Post-Traumatic Stress Disorder and Young People
By Natasha Tanic
Research shows that five percent of adolescents in the United States experience post-traumatic stress disorder (PTSD) in their lifetime. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), 60 percent of adults report experiencing abuse or other family-related traumatic experiences during childhood.
What is Trauma?
Trauma is an event (in which a child or teenager is involved or is witness to) that makes him/her feel intensely threatened. A traumatic event usually involves violence, sexual assault, a car accident, combat, or natural disaster.
PTSD features in adolescence often closely resemble PTSD in adults. First reactions to trauma typically include shock and denial. Other most common PTSD reactions are:
· Sudden mood swings
· Impulsive behavior
· Trouble sleeping
· Self-destructive behavior
· Difficulty concentrating
However, there are a few signs of adolescent PTSD that differ from post-traumatic stress disorder in adults. For instance, adolescents are more likely than younger children or adults to exhibit impulsive or aggressive behavior and other atypical signs of PTSD.
Types of Trauma in Young Age
There are different traumatic events that adolescents can be exposed to, including physical, sexual, and emotional abuse and neglect, war and terrorism, and natural or human-made disasters.
Bullying and cyberbullying represent a deliberate action that causes emotional, psychological, physical, and social harm to someone. Bullying is a form of aggression and harassment that typically happens repeatedly, preventing an adolescent from enjoying a safe and stress-free day-to-day life.
Bullying can be verbal (teasing, threatening, name-calling), physical (tripping, hitting, etc.), and social (embarrassing someone in public, spreading rumors, etc.).
Cyberbullying involves posting hurtful text or pictures about someone online and sending them harmful or false content electronically (via text messages, email, social media, etc.).
Sexual and/or Physical Abuse or Assault
Any sexual contact that happens without explicit consent and any behavior that results in serious emotional or physical harm or exploitation of an adolescent can cause trauma.
Emotional abuse, maltreatment, and neglect can seriously impair mental health in children and teenagers and trigger PTSD.
An adolescent can be a victim of violence, including exposure to homicide or other extreme violent events.
War or Terrorism
Young people exposed to acts of war or terrorism such as shooting, bombing, or being held hostage most commonly suffer PTSD.
Natural or Manmade Disaster
Major accidents or disasters that occur naturally (e.g., earthquakes, tornadoes, hurricanes) or human-made disasters (e.g., mass-shootings) can cause post-traumatic stress disorder.
Subtle Signs of PTSD with Young People
The effects of trauma can be sweeping and life-long. Traumatic experiences can seriously impair a young person’s ability to learn and develop. Therefore, it is vital to recognize adolescents who have experienced trauma, provide support in coping with trauma, and prevent the development of PTSD.
In addition to anxiety and depression, which are nearly always present, adolescents with PTSD may often experience irritability, sudden mood swings, nightmares, flashbacks, and impulsive or self-harming behavior.
However, sometimes the signs and symptoms of trauma can be subtle and difficult to recognize, which can cause an adolescent to be incorrectly diagnosed and receive inappropriate treatment.
One of the less visible signs of PTSD can be social anxiety and isolation. An adolescent may start avoiding people or activities they usually enjoy. Feelings of detachment and estrangement from others may signal that a young person has post-traumatic stress disorder.
An adolescent’s fear of coming in contact with anything that reminds them of trauma may result in strained relationships and problems interacting with people.
Other atypical signs of trauma may include severe migraines, drug and alcohol abuse, eating disorders, and a rapid weight loss.
Some trauma survivors experience excruciating migraines, often followed by horrifying dreams that don’t allow the person to rest even during sleep.
Drug and Alcohol Abuse
Some adolescents may reach for alcohol and drugs in an attempt to cope with a traumatic experience.
Eating Disorders or Rapid Weight Loss
Abnormal eating habits and eating disorders are often signals of post-traumatic stress disorder. An adolescent may experience drastic changes in their diet and appetite as well as a rapid weight loss without trying or increased appetite and binge eating.
These atypical signs and symptoms of PTSD may go undiscovered for a long time or cause an adolescent to be wrongly diagnosed with different mental health disorders and feel no benefits from the treatment provided. So, it is essential to understand the signs of PTSD, so adolescent gets the appropriate trauma treatment.
Different psychotherapy approaches can help adolescents with PTSD understand their feelings and strengthen their inner resources. The most effective PTSD therapy treatments involve Cognitive Behavioral Therapy (CBT) for trauma, Eye Movement Desensitization and Reprocessing (EMDR), and Psychological First Aid.
Research shows that CBT is the most effective therapy for treating children and adolescents. The treatment that is most commonly used is Trauma-Focused CBT.
The main aim of the TF CBT approach is to change the upsetting thought patterns that disturb adolescents’ day-to-day life. Methods of TF CBT include:
· Exposure (directly discussing the traumatic event)
· Anxiety management strategies (relaxation and assertiveness training)
· Correction of distorted trauma-related thoughts.
Eye Movement Desensitization and Reprocessing
EMDR therapy focuses on upsetting emotions and thoughts that result from a traumatic event rather than on trauma itself. The EMDR recovery process for trauma involves three stages:
· Safety and stabilization (an adolescent learns to establish personal safety and self-care)
· Remembrance and mourning (a person assesses traumatic memories with a therapist and works through their feelings)
· Reconnection and integration (an adolescent learns self-compassion and self-acceptance) and integrates trauma into the life experience).
Psychological First Aid
Psychological First Aid involves providing comfort and support and can be used in schools and traditional settings. This approach to trauma normalizes young people’s reactions and helps caregivers deal with changes in the teenager’s emotions and behavior. Psychological First Aid teaches relaxation and problem-solving skills, but also refers the adolescents with severe PTSD symptoms for additional treatment.
Digital Therapies for Adolescent PTSD
In treating PTSD in adolescents, care providers can supplement in-person treatment with digital therapies. Adolescents who have experienced trauma may be more inclined to engage through digital platforms than in face-to-face conversations, allowing caregivers more access and higher likelihood of success. Providers can also engage with patients outside of the clinic to offer continuous support, resources and treatment plans that can be implemented on a day-to-day basis. Fitango Health’s active patient engagement product suite—inclusive of customizable action plans, education plan, assessments, and telemedicine—allow caregivers, adolescents and family members to be active participants in the adolescent’s treatment and recovery. Adolescents can journal, track triggering events and monitor mood levels over time, allowing providers to better discern trends and prescribe more individually tailored therapies. Longer-term, patients can be more engaged and achieve better outcomes with technologies like Fitango Health.
Fitango Health’s digital solutions can also help address the conditions that develop as a result of PTSD. Care providers can customize action plans to address eating disorders or prescribe drug and alcohol rehabilitative resources as part of an adolescent’s digital treatment plan.
For providers who already leverage digital technologies in their practice, Fitango Health’s robust API technology allows for easy integration of key components directly into existing platforms. Providers can offer an improved treatment experience to their patients by incorporating some or all of Fitango’s resources to create a comprehensive engagement solution.
Some additional supportive strategies to help adolescents manage PTSD include reflective listening, forming strong positive bonds with caregivers and teachers, and setting clear routines and structure to provide stability and safety. Through a combination of in-person therapy, digital health technology, and social supports, adolescents can receive successful treatment for PTSD.