All children experience stressful events that shape their views of themselves, others, and the world in general. In most cases, they recover quickly without ongoing mental health problems. However, sometimes, children who experience extreme stress may be affected long-term.
Those who’ve lived through an event that could have caused them or someone else to be killed or badly hurt are most likely to have ongoing symptoms of stress. These events may include being in an active shooter situation in a public place, experiencing physical or sexual abuse, being involved in a car accident, and living through a fire or flood. If symptoms of stress last longer than a month, the child may be diagnosed with post-traumatic stress disorder (PTSD).
According to the National Center for PTSD, 15-43 percent of girls and 14-43 percent of boys experience at least one trauma by the time they turn 18. Of those kids, between three and five percent of girls and one and six percent of boys develop PTSD.
Every year, child protective services agencies throughout the country field about three million reports involving about 5.5 million children. Of the reports with proven abuse, multiple types of abuse occur:
- Neglect (65%)
- Physical abuse (18%)
- Sexual abuse (10%)
- Psychological abuse (7%)
Children are just as vulnerable to developing PTSD as adults. However, because their symptoms often present differently, this condition is more likely to be overlooked in children. For example, adults with PTSD are more likely to develop depression or a substance use disorder. Preschool-aged children, on the other hand, may develop separation anxiety or have argumentative or defiant behaviors. In older children, there’s even less research and understanding of how PTSD presents.
While PTSD may look different in children than in adults, and it may be easy to brush symptoms off as childhood quirks, early intervention is key to long-term mental health. This gives the child the opportunity to build skills for recognizing and handling triggers and navigating safe situations that may cause trauma-related fear.
Mental Illnesses in Children
Children may develop the same mental health conditions as adults, but they typically have different symptoms, making them harder to recognize and diagnose. As a result, many children with treatable conditions don’t get the help they need.
Common Mental Health Disorders in Children
- PTSD: PTSD is characterized by intense ongoing fear or sadness stemming from a traumatic event or situation. Children with this disorder may have difficulty sleeping or concentrating in school, they may have angry outbursts, and they may relive the event repeatedly either in their minds or through play.
- Anxiety disorders: Children with anxiety disorders typically live with persistent fears and worries that affect their ability to participate in play, social interactions, and school. The types of anxiety disorders most often diagnosed in kids include obsessive-compulsive disorder, generalized anxiety, and social anxiety.
- Attention-deficit hyperactivity disorder: Children with ADHD may have trouble focusing on tasks for extended periods of time. Boys with ADHD often have external symptoms such as excessive energy, impulse control issues and physical aggression. Girls with this condition are more likely to have internal symptoms including low self-esteem and inattentiveness along with verbal aggression.
- Autism spectrum disorder: ASD usually becomes evident in early childhood, typically around age 3. Severity and symptoms vary considerably, but in general, children with this disorder have difficulty communicating, interacting with others, and reading social cues.
- Depression: Depression in children is characterized by persistent sadness that interferes with relationships, schoolwork and social activities. Children with depression may have difficulty concentrating, experience fatigue, withdraw socially, or experience ongoing feelings of guilt or worthlessness.
- Eating disorders: Eating disorders, including anorexia nervosa, binge-eating disorder, and bulimia nervosa, are rooted in disordered thinking about body weight and weight loss, the role of food, and the ideal body type.
Treatment for Mental Illnesses in Children
The CDC estimates that about one in five kids in the United States has a mental illness or behavioral disorder. Unfortunately, only about 20 percent of those children get professional help from a specialized mental health care provider. Untreated mental health disorders, including PTSD, can have a significant negative impact on the child’s development and transition to adulthood.
There are numerous reasons for the lack of treatment, including a shortage of mental health professionals who specialize in treating children, families’ inability to afford services, and an increase in demand for services. Adults who’ve seen the child progress through various phases and developmental milestones may pass a mental illness off as another stage the child will get through.
Another roadblock that keeps children from accessing mental health care services may be that mental illnesses in children aren’t taken as seriously as illnesses in adults. This likely stems from the myth that children are resilient. Many children appear to “bounce back” from traumatic events such as abuse, divorce, relocating to a new home and school, losing friends, or experiencing the death of a loved one. Even through significant adversities, children maintain their ability to play, laugh and smile. This may lead the adults in their lives to erroneously believe that they’re effectively coping.
The truth is that children aren’t naturally resilient. When they experience a trauma, they don’t draw from a secret well of strength to get through. Instead, they tend to internalize their feelings. Some children act out. They haven’t yet learned the skills they need to navigate traumatic events and they don’t have the same capacity as adults to put words to their feelings.
PTSD in Children: What Are the Complications?
Because children are more likely than adults to internalize stress reactions, they are more vulnerable to complications. A child with PTSD is at a greater risk of developing mental health disorders such as anxiety, depression, and suicidal thinking. Their emotional responses may be explosive or unpredictable, and they may react to reminders of the trauma with anger, fear, sadness or avoidance.
Children with histories of trauma may also struggle with developing problem-solving skills and reasoning. As a result, they may have difficulties with taking in new information, planning for the future, or abstract reasoning skills.
Physical complications are also common in children with untreated PTSD. Oftentimes, childhood PTSD can cause body dysregulation, meaning that they are extra-sensitive to stimuli such as sounds, smells, and touch.
Benefits of Early Intervention
While not all childhood traumas can be avoided, early intervention and proper treatment can safeguard the child’s long-term physical, mental, and emotional health. According to one study, addressing the child’s newly developing trauma-related fears can help them develop healthy coping skills. Through early intervention, children have opportunities to talk about the trauma and learn how to manage triggers in a healthy way. This can minimize long-term effects and prevent emotional and developmental issues.