Post-Traumatic Stress Disorder (PTSD)

• When children experience unimaginably traumatic events over a long period of time, it can affect their emotional and physical health to the extent that the event anchors itself into the psyche of that child and can potentially cause them to suffer from an emotional disorder thereafter.
• The emotional state of the child’s parents, which may reflect their anxieties and sadness regarding the event itself, plays a huge role in a child developing PTSD.

The emotional disorder or mental health condition that arises as a result of a particularly traumatic or dangerous event is referred to as post-traumatic stress disorder. This condition can be a consequence of numerous forms of severe emotional trauma or extremely dangerous, unimaginable and life-threatening situations that may have directly affected the patient or those around them. Such events may include the loss of a close family member, which could result in extreme stress for the surviving family member. This type of stress can sometimes be so severe that the sufferer is unable to accept and adjust to what has happened. Such traumatic events lead to emotional stress that differs from the stress which usually affects people who suffer a loss in the sense that it is much more serious and extreme. Examples of the type of event that can trigger such a reaction include:

• Natural disasters like flooding or an earthquake
• Severe accidents, including mass-casualty incidents
• Civil unrest or being a witness to war
• Witnessing a murder or the suicide of a loved one
• Experiencing extreme physical abuse, such as rape or torture
• Living in a particularly violent household (for children)

The symptoms of PTSD can affect anyone of any age or gender. These symptoms can manifest themselves in the following four forms:

1. Re-experiencing: Continuously thinking back to the event(s) or experiencing the event(s) again through memories can make the sufferer feel like they are going through the trauma again and again. This can make them feel anxious and afraid of experiencing these flashbacks. Dreaming about the event, as well as physical and emotional reactions may also affect the sufferer if they encounter a situation or object that triggers a flashback to the initial traumatic situation.
2. Avoidance: Feeling afraid of certain locations or situations that remind them of the event means the sufferer will also tend to avoid these places or situations thereafter. They may also be afraid to venture outside due to the fear of encountering particular aspects that may cause them to relive the distressing event, including a fear of certain places, situations, activities and topics of conversation.
3. Negative alteration of cognition and mood: Feelings of negativity can pervade all aspects of the sufferer’s life to the extent that they are incapable of feeling optimistic about anything and cannot gain happiness or even feel interested in certain activities. This may also cause them to feel different to other members of society due to their constantly pessimistic views, beliefs and expectations, which lead them to interpreting everything in a negative way. Some people may struggle to remember key aspects of the event that caused their condition and this may lead to them feeling closed off from the event and its subsequent consequences. Such thoughts can eventually lead to feelings of personal responsibility for the events themselves or blaming others which may then lead to further negative feelings, such as becoming easily angered and afraid or constantly feeling ashamed and guilty.
4. Hyperarousal symptoms: Symptoms related to heightened awareness, being overly careful and always being on the lookout for danger which can all lead to the sufferer becoming easily frustrated, afraid and angry. Such symptoms include feeling shocked and jumpy when they hear a loud noise which then has an effect on the concentration span of that person. This hyperarousal may also lead to the patient waking suddenly throughout the night, experiencing fitful sleep or even being unable to sleep altogether.

Factors which may signal that a child could develop PTSD:

• The violence they’ve suffered
• The extent to which the event carries meaning for the patient
• The length of time which has passed since the event occurred
• The coping mechanisms and personality of the patient when encountering stressful situations
• The age of the child
• Their past experiences
• The environment they inhabit
• The lack of a social support network
• A child who must live with emotional and social hardships on a daily basis

The emotional state of the child’s parents, which may reflect their anxieties and sadness regarding the event itself, plays a huge role in a child developing PTSD. This includes whether or not the parents offer their child support and encouragement, as well as the state of their relationship with the child and how they choose to raise the child.

Does PTSD and its symptoms require treatment?

Treatment and support are considered to be vital and should be carried out as soon as possible, especially for the initial symptoms that arise after a traumatic event. If these symptoms are left untreated and overlooked, or if the treatment and assistance are not offered soon enough, that child may develop chronic symptoms that last into adulthood and beyond.

What are the initial forms of treatment for PTSD?

1. Keeping a close eye on the emotional wellbeing of the patient
2. Speedy rehabilitation of their surrounding community
3. Screening for symptoms, behavioral observations and analysis of the child’s symptoms
4. Analysis of the extent to which the patient’s life has been affected by the distressing events, in order to find out whether they are suffering from any other psychological disorders, including:
   • Depression
   • Anxiety disorder
   • Phobias
   • Alcohol or drug addiction
     (Parents and guardians are especially important when it comes to carrying out the analysis.)

Treatment for PTSD

Emotional support treatment which consists of psychotherapy in various forms, including:

1.Trauma-focused cognitive therapy: This begins with chatting to the child about the events that have occurred alongside providing them with suggestions about how to relieve any fears that may arise from certain situations. Additionally, advice may be offered on how to adjust their beliefs and thoughts about what happened at that time, so that they can be trained in how to regulate their emotions in order to deal with any negative feelings they may be experiencing. Parents and guardians also play a part as they can help build the child’s understanding through talking to them about their own feelings regarding the situation that occurred and how they deal with the resulting emotional distress. This includes using their parental skills in helping the child to alter any inappropriate behavioral responses they may be displaying in a way that ensures they know how to react appropriately thereafter.

Cognitive-behavior therapy (CBT): This involves carrying out personalized psychotherapy.

• Child-parent psychotherapy and family therapy are considered effective in collectively analyzing ways to deal with emotional stress and discomfort as well as working out solutions to issues for which parents and guardians can offer support to the child.
• This type of therapy involves making changes and finding ways to adjust the child’s environment by providing teachers, parents, children and anyone connected to the patient with knowledge about PTSD. This includes co-prognosis of the condition and making plans for the family to get back together as soon as possible. Additionally, managing their school environment, so that the child can make a speedy return to normality, providing them with safety and stability at home and within the community, and ensuring preventative measures are in place to stop any repeat of the distressing events occurring will all go a long way to meeting the emotional needs of the child.

Medication used in the treatment of PTSD

Currently, the selective serotonin reuptake inhibitors (SSRIs) group of medications, such as sertraline and paroxetine, are effective in the treatment of adult sufferers. However, studies into their effect on children with PTSD remain inconclusive.Therefore, the use of medication to treat children and adolescents with PTSD should be carefully considered on a case-by-case basis.

Advice on what to do when a child displays symptoms of PTSD:

• The child’s main caregiver is of the utmost importance in ensuring that the child’s needs are met, that they are offered support and encouragement, and that they are listened to. This will all help to ensure that the child feels confident that they have someone on whom they can depend to offer them care and protection.
• Avoid giving interviews that are not part of the child’s treatment or interviews which are to be broadcast through media outlets.
• Do not constantly ask the child involved to repeat or relate the events that they experienced.
• Do not constantly refer to the event in a way that may cause the child to feel responsible but instead ensure an environment whereby the child feels comfortable if they wish to talk to someone about their feelings regarding the event.
• Try to ensure the child has every chance to partake in everyday activities so that they can make a return to normality as soon as possible. Parents and guardians are required to play their part by offering constant emotional encouragement and support, because they play the most important role in helping to treat that child’s symptoms or condition which has occurred as a result of extreme trauma.