Does PTSD Look Different in Adults and Children?

After living through, experiencing firsthand or just witnessing abuse, both adults and children are susceptible to posttraumatic stress disorder, or PTSD. This is when the trauma reemerges in the form of intense flashbacks or nightmares, and as a result, causes the person to feel anxious, angry or depressed.

PTSD can follow any type of trauma. It’s most commonly associated with war veterans—it used to be called “shell shock” or “combat fatigue,” but it can actually happen to anyone—people who have lived through natural disasters or have been in a bad car accident, individuals who have been assaulted or raped, or those who have lived through domestic violence. 

What PTSD Looks Like in Kids

It wasn’t until 2013 that the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) recognized that PTSD could be diagnosed in children ages 6 and under. In 2012, a study by the National Center for Mental Health Promotion found that 26 percent of children in the U.S. will experience a traumatic event before they turn 4. This can include not only being abused, but also seeing abuse by a family member toward another, or maltreatment or severe neglect from a parent. 

The tricky thing about identifying PTSD is that kids typically won’t be aware that they have it. Unlike diseases, there’s no blood test for PTSD, so diagnosing it involves asking a lot of questions and connecting the dots between what’s going on now and what they may have seen or experienced in the past, says board-certified forensic psychiatrist Rupali Chadha, MD, Chief of Medical Staff at Metropolitan State Hospital in Norwalk, Calif.

“A child cannot always express what they’re experiencing or going through, so there are not the classic symptoms [of PTSD],” Chadha says.

In children, PTSD can look like the following:

• Irritability
• Social withdrawal
• Nightmares
• Anxiety or acting “jumpy” in certain situations
• Problems with concentration and attention
• Insomnia
• Avoiding people, places or activities associated with the trauma
• Persistent worry that the world is unsafe 
• Unable to attach to people

Luckily, PTSD in kids is easier to treat than when it occurs in adulthood, says the doctor, saying that kids are resilient, for one, but also that their brain chemistry helps.

“Kids brains are sponges—they can regrow areas that have been adversely affected, so it’s easier to treat in that sense. But the hard part is identifying the kids who need help.” A parent or caregiver who recognizes any of the above symptoms in a child should bring them to the attention of the child’s physician as soon as possible before symptoms can worsen. In one study out of Amsterdam, researchers found children and adolescents with PTSD were successfully treated with only a few hours of Eye Movement Desensitization and Reprocessing (EMDR) or cognitive behavioral writing therapy. You can find other treatment options on the Child Mind Institute website.

Easier to Spot, Tougher to Treat in Adulthood

In adults, PTSD can show up as any of the symptoms earlier listed for children. Most frequently, says Chadha, this includes reexperiencing the trauma through nightmares, memories or flashbacks. There is a persistent ongoing hyper arousal, meaning survivors with PTSD might feel constantly on edge. 

Studies show that some 88 percent of female survivors in domestic violence shelters were living with PTSD, and at least 75 percent suffer from severe anxiety. Symptoms may not show up right away, either. A survivor could escape abuse and find anxiety and flashbacks kick in six months after she leaves. It can be confusing, unnerving and debilitating. 

Unlike kids and their “sponge-like” brains, adult brains are bit more inflexible when it comes to change. That doesn’t mean PTSD can’t be overcome, but the condition is often talked about in terms of treatment and not cure.

“For some people, PTSD symptoms gradually fade over time. Other people find that symptoms may increase when they encounter reminders of their traumatic events. Anniversaries of the event, for example, are commonly difficult times,” says John H. Krystal, M.D. of the Brain and Behavior Research Foundation. 

Add to that the barriers that exist for adult survivors to access treatment. They may still be under the control of an abuser, they may be experiencing gaslighting—a situation where the abuser convinces them nothing is wrong—or they may face stigmas that prevent them from reaching out for help. They may feel guilty, as though they were at fault for the abuse. Or, financial barriers could stand in the way for them to seek treatment.

No matter what, a survivor who recognizes PTSD in themselves should consider reaching out to talk to someone, such as a trained domestic violence advocate, who may be able to point them to local, low-cost or free services, such as counseling and support groups. Holistic approaches have also been shown to help improve symptoms of anxiety and PTSD, including massage therapy, tapping, acupuncture and journaling. 

You can also start here: “5 At-Home Healing Techniques.” But also be aware, if at any time your symptoms of PTSD begin to take a turn into feelings of hopelessness, self-harm, harm to others or suicidal thoughts, reach out to your primary care physician right away for immediate professional help.