Trauma (Post Traumatic Stress Disorder)

Type and nature of distress

Young people are displaying signs of trauma/ Post Traumatic Stress Disorder. These difficulties cause significant distress to a young person and significantly disrupt daily coping such as school/ college, socialising and even self-care activities (e.g., sleep, bathing, eating). Despite trying advice in the green and amber stages, the young person still experiences trauma symptoms at least 1 month after the traumatic event. Examples of situations that may cause/ contribute to a young person feeling low in mood or depressed:

• Severe/ chronic bullying or abuse (including neglect, emotional, physical, sexual)
• Social or family financial stressors (such as family breakdown, conflict or parental/ sibling ill-health)
• Grief or loss
• Witnessing or experiencing a traumatic event
• Witness or experiencing an accident or injury
• Overwhelmed by pressures and stressors including individual factors e.g., health, social factors e.g., relationships, occupational factors e.g., school/ college and environment e.g., living circumstances

What you might see or a young person might report

As well as the features in Green and Amber, the following might also be present:

• Flashbacks of the traumatic event (sudden/ unexpected memories or recalling aspects of the traumatic event without warning or trying)
• Children may re-enact the traumatic event repeatedly in their play
• Disrupted sleep; nightmares/ night terrors (that may or may not be linked to the traumatic event)
• Hypervigilance to threat and danger
• Isolating self from friends and family
• Episodes where young person appears non-reactive/ shut down/ in a day-dream type state
• Poor memory or recall as well as periods of confusion or feeling spaced out- may report things not feeling real
• Withdrawn and uncommunicative or not wanting to be left alone at all- this may seem uncharacteristic or age inappropriate for some teenagers
• Refusal to leave the house or attend/ take part in activities such as school, hobbies, interests, seeing friends
• Significant impact on health and wellbeing such as not sleeping or eating for a sustained period of time. May show signs of physical compromise as a result.
• Appearing uncaring or unbothered about people or activities they previously would have cared about- may not honour commitments or responsibilities which is uncharacteristic
• May on occasion becoming agitated, distressed, oppositional or aggressive towards others
• Reactive and impulsive behaviour such as running away which may place them or others in danger
• Feeling hopeless about the future- not being able to see a future and appearing to give up on dreams, goals and hopes
• Thoughts, feelings, urges, plans or intent to harm self or end their life or harm others. Please note that not all young people who engage in self-harm behaviour are depressed or suicidal. There are many reasons why a young person may engage in self-harm behaviour.

Things to try, support and next steps

As well as the steps in Green and Amber the following might be helpful:

• Speak with your child’s GP
• Speak with the School Nursing Team
• Depending on the context and/ or the origins of the distress being experienced, other services may be helpful. There may be a role for other services such as Children’s Services or other statutory or voluntary organisations that can support if there are clear triggers for anxiety e.g., abuse, domestic violence, bullying, being a young carer etc.
• See the life issues section of the Hampshire CAMHS website for additional information and resources: www.hampshirecamhs.nhs.uk
• Seek advice, guidance and support from Young Minds Parent Helpline: 08088025544
• Access the “Help I’m in Crisis” Button on the Hampshire CAMHS website website during times of stress or crisis
• Consider making a self-referral to a CAMHS Service
• If your young person is at risk of harm, please make this clear when making the referral

Other Resources:

• The Simple Guide To Child Trauma: What It Is And How To Help, by de Tierry, Betsy de, Emma Reeves et al.,