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Post Traumatic Stress Disorder

Understanding Post-Traumatic Stress Disorder (PTSD)

Post Traumatic Stress Disorder (PTSD) is a condition that can occur after a person experiences a traumatic event.  Events such as abuse, a car accident, loss of a loved one, natural disasters, school shootings, living in a dangerous neighborhood, and physical trauma are among some of the most common reasons children develop PTSD.

Symptoms of PTSD usually begin within three months of the traumatic event but can lie dormant for years.

Symptoms of PTSD

  • Flashbacks – reliving the traumatic event
  • Nightmares
  • Actively avoiding things that may trigger traumatic thoughts
  • Feeling tense or anxious
  • Increase in startle response
  • Difficulty sleeping
  • Irritability
  • Difficulty concentrating

In order for PTSD to be considered a disorder, these symptoms must be affecting relationships, behaviors or academics.  Young children express these symptoms somewhat differently than teens and adults. Children are reported to show an increase in bedwetting and may cling more to trusted adults. Children will commonly act out the traumatic event through play. For example, if a child was involved in a severe car accident, he might continually crash a toy car.  Teens share many of the same symptoms as adults, but may also display disrespectful or oppositional behaviors.

There are three primary risk factors leading to PTSD symptoms:

  1. The severity of the trauma.
  2. How parents reacted to the trauma
  3. How close or far away the child was to the trauma.

Many children and teens diagnosed with PTSD are subjected to abuse in the home. According to the National Children’s Alliance, there are over 3 million reports to Child Protective Services each year. Of these reports over 30% are verifiable and are addressed. Most of these reports are made due to neglect or physical abuse allegations. Children who regularly observe violence in the home, at school, or on the playground, can be dramatically impacted by their experiences. These instances can greatly affect how a child perceives their safety. They may feel threatened while at home, at school, or with friends.

Over one-third of children will experience some sort of traumatic event, and symptoms of PTSD may arise after the event.  How and when they receive treatment is key.

Treatment for Post Traumatic Stress Disorder


PTSD can be diagnosed by a mental health professional, such as a therapist, psychologist, or a psychiatrist. The goal of treatment is to regain feelings of control over life while eliminating symptoms. There are many ways to achieve this goal. Some of the most common therapy models used are cognitive behavioral therapy, interpersonal therapy, and exposure therapy.  Cognitive behavioral therapy can help link the traumatic event to core beliefs and overcome them by reframing the experience. Interpersonal therapy relies on the support of others while exposure therapy will gradually desensitize the traumatic triggers. Young children benefit from play therapy. In play therapy, the child is able to act out the traumatic event and rationalize their experience with support and guidance from trusted adults.  Education, support, and safety are important to a successful recovery. Teens benefit most from talk therapy. They are able to express their fears, anger, sadness etc. in an environment that is safe and controlled. Many teens living with PTSD may find it difficult to control anger and impulses. Addressing these issues early on will help develop coping skills needed to manage their daily lives.


Some medications have been proven effective to help lessen the effects of PTSD symptoms.  Antidepressants are most commonly prescribed to treat PTSD in addition to therapy.


A major concern for those with PTSD is the prevalence of self-harm and suicidal thoughts. If you or your child feel any motivation to self-harm after a traumatic event, get help immediately.  Call the National Suicide Prevention Lifeline at 1(800)273-8255 or visit an emergency room.

After experiencing a traumatic event, act quickly to receive help.  Waiting to seek treatment may worsen PTSD symptoms over time.  If your child experienced a traumatic event, be aware of some of the alternate symptoms of PTSD that children more commonly express. The Heads Up Checkup symptom checker can help determine if you or your child has symptoms of PTSD.

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Post Traumatic Stress Disorder2018-03-21T11:27:45+00:00

Adjustment Disorder

Understanding Adjustment Disorder

Adjustment disorder is a disturbance in someone’s normal level of function due to a stressful event. The negative impacts are short-term and are specifically focused on the stressful event. Adjustment disorder can often mimic other mental health concerns, so make sure that symptoms are not related to other diagnoses like anxiety, depression, or conduct disorder. Adjustment disorder typically manifests after a life-changing experience – such as moving to a new house, money troubles, losing a friendship, a breakup, divorce, illness or health-related concerns, a car accident. Events like these can trigger a response in your child that can be debilitating.

Signs of Adjustment Disorder

Depressed mood


Disturbance of conduct

Excessive worry

Poor concentration



Loss of self-esteem

Feelings of hopelessness


Feeling stuck

Poor school performance

The symptoms of adjustment disorder typically begin within three months of the stressful event and end within six months.

Children most often experience symptoms of poor school performance, difficulty concentrating, anxiety, sadness, reclusiveness, or attention seeking behaviors. Keep in mind that children may have more difficulty identifying these symptoms as a reaction to a stressful life event. If you are concerned that your child may be experiencing symptoms, seek professional help. Gathering information, persistence, and patience under an experienced professional will yield the best results toward a diagnosis and treatment plan.

Some Things to Consider

Has my child experienced a significant life event?

(Remember that a child’s interpretation of what constitutes a significant life event can be different than an adult's).

Did this event happen in the past three months?

Has it been over six months since the event?

Have the symptoms been extreme and impairing my child’s daily functioning?


Treatment is designed to solve the problem fast. Crisis intervention is sometimes used as a first attempt to reduce extreme or potentially harmful symptoms such as self-harm or substance abuse. The goal of crisis intervention is to assist the child's return to a normal state of functioning. Cognitive Behavioral Therapy (CBT) has proven to be an effective means to overcome adjustment disorder. CBT focuses on reframing the life event into something that is not so threatening, and that the child has control over. For example, a child who moves to a different state is struggling to adjust to her new environment. Feelings of loss, sadness, anxiousness, fear of a new school, are affecting her school performance, sleep, and overall quality of life. CBT could help this child sort through those negative feelings and reinterpret them as – this is a new opportunity for me to make friends, learn about a new state, enjoy a new afterschool activity. Gaining perspective and awareness of why these feelings are negative and the event is stressful is key to resolving the issue. Perhaps during the move, she was forced to say goodbye to her best friend. Naturally that would cause negative feelings, but she may not be aware of that factor. Helping her acknowledge that she misses her friend may help her move in the right direction. Giving her a fun way to keep in contact with her best friend would be a quick solution to help her remain connected and for her to feel safer and in control over her circumstances. In most cases, high levels of support will help smooth the bumpy road of adjusting to a new life situation. Support groups for victims of disasters, car accidents, illness and the like, are regularly available in most communities or online. Family support sessions can strengthen the family unit and allow for family members to transition together.

Adjustment disorder can be a difficult mental health concern to diagnose. Make sure to consult with an experienced professional to get the best treatment for your child after a significant life event.

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Adjustment Disorder2018-03-20T13:33:21+00:00

Reactive Attachment Disorder

Understanding Reactive Attachment Disorder

Reactive Attachment Disorder (RAD) is not very prevalent, but its impact on a child’s overall emotional functioning is huge. Young children need love, support, nurturing care, security, and trust with their caregivers in order to understand and develop healthy relationships. Some children, unfortunately, do not receive this level of care. Children who are neglected, abused, placed in too many different environments or have their primary caregiver (like a mother or father) taken away suddenly, can struggle to form secure relationships. These unfortunate circumstances usually happen in the first five years of life and impact a child dramatically.

If a child is experiencing RAD symptoms, they may act withdrawn, disengaged, or unresponsive to caregivers and others. The most common example of this would be when a child is removed from an abusive household where he was neglected and left alone for most of the day. He is placed in a foster home but struggles to engage, communicate or relate to his new caregivers. He may not seek any comfort from adults when distressed, injured, in need or scared. Another common symptom associated with RAD is emotional disruptions without any obvious cause. These can include irritability, fearfulness, sadness, and aggression.

Signs of Reactive Attachment Disorder


Disinterest with other

No reaction to attempts to comfort

Weary of others

Lack of trust

Disinterest in play with others

Emotional outbursts

There is no “cure” for RAD, but therapy can dramatically improve the child’s overall lifestyle and future outcome. Being in a safe and stable environment is the first step to helping the child build healthy relationships with caregivers and other adults. The child must feel safe and comfortable for a long enough period of time to be able to view his caregivers as positive and safe supporters. Although RAD symptoms will usually dissipate after being placed in a secure environment, therapy primarily focuses on communication skills, behavior, and relationships. Communication of needs, fears, and interests with “safe” adults will be critical to building trust. Behavior therapies are effective for the management of how emotions are expressed and increasing coping skills. Relationship therapies can assist the family unit in trust building, and maintenance of a positive environment for the child. The process can be slow, as it is based on repeating positive interactions until trust is built, but over time this level of patience and consistency can help a child with RAD develop healthy relationships with others.

RAD can mimic or co-exist with many other disorders found in children, so be sure to consult a trained and experienced professional in order to receive the correct diagnosis and treatment plan.

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Reactive Attachment Disorder2018-02-12T12:35:42+00:00