What is traumatic stress?
Children, like adults, sometimes experience or witness something extremely frightening and dangerous, such as a road accident, a serious injury or a crime. This can cause a traumatic stress reaction, which affects the way the child thinks, feels and behaves. Children can be as severely affected as adults. If you recognise it, you will be better able to help your child to recover, and also to know when to seek professional help.
What are the signs of traumatic stress?
Individual children react in different ways to traumatic events. How they react may also depend on their age. Immediately after the traumatic event, children may find it hard to sleep and have bad dreams and nightmares. Sometimes, the effects may not appear for days or weeks. Children may, however:
- become fearful, clingy and anxious about being separated from their parents;
- start bedwetting and thumb-sucking again;
- become preoccupied with thoughts and memories of the event;
- be unable to concentrate;
- be irritable and disobedient;
- complain of physical symptoms such as headaches and stomach-aches.
All these are normal reactions to an extremely frightening event. With help and support from the people close to them, children begin to get over the shock in a few days, and usually recover after a few weeks.
If the traumatic event was severe where the child’s life was at risk or where the trauma persisted over a long time such as in the case of child abuse or domestic violence, they may present with post traumatic stress disorder (PTSD). t is difficult, however, to make a diagnosis in a child under the age of 7 years.
Some of the typical signs of PTSD are:
- ‘Flashbacks’ of the event. For a few moments, it seems as though they are re-living the experience in your mind, like watching an action-replay, which can be distressing and frightening – particularly for children.
- Deliberately avoiding thoughts or feelings about it. If they have been in a car crash, you may avoid roads, or even TV programmes about cars because it reminds them of the accident.
- Sleeping badly.
- Being easily startled and appearing frightened at the slightest noise.
These reactions can go on for months, and can interfere considerably with a child’s daily living. They may be unable to enjoy playing or find it difficult to concentrate on their school work. Occasionally, these problems can continue as the child grows into adulthood.
How can I tell if I have PTSD?
Have you experienced a traumatic event of the sort described above? If you have, do you:
- have vivid memories, flashbacks or nightmares?
- avoid things that remind you of the event?
- feel emotionally numb at times?
- feel irritable and constantly on edge, but can’t see why?
- eat more than usual, or use more drink or drugs than usual?
- feel out of control of your mood?
- find it more difficult to get on with other people?
- have to keep very busy to cope?
- feel depressed or exhausted?
If it is less than 6 weeks since the traumatic event and these experiences are slowly improving, they may be part of the normal process of adjustment.
If it is more than 6 weeks since the event, and these experiences don’t seem to be getting better, it is worth talking it over with your doctor. (Young minds)
Children and PTSD
PTSD can develop at any age. Younger children may have upsetting dreams of the actual trauma, which then change into nightmares of monsters. They often re-live the trauma in their play. For example, a child involved in a serious road traffic accident might re-enact the crash with toy cars, over and over again.
They may lose interest in things they used to enjoy. They may find it hard to believe that they will live long enough to grow up. They often complain of stomach aches and headaches. (Young minds)
What can help?
The best approach, immediately after a traumatic event, is to accept that a child will be distressed – this is normal. At this stage, parents can help greatly by letting their child talk about the event if they want to, or helping them to relive it in games and drawings.
Leaving children alone ‘to forget things’ does not help. Talking can help children to adjust. It helps them to make sense of what has happened, to feel less alone with their worries and to regain a sense of control. However, forcing someone to talk about it, when they don’t want to, does not seem to be helpful.
If you have been involved in the traumatic event, you may also be distressed. It is usually better to admit to your children that you are feeling sad and upset. At the same time, you need to make it clear that you don’t expect them to look after your feelings. If you recognise that you have symptoms of PTSD then get help. Your child will manage their feelings and emotions better if you are not feeling fearful or anxious yourself.
When to seek help?
Ask for help if:
- the child’s upset feelings and behaviour seem to be getting worse
- the signs of extreme stress last for longer than about one month
- worries prevent you, your child or your family getting on with normal, everyday life
- the child has symptoms of PTSD that go on for longer than a month.
Where can I get help?
If you are concerned about your child at any time following a traumatic event, consult your GP who will be able to refer you to your local child and adolescent mental health service (CAMHS).. These services often has long waiting lists. If you want your child to be seen sooner, you could seek the help from a private practitioner such as a psychiatrist or a psychologist. If you want to contact me or come and see me, you are more than welcome to do so.
Sometimes, children find it easier to talk to other adults rather than their parents. Professional help may be needed to help get them get back to normal more quickly, and to prevent or reduce the harmful effects of prolonged stress reactions.
Things you can do to help:
- Give them time, and listen
- Let them know you are there and that you care
- Let them know it was not their fault
- Maintain routine and structure
- Don’t ignore their worries
- Don’t expect them to snap out of it quickly, it will take the time it takes
- Provide reassurance and help to connect them to their sense of strength, but let them know that it is also ok and not a sign of weakness to be vulnerable.
- Remind them why you like and value them
- Make sure you look after yourself as well!
What is the treatment?
The good news is that this is treatable. In most cases therapy is the first line of intervention. This may take the form of individual therapy or family therapy. Evidence based forms of intervention are EMDR or CBT. In some cases medication may be required in order to help someone sleeps or to help with associated anxiety or depression.
Useful addresses and telephone numbers
Cruse Bereavement care
Helpline: 0808 808 1677
Free 24/7 helpline for children and young people
Helpline: 0800 11 11
Textphone: 0800 400 222
Helpline: 08457 909 090
For people under 19 years. Confidential and anonymous email and telephone helpline support run by young volunteers.
Email and online chat via website Monday and Wednesday 6:30 – 9:30 at
Email support for young people between 12 – 16 years. There is on-screen advice about all sorts of things e.g., bullying, relationships, exams, drugs, difficulties at home etc.
Helping people to cope with crime.
Supportline: 0845 303 0900