Six Symptoms of PTSD in Teenagers

Post-traumatic stress disorder (or PTSD) is an anxiety disorder that can develop following a traumatic event.  PTSD can occur in teens who experience a traumatic event personally, are witness to a traumatic event, or in rare cases, hear about a trauma that has happened to a loved one.  “Trauma” can imply many different things, but some common examples are:

• Physical, sexual, or verbal abuse
• Serious illness or injury
• Being witness to, or involved in, a car accident
• Violent crimes (such as kidnapping, physical assault, murder, etc.)
• Undergoing major surgery
• Community violence (such as a school shooting or the suicide of a friend or loved one)
• Experiencing natural disasters

It is estimated that approximately 5% of teenagers between the ages of 13 and 18 will develop PTSD; and the more severe the trauma, the more likely a teen is to be affected by the symptoms of PTSD.

Post-traumatic stress disorder in adolescents and teenagers has been widely researched over the years.  Through this research, a number of common symptoms associated with PTSD have been identified.  These symptoms are used for diagnostic purposes, but are also helpful in understanding the behavior and emotions of those who have experienced trauma.

1. Re-experiencing – re-experiencing, or reliving the traumatic event, is a very common symptom of post-traumatic stress disorder. Teenagers with PTSD may experience the reliving of the traumatic event in various ways including:

• Nightmares – nightmares are threatening, or scary dreams. And while everyone has a nightmare from time to time, PTSD sufferers tend to have a much more prevalent occurrence of nightmares.  In fact, research indicates somewhere between 71%-96% of individuals with post-traumatic stress disorder have recurrent nightmares.  The nightmares experienced following a traumatic event may be a replay of the event, but not always.  Research also has discovered trauma-related nightmares are different than other nightmares in that they may occur earlier in the night, and during different sleep stages than “regular” nightmares. Additionally, the trauma-related nightmares usually cause more body movements for the person having the nightmare.
• Flashbacks – flashbacks have been described by some people as “waking nightmares.” Flashbacks are intense (often recurrent) episodes of re-living a traumatic event or experience.  Flashbacks tend to come on suddenly, often without an identifiable trigger, and can feel uncontrollable and overwhelming.  In the midst of a flashback, one might feel as if the event were happening again, making it hard to distinguish between the flashback and reality.  This is because flashbacks can bring on sensations almost identical to those experienced during the traumatic event, such as certain sounds, smells, and physical senses in the body.  Because of the intensity of flashbacks, some people may dissociate.  Dissociation is a common response to overwhelming emotional pain, and is a way for the sufferer to disconnect from that pain.
• Intrusive memories – many teenagers with PTSD have intrusive memories and/or thoughts resulting from trauma. An intrusive memory can be just as intense as a flashback; often, the only difference is that the person knows he or she is not back in the traumatic event.  Intrusive memories can last anywhere from a few seconds to a few hours.  As with flashbacks, intrusive memories can cause a person to dissociate.

Important to remember here is that not all people who experience trauma even remember the initial trauma, let alone re-experience it. The frequency and nature of the trauma(s), along with the age of the person play major roles in whether or not he or she will remember that trauma.

2. Avoidance – a teenager who has been through a traumatic event may make attempts to avoid external (and internal) stimuli that remind him or her of the trauma. This often means going to great lengths to avoid people, places, thoughts, or conversations that have any connection or correlation to the traumatic event.  In an effort to “avoid,” teens may keep themselves very busy, as a way to distract from any potential reminder of the trauma.
3. Hypervigilance – hypervigilance (also called hyperarousal) is similar to being easily startled. Hypervigilance is a common symptom in teens with post-traumatic stress disorder and implies an amplified perception of sensory activity.  This elevated perception increases anxiety, which can cause a teen to feel the need to constantly check his or her surroundings for potential threats. The hypervigilance associated with PTSD arises due to changes that occur in the brain as a result of the trauma. The amygdala becomes hyperactive during the actual event, yet remains overactive long after the traumatic event has ended. Hypervigilance is described by many as feeling on guard, keyed up, or on edge, and can manifest through restlessness, reactivity to loud noises, being jumpy or easily startled, etc.  The post-traumatic stress disorder symptom of hypervigilance can also greatly affect one’s sleep cycle, in terms of the ability to fall and stay asleep.
4. Depression – just as hypervigilance is connected to changes in the brain associated with trauma, depression is as well. While the amygdala and hippocampus become overactive in those with PTSD, the prefrontal cortex tends to become less active.  The prefrontal cortex is responsible for emotion regulation, behavior, and impulse control. An underactive prefrontal cortex typically results in decreased positive emotions, increased irritability, and social withdrawal (isolation). The change in prefrontal cortex activity connected to trauma is a big contributing factor as to why many teens that are diagnosed with PTSD are also diagnosed with a co-occurring Major Depressive Disorder.
5. Physical Reactions – physical pain immediately following a traumatic event can obviously occur if the trauma involved physical impact of any kind (such as physical or sexual abuse). Yet, even if the trauma did not involve physical contact, the symptoms of PTSD themselves can cause a person physical pain.  Hypervigilance, changes in sleep patterns, and increased stress can significantly influence one’s physical health.  Back pain, migraines, stomachaches, muscle tension, and other body aches are commonly reported amongst PTSD sufferers.  Additionally, the co-occurring disorders frequently diagnosed in those with post-traumatic stress disorder (i.e. – depression, anxiety) can bring about physical discomfort and ailments.
6. Negative outlook – although many of the symptoms of post-traumatic stress disorder in teens look similar to those experienced by adults, a negative outlook is more specifically associated with younger people with PTSD. This is likely due to a teen’s shorter life span in terms of the number of years he or she has been alive leading up to the traumatic event.  This negative outlook is a result of an often distorted and persistent view of the world as a dangerous place.  Unfortunately, this negative outlook often extends beyond a worldview.  Teenagers who have experienced trauma in their short lives frequently also have a negative view of themselves as well.  This can lead many to believe they are at fault for, or the cause of, the traumatic event, and the resulting effects.  Additionally, this negative outlook may affect one’s view of the future, contributing to feelings of hopelessness.

PTSD symptoms can be extremely challenging to cope with, and have the potential to impact social, developmental, educational, occupational, and/or health functioning.  Essentially, the symptoms of PTSD can have a huge toll on a teenager’s quality of life. Yet, post-traumatic stress disorder is treatable.  If you think your teen may have experienced trauma, or may suffer from post-traumatic stress disorder, contact Polaris Teen Center at 844-836-0222 to find out more about PTSD specific programs and services.

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Polaris Teen Center is a residential treatment facility for teens and adolescents suffering from severe mental health disorders. Our highly accredited facility is fully licensed and certified in Trauma Informed Care and is a part of the Behavioral Health Association of Providers (formerly AATA).

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