Like adults, children can develop PTSD after experiencing a traumatic event. With the right support, children can begin to heal from their trauma.

If your child has recently experienced a trauma, you might notice that they appear withdrawn or troubled by memories or nightmares. They might seem detached, startle easily, or be unusually clingy. You might wonder if they’re showing signs of post-traumatic stress disorder (PTSD).

Traumatic events can have an intense physical and mental effect on our brains and bodies. The body goes into fight, flight, or freeze mode as a way of coping with danger. In some cases, the body isn’t fully able to recover from the extreme stress state, leading to the symptoms that make up PTSD.

When left unresolved, the mental and physical effects of childhood trauma can persist into adulthood. In fact, adverse childhood experiences (ACEs) — such as violence, abuse, or neglect — that occur before age 17 could lead to some chronic health problems, mental illness, and substance use disorders in adulthood.

The good news is that early intervention can greatly improve a child’s development and ability to heal and thrive. Noticing the symptoms and seeking support are the first steps.

What is childhood PTSD?

PTSD in children occurs before the age of 18. This condition can develop after a child has witnessed or experienced a traumatic event. A child experiencing PTSD may have ongoing thoughts or memories about the event that they found terrifying, resulting in sleep problems and them seeming detached.

While PTSD-like symptoms are common in children and adolescents after a trauma, PTSD is rare in young people, the Child Mind Institute reports. A mental health professional may diagnose PTSD if the symptoms have been present for more than 1 month and negatively affect the child’s well-being and ability to function.

Not every traumatic event leads to PTSD. The risk of a child developing PTSD after a trauma is influenced by many factors, including:

how close the child was to the trauma
the severity of the trauma
how long the traumatic event(s) lasted
whether the trauma was recurrent
the resiliency and coping skills of the child
support from the family and community after the event

Symptoms of PTSD in children

Trauma can lead to a wide range of thought, mood, and behavioral symptoms. Many of the symptoms of PTSD in adults also appear in children, adolescents, and teens.

It can take some time after an event for the effects of trauma to show up. If they develop soon after an event, the symptoms usually improve after 3 months. Sometimes, the effects might not show up for 6 months or more after the trauma happened.

For a diagnosis of PTSD, the child will have experienced disruptive symptoms for at least 1 month. Common symptoms of PTSD in children include:

flashbacks or feeling as if the trauma is happening again
seeming nervous, jittery, or extra alert, also known as hypervigilance
seeming “out of it,” detached, or in a daze
unwanted thoughts or memories about the traumatic event
trouble sleeping, including nightmares
avoidance of people, places, things, or situations that are reminders of the traumatic event
problems in school
no longer enjoying activities they used to
intense outbursts of anger or sadness
unexplained physical symptoms, such as headaches or stomach pain
worries about death or getting hurt
regressive behaviors, such as thumb-sucking or bed-wetting

Adolescents or teens might turn to substance use, such as alcohol or drugs, to deal with the trauma and its effects.

Causes

A traumatic event, as defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), involves “actual or threatened death, serious injury, or sexual violence.” Causes of PTSD can include one-off events or repeat events. For a child, it could be learning that a traumatic event happened to a parent or caregiver.

PTSD symptoms can arise after a child experiences or witnesses a trauma that happened to them or someone they’re close to.

Common one-off events that can cause PTSD include:

car accident
natural disaster, war, or terrorist attack
being attacked by an animal
serious illness
the death of someone close, like a family member or friend
seeing violence where they live
experiencing a crime, like a mugging

When trauma is ongoing, some children can develop complex post-traumatic stress disorder, also known as complex PTSD or C-PTSD. While PTSD occurs after an isolated event, complex PTSD arises after repeated or ongoing trauma.

Possible causes of C-PTSD include:

childhood neglect
repeated domestic violence or abuse
repeatedly witnessing abuse or violence
ongoing bullying
torture or kidnapping

Diagnosis

For a child to receive a diagnosis of PTSD, their symptoms need to be present for at least a month. Many children with PTSD first experience symptoms within 3 months of the traumatic event, but symptoms can also begin months or years after the trauma.

A mental health professional can diagnose PTSD based on a mental health evaluation. A medical professional can also rule out any physical illnesses that could cause symptoms.

Treating PTSD in children

Treatment for PTSD in children usually involves therapy and can sometimes include medication to help with intense feelings or to combat nightmares. Some of these are the same as PTSD treatments in adults.

Psychotherapy, or talk therapy, can help your child manage their feelings around the traumatic event. This might involve talking, drawing, or writing about their thoughts, feelings, and experiences. A therapist can also help children learn coping skills to manage their symptoms.

It can help to have the parents or caregivers involved in treatment to support their child’s healing process.

Trauma-focused cognitive behavioral therapy (CBT) is one evidence-based psychotherapy that helps children recover from trauma and youth PTSD.

Your doctor or therapist might suggest medication to help with fear and anxiety. Medicine can also help with ongoing nightmares.

Teaching kids relaxation skills, such as breathing exercises, can also help them manage the physiological symptoms of anxiety.

It’s important to find professionals who have specific experience working with children, as kids often have different needs than adults.

How to help a child with PTSD

As a parent or caregiver, helping a child with PTSD can feel overwhelming. You may feel unsure about how to comfort children who are dealing with the aftermath of trauma. With the right tools, adults can play an important role in helping their child manage PTSD.

Some ways that you can help your child with PTSD include:

Talk with a professional. Most parents and caregivers aren’t trained in the best ways to support a child through a traumatic experience, but plenty of mental health professionals are available to help.
Acknowledge the traumatic event. Pretending that things are fine isn’t likely to help your child. Let your child talk about the event and how it makes them feel as much or as little as they want.
Talk with them about treatment. Some children and adolescents are resistant to getting therapy or taking medication. Explain that treatment can help them feel better. Reassure them that there’s nothing “wrong” with them and that many people need professional help to feel better.
Keep a routine. Continue doing usual things with your child, such as reading a bedtime story or playing games together, or creating new routines that include more activities your child enjoys.
Help them sleep. If your child has trouble sleeping, find ways to help them feel comforted. It’s OK for your child to sleep with a light on or to sleep in your room, at least for a short time. Talk with your child’s doctor about long-term tools to help your child sleep better.
Validate their feelings. Let your child know that it’s OK to cry and feel upset.
Empower your child. Help your child feel in control and empowered by letting them make choices for themselves, such as what to wear or what they want to eat.

Next steps

PTSD is a challenging condition for children and parents alike. It’s common to feel overwhelmed or helpless, especially if you aren’t sure how to help a child in distress.

This condition is manageable, and many children can find relief. A healthcare professional can connect your child with treatment and resources to help them thrive.

The Child and Adolescent Psychiatrist Finder from the American Academy of Child & Adolescent Psychiatry can help you find local support.

Complex post-traumatic stress disorder (complex PTSD). (2021). https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd-and-complex-ptsd/complex-ptsd/
Helping children and adolescents cope with disasters and other traumatic events: What parents, rescue workers, and the community can do [Fact sheet]. (n.d.). https://www.nimh.nih.gov/health/publications/helping-children-and-adolescents-cope-with-disasters-and-other-traumatic-events/
How common is PTSD in children and teens? (n.d.). https://www.ptsd.va.gov/understand/common/common_children_teens.asp
Pai A, et al. (2017). Posttraumatic stress disorder in the DSM-5: Controversy, change, and conceptual considerations. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5371751/
Post-traumatic stress disorder (PTSD). (2021). https://www.cdc.gov/childrensmentalhealth/ptsd.html
Post-traumatic stress disorder basics. (n.d.). https://childmind.org/guide/post-traumatic-stress-disorder/
Post-traumatic stress disorder in children. (n.d.). https://www.chop.edu/conditions-diseases/post-traumatic-stress-disorder-children
Posttraumatic stress disorder (PTSD) in children. (n.d.). https://www.stanfordchildrens.org/en/topic/default?id=post-traumatic-stress-disorder-in-children-90-P02579
Prevalence of post-traumatic stress disorder among adolescents. (2017). https://www.nimh.nih.gov/health/statistics/post-traumatic-stress-disorder-ptsd
Trauma-focused cognitive behavioral therapy. (n.d.). https://www.tfcbt.org/about-tfcbt/

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