Post-traumatic stress disorder or PTSD is a mental health disorder,
that may develop after exposure to exceptionally threatening or frightening events.
Traumas are events that involve actual or threatened serious injury,
death or sexual violence.
For example, being assaulted, witnessing domestic violence
or getting caught up in a disaster, such as a fire.
People can experience a trauma because they're involved in it themselves,
or because they witness it, or because they hear about it.
Exposure to trauma is common amongst young people, so we know that by the end of adolescence,
about 75% of young people will have faced some kind of traumatic event.
Immediately after a traumatic event, all children are likely to feel frightened,
distressed and in shock.
Most will recover well with the support of family and friends.
The reactions that young people can experience after a trauma can be really broad
but we know that there are some responses that are more common.
Young people will often see vivid images in their mind after a trauma,
but they might also hear, feel or smell things that happened during the event.
These memories are experienced as uncontrollable and have a here-and-now quality,
so it could almost feel like the trauma is happening again.
Young people might experience changes in thinking and attitudes after a trauma.
Survivors have learned that life is fragile so they might see the world as a dangerous place.
Many young people feel guilty
and blame themselves for things that did or didn't happen during the traumatic experience.
Children might notice changes in their body,
feeling more jumpy or easily startled.
Reminders of the event might make them feel panicky,
they can have difficulty sleeping and find it hard to concentrate at school.
Changes in mood and feelings also often follow a traumatic experience.
Young people can be sad and withdrawn as well as irritable,
becoming snappy or oppositional with their parents or siblings.
Avoidance is a common response to trauma.
Children will work hard to push horrible pictures from their mind.
They might also try to avoid reminders of the event
and that can really restrict day-to-day life.
Young people may not want to talk about the trauma,
meaning adults often underestimate the extent of a young person's suffering.
Most young people will experience at least some of these reactions after a traumatic event.
For some young people these symptoms will persist for longer than a few weeks
and they'll start to interfere with day-to-day life,
and in these situations we might consider a diagnosis of post-traumatic stress disorder, or PTSD.
PTSD will present differently depending on the developmental stage and age of the young person.
We now know that very young children can,
and do, develop PTSD after a trauma
but they often present with different difficulties, compared to adults and older children.
Very young children might reenact parts of the traumatic events in their games or they
or they might draw parts of it.
For example, a young child who has witnessed lots of domestic violence,
might repeatedly hold two dolls and hit them against each other,
or a child who was involved in a fire,
might draw orange flames on a page over and over again.
Younger children are less likely to have dreams about the traumatic event
but they'll often have an increase in general nightmares, for example, about monsters.
It's important to say that anybody can develop PTSD after a traumatic event.
It is not in any way a sign of weakness.
We do know that there are various factors that make us more
or less likely to go on to develop difficulties.
Some of these factors are to do with the trauma itself,
so the severity of the exposure can make us more likely to develop problems.
If we're really reluctant to talk about what's happened, or think about what's happened,
that can make problems more likely.
There are also some groups of young people who are more vulnerable
because they will most likely be facing more traumatic events in their lives.
So, for example, we know that young refugees and unaccompanied asylum seekers,
are a particularly vulnerable group.
It can be extremely difficult for adults to know whether a child is experiencing intrusive memories
or thoughts after a trauma.
Children are usually really reluctant to talk about anything to do with the traumatic event.
It can be important for parents to keep their eyes open
for some of the more observable, signs of difficulties.
For example, a child might have a change in their sleep pattern,
struggling to go off to sleep,
or they might find it difficult to concentrate in school or on their homework.
It's important for adults to ask directly about difficulties
and about upsetting memories because children are unlikely to bring them up themselves.
Children should never be made to feel that they have to talk,
but adults should make it clear that they're available to listen and to help whenever the child needs it.
We find that most young people will recover well in the first few weeks after the event
but if a child is showing really severe reactions in the first weeks after the event
or if their symptoms go on after about a month,
then parents should seek some help.
The best way to seek help is through your family GP or through a school nurse or Senco.
Help is usually provided by the local Child and Adolescent Mental Health Service.