‘Shell shock’ was first coined after World War I to describe wide ranging symptoms suffered by soldiers, from tinnitus to mutism to a blank look in the eyes they called the ‘thousand-yard stare’. It was not until 1980, after the Vietnam War, that post-traumatic stress disorder (PTSD) was officially recognised as a mental disorder.
Today, the NHS defines PTSD as ‘an anxiety disorder caused by very stressful, frightening or distressing events.’
The term most commonly conjures imagery of war and bloody battles, even to this day. And while this is understandable – given the circumstances in which it was first discovered – PTSD can affect anyone of any age, in peacetime and wartime alike.
Being as it’s PTSD awareness day, we wanted to bring awareness to the ways that PTSD affects a lesser acknowledged, and perhaps surprising demographic: children.
‘A difficult child’
Historically, children were believed to be unaffected by PTSD, and their responses to trauma were brief and soon forgotten.1 It was thought that, because of their less developed brains, they probably didn’t have a clear understanding of traumatic events that happened to them and therefore remained largely unaffected.
So, when children exhibited symptoms of PTSD, such as problems concentrating or irritability, they were simply labelled troublesome children who perhaps just needed better disciplining.
More recently, however, a growing body of research is uncovering the prevalence of PTSD in children – or in adults as a direct result of childhood trauma. According to Stanford Medicine, around 4% of children under 18 experience trauma that leads them to develop post-traumatic stress disorder: around 7% of girls and 2% of boys.2
Contrary to previous belief, when asked about traumatic experiences, it was discovered that children with PTSD actually have highly accurate recall.1
Common causes include physical or sexual abuse, neglect, bereavement, witnessing crimes and being in dangerous accidents. Studies have also suggested that a child witnessing domestic violence in parental relationships has a causal link to PTSD symptoms.3
Shaping the brain
In comparison to a fully-developed adult brain experiencing trauma, a child’s still-developing brain is physically shaped in response to the trauma.
The volume of certain brain structures associated with learning and memory can be altered – namely a decrease in the volume of the hippocampus. Therefore, the brain cannot develop in a psychologically healthy way.1
As a result, these children will often go on to suffer from depression, anxiety and pathological grief later in life.1
Spotting the signs
Many symptoms of PTSD overlap in children and adults, such as vivid flashbacks and panic attacks.
But when dealing with a child, who can often display extremes of emotion with apparently little stimulus, it may be more difficult to spot PTSD symptoms.
Adding to this, is a child’s potential inability to link a traumatic event with the way they are feeling – adults are more likely to be aware of an event acting as a trigger and be able to ask for help.
Symptoms to look out for2:
- Trouble sleeping or recurring, upsetting nightmares
- Losing interest in hobbies and schoolwork
- General lack of responsiveness or seeming emotionally numb
- Recurrent stomach issues and headaches
- Avoiding things related to a traumatic event
- Re-enacting trauma through play
Age can also affect the symptoms experienced – for example, younger children are more likely to feel fearful whereas older children are more likely to exhibit aggression.
Treating PSTD in children
Typical treatments for children with PTSD are psychotherapy and psychiatric drugs, either independently or combined.
These talking therapies range from the more standard, such as Cognitive Behaviour Therapy (CBT), to the more experimental. Exposure therapy, for example, allows the patient to safely face the situation and memories that have triggered their disorder. Some clinics even use virtual reality programs to re-enter memories. The aim of this treatment is to allow patient to face and process their experience in order to gain closure.
Alongside this, a range of medications are prescribed in the treatment of PTSD, most commonly anti-depressants and anti-anxieties. However, a drug called Prozasin, which is primarily prescribed to treat high blood pressure, is sometimes prescribed to treat the night terrors many child sufferers experience.
With regards to future therapies, new research is hoping to reduce fear and fear relapse. Dr Stephen Maren’s work shows that stress increases the activity of fear-promoting regions of the brain, and reduces activity in neighboring fear-reducing regions. He thinks this brain activity could be reversed by increasing the activity of neurons that release the fight-or-flight neurotransmitter, norepinephrine.4
Helping young minds
We’ve been fortunate enough to be able to work on several paediatric and mental health projects. For The Anna Freud Centre, we developed an app for children with ADHD and behavioural issues. ReZone helps children manage their behaviour through interactive tools, breathing videos and colour experiences that gently encourage reflection and self-critique.
If you’d like to discuss anything in this blog, or your marketing challenges in paediatrics or mental health, get in touch.
- “Science – in the news: Post-Traumatic Stress in Children.” Pediatric Research. Available at: https://www.nature.com/articles/pr200729.
- “Post-Traumatic Stress Disorder in Children.” Stanford Medicine. Available at: https://www.stanfordchildrens.org/en/topic/default?id=post-traumatic-stress-disorder-in-children-90-P02579.
- “Perceptions of Family Relationships and Post-Traumatic Stress Symptoms of Children Exposed to Domestic Violence.” Journal of Family Violence. Available at: https://link.springer.com/article/10.1007%2Fs10896-018-00033-z.
- “New study advances treatment options for PTSD.” ScienceDaily. Available at: sciencedaily.com/releases/2019/04/190411131503.htm.