What is typical distress after traumatic events?
It is expected for a child or adolescent to struggle and feel scared or upset after one, or multiple seriously frightening or upsetting events. It usually takes them a little while to recover and readjust after traumatic experiences.
It is fairly common that children or adolescents present with tantrums, moodiness or mood swings, going back to behaviors they had in earlier ages like trouble separating from caregivers or difficulty being alone, disturbed sleep, and difficulty concentrating shortly after experiencing a trauma. They also tend to avoid situations or places that are associated with what has happened to them, have flashbacks or nightmares of the event, as well as feel anxious, easily annoyed, guilty, sad, angry, or ashamed.
Most children and adolescents tend to naturally recover from a traumatic experience as time goes by, but some continue to struggle one month or more after experiencing a traumatic event. Even though long-term pain may be a cause of concern, attention and support is always necessary to deal with the aftermath of trauma.
When should I be concerned about a child’s persistent distress after traumatic experiences?
Signs that a child or adolescent is experiencing persistent distress after a traumatic experience, like being "haunted" by what happened, can include:
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Examples |
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Frequently remembering and feeling as if the experience is happening again |
Acting out the upsetting event during playtime Images, sounds or unwanted thoughts about the experience popping into their minds Nightmares or dreams related to what happened Feelings of distress when remembering what happened |
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Avoidance of places, people, or activities that can be reminders of the traumatic experience |
Not wanting to or being strongly reluctant to do anything that could be related to the trauma (e.g., riding a car if the trauma is an accident, or wearing the same clothes as the ones worn on the day a bad experience happened) |
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Negative changes in mood or the way the child perceives the world |
Tantrums, moodiness, and mood swings Being easily annoyed or restless Having trouble separating from caregivers or being alone Feelings of guilt, like what happened was their fault, shame, anger, or sadness Seeing the world as a dangerous or bad place Losing their interest in school or activities they previously enjoyed |
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Anxiety symptoms because of being always on alert internally |
Expressing fear more often Difficulty concentrating on several tasks Disturbed sleep Getting more easily and more frequently frightened with sudden sounds or unexpected movements Headaches, stomachaches, or other physical complaints |
What can I do to help a child with persistent distress after traumatic experiences?
Caregivers know their children best. If you are a caregiver, there are a few things you can try to do to help children better understand what's happening to them, although you might also feel challenged.
- Help your child feel safe. All children, from toddlers to adolescents, will benefit from your touch, cuddling, hugs or just a reassuring pat on the back. It gives them a feeling of security, which is important in the aftermath of a frightening or disturbing event.
- Be there for your child. You can provide quality time and a supportive ear to your child to hear about what they are going through. Listen well. It is important to understand how your child views the situation, and what is confusing or troubling to him or her.
- Acknowledge the event and what your child is feeling. If a child admits to a concern, do not respond, “Oh, don’t be worried,” because he may feel embarrassed or criticized. Simply confirm what you are hearing: “Yes, I can see that you are worried.”
- Act calm. Children look to adults for reassurance after traumatic events. Avoid discussing your anxieties or worries with your children, or when they are around.
- Maintain routines as much as possible. Amidst chaos and change, routines and consistently setting rules and limits reassure children that life will be okay and predictable again. If you are unable to keep the same routines, try to include some familiar rituals for your child.
- Help children enjoy themselves. Encourage kids to do activities they usually like and to engage with peers. The distraction may be good for them and give them a sense of normalcy.
- If you have information about the traumatic event, share information about what happened with your child. It’s always best to learn the details of a traumatic event from a safe, trusted adult. Be brief and honest and allow children to ask questions to help with confusion and distorted assumptions. Don’t presume kids are worrying about the same things as adults.
- Validate your child's emotions. Let your child know it is normal to experience anger, guilt, and sadness, and to express things in different ways—for example, a person who is sad may, or may not cry. Express your belief in your child's self-competence and provide encouragement.
- Help children with breathing exercises. Breathing becomes shallow when anxiety sets in; deep breaths can help children calm down. You can say, “Let’s breathe in slowly while I count to three, then breathe out while I count to three” and help the child breathe.
- Prevent or limit exposure to upsetting news (especially when related to the trauma). This is especially critical with toddlers and school-age children, as seeing disturbing events on TV or on the internet or listening to them on the radio can make them seem to be constant. Children who believe bad events are temporary can more quickly recover from them.
- Consider letting your child's teachers know what was experienced to better understand school behaviors.
If you have already tried some or most of these suggestions and the problems your child is facing persist for more than a month, it may be time to seek out professional support.
Distress after traumatic events that are present after more than a month of the occurrence of the event, that is too intense and that negatively interfere with your child and family’s daily lives may indicate the possibility of Post-traumatic Stress Disorder (PTSD).
What kind of professional support can I seek out for help?
It is not unusual that some caregivers feel embarrassed, inadequate, or guilty if their child is struggling after a traumatic event. But, if you are concerned about your child, support and guidance are available now. Communicate concerns during and between visits with your child's doctor.
Pediatricians or family physicians can help to address initial concerns and refer to specialized professionals. Also, whenever possible, a consultation with a mental health professional may be helpful. These professionals also work with caregivers so that they know how to support their children outside of therapy sessions.
The public system provides services through the Child and Adolescent Mental Health Services (CAMHS) and Centers of Multidisciplinary Assessment, Counseling, and Support (KEDASY).
Where to find more information
Specific, detailed, and clinical information on Post-traumatic Stress Disorder (PTSD) can be found at [clinical short guide at the program website].
If you want to know more about the closest available services for educational and public health systems for children and adolescent assistance across the country, go to our Services Mapping webpage here.
You can also find more information by pointing your phone camera at the QR code below or by clicking here.
