The American Academy of Child and Adolescent Psychiatry CHILD ABUSE

PTSD in Children - Family Fact Sheet
PTSD in Children and Adolescents -- A National Center for PTSD Fact Sheet

American Academy of Child and Adolescent Psychiatry

THE DEPRESSED CHILD

Not only adults become depressed. Children and teenagers also may have depression, which is a treatable illness. Depression is defined as an illness when the feelings of depression persist and interfere with a child or adolescent’s ability to function.

About 5 percent of children and adolescents in the general population suffer from depression at any given point in time. Children under stress, who experience loss, or who have attentional, learning, conduct or anxiety disorders are at a higher risk for depression. Depression also tends to run in families.

The behavior of depressed children and teenagers may differ from the behavior of depressed adults. Child and adolescent psychiatrists advise parents to be aware of signs of depression in their youngsters.

If one or more of these signs of depression persist, parents should seek help:

Frequent sadness, tearfulness, crying
Hopelessness
Decreased interest in activities; or inability to enjoy previously favorite activities
Persistent boredom; low energy
Social isolation, poor communication
Low self esteem and guilt
Extreme sensitivity to rejection or failure
Increased irritability, anger, or hostility
Difficulty with relationships
Frequent complaints of physical illnesses such as headaches and stomachaches
Frequent absences from school or poor performance in school
Poor concentration
A major change in eating and/or sleeping patterns
Talk of or efforts to run away from home
Thoughts or expressions of suicide or self destructive behavior

A child who used to play often with friends may now spend most of the time alone and without interests. Things that were once fun now bring little joy to the depressed child. Children and adolescents who are depressed may say they want to be dead or may talk about suicide. Depressed children and adolescents are at increased risk for committing suicide. Depressed adolescents may abuse alcohol or other drugs as a way to feel better.

Children and adolescents who cause trouble at home or at school may actually be depressed but not know it. Because the youngster may not always seem sad, parents and teachers may not realize that troublesome behavior is a sign of depression. When asked directly, these children can sometimes state they are unhappy or sad.

Early diagnosis and medical treatment are essential for depressed children. This is a real illness that requires professional help. Comprehensive treatment often includes both individual and family therapy. It may also include the use of antidepressant medication. For help, parents should ask their physician to refer them to a child and adolescent psychiatrist, who can diagnose and treat depression in children and teenagers. Also see the following Facts for Families:#8 Children and Grief, #10 Teen Suicide, #21 Psychiatric Medication for Children, and #38 Manic-Depressive Illness in Teens.

The American Academy of Child and Adolescent Psychiatry (AACAP) represents over 6,900 child and adolescent psychiatrists who are physicians with at least five years of additional training beyond medical school in general (adult) and child and adolescent psychiatry.

Facts for Families © is developed and distributed by the American Academy of Child and Adolescent Psychiatry (AACAP). Facts sheets may be reproduced for personal or educational use without written permission, but cannot be included in material presented for sale. To order full sets of FFF, contact Public Information, 1.800.333.7636.

Free distribution of individual Facts sheets is a public service of the AACAP Special Friends of Children Fund. Please make a tax deductible contribution to the AACAP Special Friends of Children Fund and support this important public outreach. (AACAP, Special Friends of Children Fund, P.O. Box 96106, Washington, D.C. 20090).

American Academy of Child and Adolescent Psychiatry POST TRAUMATIC STRESS DISORDER (PTSD)
No. 70	10/99

All children and adolescents experience stressful events which can affect them both emotionally and physically. Their reactions to stress are usually brief, and they recover without further problems. A child or adolescent who experiences a catastrophic event may develop ongoing difficulties known as post traumatic stress disorder (PTSD). The stressful or traumatic event involves a situation where someone’s life has been threatened or severe injury has occurred (ex. they may be the victim or a witness of physical abuse, sexual abuse, violence in the home or in the community, automobile accidents, natural disasters (such as flood, fire, earthquakes), and being diagnosed with a life threatening illness). A child’s risk of developing PTSD is related to the seriousness of the trauma, whether the trauma is repeated, the child’s proximity to the trauma, and his/her relationship to the victim(s).

Following the trauma, children may initially show agitated or confused behavior. They also may show intense fear, helplessness, anger, sadness, horror or denial. Children who experience repeated trauma may develop a kind of emotional numbing to deaden or block the pain and trauma. This is called dissociation. Children with PTSD avoid situations or places that remind them of the trauma. They may also become less responsive emotionally, depressed, withdrawn, and more detached from their feelings.

A child with PTSD may also re-experience the traumatic event by:

having frequent memories of the event, or in young children, play in which some or all of the trauma is repeated over and over
having upsetting and frightening dreams
acting or feeling like the experience is happening again
developing repeated physical or emotional symptoms when the child is reminded of the event

Children with PTSD may also show the following symptoms:

worry about dying at an early age
losing interest in activities
having physical symptoms such as headaches and stomach aches
Posttramatic Stress Disorder (PTSD), "Facts for Families," No. 70 (10/99)
showing more sudden and extreme emotional reactions
having problems falling or staying asleep
showing irritability or angry outbursts
having problems concentrating
acting younger than their age (for example, clingy or whiny behavior, thumbsucking)
showing increased alertness to the environment
repeating behavior that reminds them of the trauma

The symptoms of PTSD may last from several months to many years. The best approach is prevention of the trauma. Once the trauma has occurred, however, early intervention is essential. Support from parents, school, and peers is important. Emphasis needs to be placed upon establishing a feeling of safety. Psychotherapy (individual, group, or family) which allows the child to speak, draw, play, or write about the event is helpful. Behavior modification techniques and cognitive therapy may help reduce fears and worries. Medication may also be useful to deal with agitation, anxiety, or depression.

Child and adolescent psychiatrists can be very helpful in diagnosing and treating children with PTSD. With the sensitivity and support of families and professionals, youngsters with PTSD can learn to cope with the memories of the trauma and go on to lead healthy and productive lives.

For additional/related information see other Facts for Families: The Depressed Child (#4), Child Abuse: The Hidden Bruises (#5), Responding to Child Sexual Abuse Disorders (#28), Helping Children After a Disaster (#36), and The Anxious Child (#47).

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