Post-traumatic stress disorder (PTSD) is an emotional condition that often occurs after direct or indirect exposure to a terrifying event in which a child witnessed or actually experienced physical harm. Traumatic events that can cause post-traumatic stress disorder (PTSD) include violent assaults, physical or sexual abuse, shootings, natural disasters, or car accidents. One out of 13 Americans will develop PTSD during their lifetime, which is especially common among girls and women, who are about twice as likely as boys or men to develop PTSD.

This may be due to the fact that girls and women tend to experience domestic violence, rape, or abuse more often. Most children with PTSD try to avoid any reminders or thoughts of the trauma, but despite this, they often reexperience the ordeal in intense flashbacks, memories, nightmares, or frightening thoughts. Feelings of guilt from surviving an event in which friends or family died is also often a common feature of PTSD.

Any traumatic event can cause this disorder. Children under age 10 and teenagers through age 21 are more susceptible, beginning either as a sudden response to an event or a gradual development that can become chronic or persistent. Studies indicate that people who live with PTSD tend to have abnormal levels of key hormones involved in the stress response.

Symptoms
Signs usually develop within the first three months after the event, although sometimes they may not appear until months or even years have passed. These symptoms often continue for years following the trauma, or may subside and return if another event triggers memories of the trauma. Symptoms often resemble DEPRESSION, but PTSD is not the same as depression. The symptoms of PTSD include:

• sleeplessness or nightmares
• apathy
• inability to get along with others, particularly in close relationships
• paranoia and distrust
• an unwillingness to discuss the trauma
• persistent, intense fear and anxiety
• irritation or agitation
• concentration problems
• feelings of numbness or detachment
• no longer finding pleasure in previously enjoyable activities
• helplessness
• survivor guilt
• preoccupation with the event
• physical symptoms (headache, stomach distress, or dizziness)
• suicidal thoughts, plans, or gestures

Treatment
Some children can recover from PTSD without treatment, with symptoms fading away within six months. Otherwise, cognitive-behavioral therapy can help, particularly if the trauma was unusually severe or life-threatening. This type of therapy helps a child adopt new thoughts and behaviors to replace negative ones. Temporary medications may be helpful to treat depression and anxiety and can help a child cope with school and other daily living activities. Group therapy or support groups also may sometimes help.

Parents should let a child talk about the traumatic event but should not force a discussion. The child should be reassured that her feelings are normal and that she is not crazy. Parents should let a child with PTSD make simple decisions whenever appropriate, which will help her see that she has control over certain aspects of her life. Children also must be assured that the traumatic event was not their fault and should be encouraged to discuss feelings of guilt. Regressive behavior is common and should not be criticized; sleeping with the lights on or cuddling a stuffed animal is normal and soothing.