The Diagnostic and Statistical Manual of Mental Disorders, Volume 5 (DSM-5) indicates that post-traumatic stress disorder (PTSD) is a mental health disorder that may appear after a traumatic event, and can affect anyone of any age, including children, teens, young adults, and adults. Initially recognized among soldiers returning from combat in the first and second world wars of the 20th century, psychiatrists and doctors called PTSD combat fatigue or shell shock, because the initial stressors that led to the disorder were associated with direct personal experience in an active combat zone.
In the 21st century, we know PTSD is not exclusive to combat veterans. It can happen to anyone who experiences a significant trauma or stressor during their lives. The latest data on PTSD, published by the National Center for PTSD, shows the following prevalence rates in the U.S.
PTSD Among Adults 18+
- 5% report receiving a PTSD diagnosis in the past year.
- That’s about 13 million people
- 6% report receiving a PTSD diagnosis at any point in their lives.
- That’s over 20 million people
- 8% of women report receiving a PTSD diagnosis during their lives.
- 4% of men report receiving a PTSD diagnosis during their lives.
PTSD Among Teens/Adolescents 12-18
- 5% of adolescents have PTSD in any given year
- 5% with severe impairment
- 8% of adolescent females have PTSD in any given year
- 2.3% of adolescent males have PTSD in any given year
- By age:
- 13-14: 3.7%
- 15-16: 5.1%
- 17-18: 7.0%
That’s important information, which tells us that right now, there are millions of people living with PTSD around the country. Fortunately, effective, evidence-based treatment is available. People with PTSD can learn to manage their symptoms and dramatically reduce the disruption and discomfort caused by emotional and physical consequences of PTSD.
A Note on PTSD and Veterans
At BACA, we focus on adolescents and young adults. With a wide age range of 11-29, we support patients who are still basically children, i.e. 11-12 years old, as well as patients who are one hundred percent grown adults, i.e. 25-29 years old, some of whom are are veterans who’ve served in active war zones overseas, which increases risk of PTSD.
When we consider the prevalence rates for PTSD, the U.S. Department of Veterans Affairs reminds us to think about two things:
- No study can ask every person about PTSD
- PTSD may be more prevalent during stressful times, such as:
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- War
- A global pandemic
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In addition, it’s important to understand that veterans develop PTSD at higher rates than civilians. Overall, 7 percent of veterans develop PTSD, with female veterans reporting PTSD at a rate of 13 percent, and male veterans reporting PTSD at a rate of 6 percent. To learn about rates of PTSD among veterans from various service eras – WWII, Korea, Vietnam, Iraq I&II, Afghanistan – please click here.
What is PTSD? A Clinical Definition
The DSM-V offers this definition of PTSD:
“A disorder that may result when an individual lives through or witnesses an event in which they believe that there is a threat to life or physical integrity and safety and experiences fear, terror, or helplessness.”
Experts on PTSD divide the most common symptoms of PTSD – in teens or adults – into four distinct categories:
- Unwanted thoughts/memories:
- People with PTSD may re-experience their initial trauma in the form of disturbing, intrusive memories, flashbacks, and/or nightmares.
- Avoiding people, places, or thoughts about the initial trauma:
- People with PTSD may pretend nothing bad ever happened, refuse to talk about their trauma, or go to extreme lengths to avoid individuals, locations, or circumstances that trigger thoughts about their trauma/
- Negative thought/emotion:
- People with PTSD may experience lower self-esteem, hopelessness, persistent sadness/low mood, and fatigue, which, in some cases, can lead to misuse of alcohol or drugs
- Heightened reactivity:
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- People with PTSD may be very easily startled, feel constantly fearful/on edge, become extremely angry/irritated very easily, have problems sleeping, and have difficulty concentrating
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These symptoms can range from mild to severe, from frequent to infrequent, and depending on their intensity, cause various levels of disturbance in daily activities. When left untreated and underlying trauma left unresolved, the symptoms of PTSD can lead to the following problems:
- Persistent low/sad/depressed mood
- Elevate levels of aggression and/or anger
- Difficulty managing anger
- Difficulty managing other strong emotions
- Escalating misuse of alcohol or drugs
- Problems maintaining stable, healthy relationships
- Declining performance at work/school
- Escalating risky behaviors
These disruptive behaviors and patterns of thought and emotion mean that if you or someone you know has PTSD, finding evidence-based treatment sooner rather than later is essential.
What Causes PTSD? Trauma, Risk Factors for Teens and Young Adults
As we mention in the definition of PTSD, above, the root cause of PTSD is some form of extreme stressor and/or a traumatic experience. While we all have our share of negative experiences in life, from typical disappointments to trauma like accident or illness, not all negative experiences lead to PTSD. The Harvard Center for the Developing Child indicates that children and youth who experience toxic stress or trauma can process those events with a responsive, supportive, caring adult, who may be a caregiver or a mental health professional, can mitigate the consequences of toxic stress and reduce the likelihood of developing PTSD later in life.
Traumatic events associated with PTSD include:
- Living in war zone
- Rape/sexual assault
- Physical assault, nonsexual
- Physical, emotional, or sexual abuse during childhood
- Neglect during childhood
- Natural disasters
- Serious illness or injury to self
- Serious illness or injury to loved one
These events or experiences are called risk factors, because they increase the likelihood a person might develop PTSD. On the other hand, the opposite of risk factors are protective factors, i.e. circumstances or events that reduce the likelihood a person might develop PTSD. Protective factors include:
- The presence of a supportive, caring adult
- Continuous contact with supportive people
- Telling a trusted friend or family member about the trauma
- Professional treatment and support after a traumatic event
- Believing it’s possible to develop effective coping skills
- Developing effective coping skills
- Attending peer/community support groups for trauma survivors
In some cases, people can develop PTSD when protective factors are present. This occurs most often when a person experiences more than one trauma, or the trauma they experienced was extreme, ongoing, and/or severe. If someone you know shows the signs and symptoms we mention above and risk factors are present, we encourage you to help them find professional treatment and support.
PTSD Treatment for Teens and Young Adults
The most effective treatment for PTSD in teens and young adults is a combination of psychotherapy, medication, complementary supports, and education. However, in all cases, PTSD treatment for teens or young adult must follow the principles of trauma-informed care, as defined by the Substance Abuse and Mental Health Services Administration (SAMHSA). To offer effective care, providers must understand trauma, learn how to identify symptoms associated with a history of trauma, and avoid retraumatizing patients during treatment.
Therapists and counselors establish a safe, trusting environment wherein they collaborate with patients and empower them on their own recovery journey, while respecting their history, culture, and personal relationship to their past trauma and their current and future healing and growth.
In this context of safety, trust, and mutuality, psychotherapeutic techniques may include:
- Trauma focused cognitive behavioral therapy (TF-CBT):
- Cognitive processing
- Desensitization
- Emotion identification
- Emotion regulation
Medications may include:
- Selective serotonin reuptake inhibitors (SSRIs) such as:
- Sertraline
- Paroxetine
- fluoxetine
- Selective norepinephrine reuptake inhibitors (SNRIs), such as:
- Venlafaxine
- Duloxetine
In addition, many treatment programs incorporate group therapy, peer therapy/peer support, family therapy, and complementary therapies such as yoga and meditation or expressive therapies such as music, writing, and visual art. Finally, the best treatment for PTSD in teens and young adults includes education, most often in the form of interactive group workshops on the science behind PTSD symptoms, treatment, and recovery.
Finding Help: PTSD Resources
PTSD-specific resources:
- The National Center for PTSD
- The Anxiety and Depression Association of America (ADAA) maintain this PTSD Info Page
- The ADAA Therapist Finder
- National Institute of Mental Health catalog of peer-reviewed journal articles on PTSD
General mental health resources:
- The American Academy of Child and Adolescent Psychiatry (AACAP) is an excellent resource for finding licensed and qualified psychiatrists, therapists, and counselors. Their treatment finder is convenient and easy to use.
- The National Institute of Mental Health (NIMH) maintains a page for youth, adolescent, and family mental health
- The National Alliance on Mental Illness website includes excellent resources for families
