PTSD Awareness: How to Help a Child Through Trauma
We often think of Post-Traumatic Stress Disorder (PTSD) as a mental illness that only soldiers suffer from. In fact, it has been referred to in the past as Shell Shock or Combat Fatigue.(1)
While PTSD is common in those individuals who have seen and experienced war, unfortunately, any person who has experienced trauma can develop PTSD.
This even includes children.
So what should you be looking for if you suspect that your child or another child in your life has PTSD? And how can you help them? Let’s talk about it.
We often think of Post-Traumatic Stress Disorder (PTSD) as a mental illness that only soldiers suffer from. In fact, it has been referred to in the past as Shell Shock or Combat Fatigue.(1)
While PTSD is common in those individuals who have seen and experienced war, unfortunately, any person who has experienced trauma can develop PTSD.
This even includes children.
So what should you be looking for if you suspect that your child or another child in your life has PTSD? And how can you help them? Let’s talk about it.
Symptoms
Common symptoms of PTSD specifically relating to the trauma include:
Flashbacks to the traumatic event
Intense distress when memories of the traumatic event are triggered
Avoidance of people or places associated with the event
Denial that the trauma happened
Reenacting the event
Those struggling with PTSD also tend to experience other symptoms such as:
Nightmares and sleep disturbances
Ongoing sadness, fear, and anxiety
Increased aggression or violent outbursts
Lack of positive emotions
Inability to show affection
Being hypersensitive to possible threats
Feelings of helplessness or hopelessness
Loss of interest in hobbies and activities previously enjoyed
Symptoms must continue for at least one month before a diagnosis of PTSD will be given. PTSD symptoms often appear around 3 months after the traumatic event but can appear months or even years after the event.
It’s essential to understand PTSD across the lifespan and how it can look different in children than it does in adults. Many professionals have worked tirelessly to develop diagnostic criteria for PTSD in children that are developmentally appropriate.(2)(3)
Children with PTSD may have unique symptoms such as having problems at school or regressing to behaviors like thumb-sucking or bedwetting. They also may be overly worried about dying at a young age.(5)
Causes
A variety of traumatic events can cause PTSD. These include:
Sexual, emotional, or physical abuse or neglect
Being a witness to or a victim of a crime
Watching serious illness or death in a loved one
Natural disasters, such as a hurricane or tornado
Serious car accidents
Invasive medical procedures
This list is not exhaustive. Any event that is traumatic can trigger symptoms of PTSD in a person.
It’s important to remember that not every person experiences and processes events in the same way. Two people can experience the exact same event and only one person may emerge with PTSD. This is totally normal and does not mean that there is anything wrong with that person. They simply need more support to work through their trauma.
Risk Factors
Some children are more likely to experience PTSD than others. Genetics play a role, along with a child’s temperament. A more anxious or nervous child may be more likely to develop symptoms of PTSD.
A history of personal mental illness or having many family members with mental illness can also make a child predisposed to developing PTSD
Treatments
Psychotherapy
Many types of psychotherapy may be beneficial to treat PTSD. Using the variety of psychotherapy methods available, a therapist or psychologist will encourage a child to speak, draw, play, or write about the traumatic event.(8) As the mental health professional and patient converse, they examine the patient’s thoughts and feelings to determine the best way to change them for the better.
Many people are hesitant to try psychotherapy but having a non-judgmental, objective person listen to the sufferer can be incredibly healing. Plus, they will also help a person navigate the best way to cope with their symptoms.
Cognitive-Behavioral Therapy
Cognitive-Behavioral Therapy (CBT) is most often the first line of treatment after a diagnosis of PTSD. This type of therapy helps children recognize their thought processes and feelings around the traumatic event. CBT helps a person identify distortions, or inaccuracies, in their thinking that are causing them harm.
Then, a mental health professional will help the child learn how to reframe their thoughts and change their behavior. They learn problem-solving skills and coping techniques to better handle their symptoms when they strike.
If there are other mental health illnesses at play, CBT is a great option.(7) CBT has been proven effective in treating many mental health disorders including anxiety disorders, depression, eating disorders, and more.
Dialectical Behavior Therapy is another technique used in CBT that gives sufferers more tools to manage their stress.(9) This method may be useful for children with PTSD to understand what emotions they’re feeling, how their reactions affect their relationships with others, and what behavioral skills can help change those emotions and reactions.
Acceptance and Commitment Therapy
Acceptance and commitment therapy is another type of psychotherapy that may be useful in treating PTSD. (9) This technique helps a child become more aware of their thoughts and feelings and works towards acceptance of them. Then, the mental health professional will encourage the child to commit to specific changes that will increase their ability to cope with their feelings and adjust better in stressful situations.
Supportive Psychotherapy
Supportive psychotherapy focuses on improving both a sufferer’s symptoms and their self-esteem.(10) The mental health professional is a source of comfort, support, and empathy to the child as they examine their emotional responses and behaviors. Praise, reassurance, and encouragement are used to help the child feel more comfortable with their emotions.
Medication
If a child is not experiencing improvements in their symptoms with therapy, medications may be prescribed as the next option. The use of medications in children should be used sparingly and under the careful supervision of mental health and medical professionals.
PTSD Awareness Month in the US
June marks PTSD Awareness Month in the United States. The goals of this event include raising awareness, understanding PTSD, and getting support. There’s an activity you can complete every day in June or you can join the Virtual Walk, walking 30 minutes every day to raise awareness for PTSD.
To check out more of the resources and events available, visit: https://www.ptsd.va.gov/understand/awareness/index.asp
PTSD affects about 4% of people worldwide.(6) It is dark and scary, but it does not have to be tackled alone.
Children experiencing PTSD need us to come alongside them and support them through this difficult illness. With the right treatment, full recovery is possible.
Check out my podcast, Genius Little Minds, for more information on topics such as Oppositional Defiant Disorder and Autism Spectrum Disorder. You can even submit questions you have about your own children at the bottom of this page!
Don’t forget to subscribe to my newsletter to stay up to date on all my latest blogs and podcast episodes.
References
https://www.talkspace.com/mental-health/conditions/articles/history-of-ptsd/
De Young, A.C., Landolt, M.A. PTSD in Children Below the Age of 6 Years. Curr Psychiatry Rep 20, 97 (2018). https://doi.org/10.1007/s11920-018-0966-z
Pate, Kailey Marie, "A Comprehensive Review of Post-Traumatic Stress Disorder (PTSD) in Children" (2020). USF St. Petersburg campus Honors Program Theses (Undergraduate) https://digitalcommons.usf.edu/honorstheses/263
https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral
Why Is My Child Acting Out? Oppositional Defiant Disorder Explained
Some kids are just “bad kids.” You know the ones. They run down the aisle screaming at church. They have meltdowns in the supermarket. They don’t listen, they talk back, and they laugh in the face of authority. They can’t be controlled by their parents or teachers.
In short, they’re a menace with a capital M.
Except… there’s no such thing as a “bad kid,” is there? There are good kids who need help… Kids who start to believe the worst about themselves because they’ve come to expect negative reinforcement from their parents, other adults, or their peers…
Believe it or not, that kid yelling obscenities at his mother in the school parking lot probably doesn’t want to be doing that. But children with oppositional defiant disorder, or ODD for short, have difficulty controlling their impulses and making healthy, developmentally appropriate choices.
Some kids are just “bad kids.” You know the ones. They run down the aisle screaming at church. They have meltdowns in the supermarket. They don’t listen, they talk back, and they laugh in the face of authority. They can’t be controlled by their parents or teachers.
In short, they’re a menace with a capital M.
Except… there’s no such thing as a “bad kid,” is there? There are good kids who need help… Kids who start to believe the worst about themselves because they’ve come to expect negative reinforcement from their parents, other adults, or their peers…
Believe it or not, that kid yelling obscenities at his mother in the school parking lot probably doesn’t want to be doing that. But children with oppositional defiant disorder, or ODD for short, have difficulty controlling their impulses and making healthy, developmentally appropriate choices.
What is Oppositional Defiant Disorder?
Oppositional defiant disorder (ODD) is a behavior disorder that’s typically diagnosed in childhood between the ages of 6 and 8 (3). Children with ODD can be defiant, hostile, exceptionally uncooperative, and argumentative.(1)
ODD Symptoms(2)
If your child has ODD, you may notice they frequently have an angry and irritable mood and are:
Easily annoyed by other people
Resentful
Often losing their temper
If your child has ODD, you may notice defiant, argumentative behavior where they:
Argue with authority figures frequently
Defy adults and refuse to follow rules
Deliberately annoy and upset other people
Blame others for their own mistakes, misbehaviors, or wrongdoings
If your child as ODD, you may notice vindictive behavior where they:
Behave spitefully
Try to “get back at” someone they feel has wronged them
But children with ODD aren’t having your typical toddler tantrum or teenage rebellion. Just because your toddler learned the word “no” and loves saying it to everyone and everything, for example, does not mean they have oppositional defiant disorder.(2) For a parent of a child with ODD, things like screaming matches, angry or aggressive behavior, expulsions from school, or daily rule breaking are the norm.(4) And it can be really hard on families.
In children with ODD, the oppositional and defiant behavior is persistent, extreme, and significantly interferes with their ability to function in school or have relationships with others.(1) It also has to be going on for at least 6 months in order to be diagnosed as ODD.(2)
Is ODD Genetic?
Biological, genetic, and environmental factors may all play a role in a child developing oppositional defiant disorder.(5) Unbalanced neurotransmitters may play a role too, as many children with ODD also have other mental health disorders, such as ADHD or mood disorders.(5)
Risk Factors for ODD:
Lack of supervision(11)
Poverty(11)
An unstable or dysfunctional home life(11)
Exposure to violence or aggressive behavior(8)
A family history of substance abuse(8)
Abuse or neglect(8)
Inconsistent parenting and disciplining(7)
A parent or close relative with mental illness(7)
You may be thinking, “Now, wait a minute. I’ve given my child everything! Nothing you’ve described sounds like our family. There’s no violence, no drugs. The rules are clear, easy to follow, and my child still has these out-of-control outburst and anger issues.”
A chaotic, stressful home life can contribute to mental health problems, there’s just no way around that. But even in a stable home, some children will develop oppositional defiant disorder.
Genetics may also be a factor. If a child has a close relative with mental illness, they are more likely to develop ODD.(7) Oppositional defiant disorder occurs more commonly among children whose family members have a history of ADHD, mood disorders like depression or bipolar disorder, and substance use disorders.(8)
Comorbidity
Children with ODD may struggle with one or more of the following:(9)
ADHD
Conduct disorder
Mood disorders (anxiety and depression)
ODD Diagnosis
You love your child desperately… You’d do anything for them. You’d die for them! But at this rate, you’re finding it very difficult to like them.
You know the angry outbursts, temper tantrums, spiteful behavior and arguments are, well… not exactly normal. So what’s a parent to do?
A medical doctor or mental health professional like a child psychologist or psychiatrist can diagnose oppositional defiant disorder. It’s likely they’ll want to talk to you, the parent or caregiver, and your child to conduct an assessment. They may also want to speak to your child’s teachers and conduct an assessment at school, depending on where your child exhibits their ODD symptoms.
What’s the Outlook for Kids with ODD?
About two thirds of children diagnosed with ODD overcome the disorder and don’t show behavioral symptoms anymore by the time they’re 18. (7) Amazing news, right?
It’s so important that your child get help if you think they do have ODD. Left untreated, severe oppositional defiant disorder can become conduct disorder, which is a more serious, delinquency version of ODD. But when treated early, prognosis is much better. Studies have shown that ODD symptoms resolve within 3 years in about 67% of children with the diagnosis.(14)
Treatment
There are many treatment options for children with ODD, and they will likely involve the whole family!
Family Therapy
ODD can be very taxing for parents and difficult on siblings. Family therapy can help improve communication skills, suggest systemic changes that need to be made within the family unit, and provide support for the entire family.(1) Being involved in your child’s treatment plan is important. Share your concerns, goals, and hopes with your child’s care team.
Parent-Management Training
Want to learn how to manage your child’s behavior? There’s a class for that! In parent-management training, you’ll be taught positive reinforcement techniques and how to discipline effectively.(14) Ask your child’s therapist or doctor for information on where to sign up.
Cognitive Behavioral Therapy
Often, children with ODD don’t understand that their defiant and aggressive behavior is wrong or unjustified. When asked why they behave the way they do, they might say, “because my parents are always on case.” In therapy, your child will master social skills and learn that he’s capable of making different, healthier choices.
Cognitive Behavioral Therapy (CBT) helps tackle unhelpful patterns of thinking and replaces them with healthier patterns.(10) In therapy, your child may role play scenarios he might encounter with family or friends and practice more adaptive, appropriate behaviors.
Peer Group Therapy
This can be a great resource if your child struggles to interact and socialize with peers. ODD can be hard on friendships. Peer group therapy provides a safe space for children with ODD to practice getting their social interactions right so they feel safe to try things out in the real world.
Medication
Typically, medication is not recommended to treat ODD unless another underlying condition like ADHD needs to be addressed.
Interested in Learning More?
Check out this podcast episode on ODD. You’ll learn five surprising questions you should ask yourself if you think your child has oppositional defiant disorder… and you’ll learn more about the parent-child relationship and how it can impact your child’s mental health. This is an episode you won’t want to miss!
Equip yourself with knowledge and tools to help your child thrive. Subscribe here to the Genius Little Minds podcast so you never miss an episode!
References
https://www.hopkinsmedicine.org/health/conditions-and-diseases/oppositional-defiant-disorder
https://www.healthline.com/health/childrens-health/odd-in-children
https://my.clevelandclinic.org/health/diseases/9905-oppositional-defiant-disorder
https://www.additudemag.com/what-is-oppositional-defiant-disorder/
https://www.sonorabehavioral.com/behavioral/odd/symptoms-causes/
https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral