauma may make things worse and considerably delay the moment when their body and their mind can truly start healing. Help them find self-compassion and patience while accepting and validating what happened and how they feel because of it. Reassuring them and letting them know that they will eventually overcome how they feel, helping them relax and calm their bodies, engaging in activities with them that foster positive emotions are all great steps in helping your young person to get through and process their trauma.
If your young person is NOT experiencing PTSD symptoms, there are several things you can do to help them restore their emotional stability after a traumatic event.
Make a point of noticing if your young person has developed a tendency to avoid places, objects, and certain people that may remind them of the traumatic event they have been through. If that is the case, help them to acknowledge that they do this and encourage them to stay engaged in activities they like and that will keep them grounded, such as working out, going out for a walk, playing sports, or seeing their friends.
Make sure your young person spends time with the people they love and who care about them in order to avoid becoming withdrawn, even if they don’t feel up to it.
Encourage them to talk about their experience with the people close to them and who they trust, or write down their feelings and thoughts in a daily journal.
Be patient and tolerant with them and remind them to also be patient and tolerant with themselves. Help them recognize that there are things that are out of their control and that’s okay.
It is helpful for them to take good care of themselves by keeping a healthy lifestyle, such as eating a balanced diet, working out regularly, and avoiding drugs or alcohol.
Motivate them to do more of the things they enjoy, like pursuing their hobbies or other interests that make them feel good about themselves and about life in general.
Learn about and practice mindfulness and meditation with them. These practices have a solid track record of helping people manage trauma.
However, if traumatic stress symptoms don’t subside for your young person and they feel “stuck” and unable to move on from the event for an extended period of time, then that may be a sign that they are developing post-traumatic stress disorder (PTSD).
Signs your young person may be developing PTSD
If you realize that your young person is still experiencing the following:
They are not feeling better.
The way they feel is starting to interfere with their daily life.
They are experiencing terrifying memories, nightmares, or flashbacks.
They are avoiding more and more things that remind them of the traumatic event.
They are suffering from headaches, stomach pains, and sleep disturbances.
They are experiencing suicidal thoughts.
Then it is time for you to reach out for more help. Do not hesitate to do so, whatever the reason. Your young person needs more help and time will not heal their trauma; PTSD requires the help of medical professionals.
Your young person’s brain (if diagnosed with PTSD) has literally rewired their nervous system in response to the traumatic event they experienced. Some experts say that time actually makes PTSD worse if left unaddressed. Even the most strong-willed trauma survivors aren’t able to power their way out of PTSD. This is why it is so important for you to seek professional help for your young person.
Get in touch with a therapist who specializes in trauma and schedule an appointment for your young person. Let them know what your young person has gone through and how they are feeling. Trauma therapists use certain types of therapies that are very effective in treating PTSD and that will help your young person recover from the pain and suffering caused by its symptoms. It is always important to also advocate for your young person as well. Find a therapist they feel safe and supported with. To check out some options for therapeutic care visit Psychology Today to access their database of healthcare professionals.
Treatment Options for PTSD
The most common forms of treatment for PTSD include the following:
Trauma-Focused Cognitive Behavioral Therapy – helps preteens and teens identify their thought processes so they can reframe their experience in order to come to terms with what happened and move on.
EMDR (Eye Movement Desensitization and Reprocessing) – EMDR therapy allows for the accessing and processing of traumatic memories to bring them to an adaptive resolution. After successful treatment with EMDR therapy, emotional distress decreases, negative beliefs are reformulated, and the state of hyperarousal is reduced.
Dialectic Behavioral Therapy (DBT) – teaches specific skills that allow preteens and teens to become self-aware and to manage stress and difficult emotions more effectively.
Somatic (body-based) Therapy – supports preteens and teens to process trauma in order to restore the nervous system’s balance.
Motivational Enhancement Therapy – promotes self-motivated change in thinking and behavior.
Experiential Therapies (such as adventure therapy, art therapy, equine-assisted therapy or music therapy) – help preteens and teens recover from trauma through hands-on, real-life experiences that build trust and self-confidence.
As mentioned earlier, always keep in mind that there is nothing trivial about a traumatic event, and that the way that your young person feels is a very normal response to a very abnormal situation.
A traumatic event can never be erased and it will never be possible for your young person to pretend that it never happened. Nonetheless, with the right care and support, they will learn to manage it and live with it in a way that will build their mental strength and their resilience, two skills that will become major assets for them as they move on with their life.
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