Teen Trauma–PTSD and Treatment Issues
Teen trauma and PTSD are unfortunately common issues among teenagers who have substance problems. Research has well-documented the correlation between trauma reactions and substance use for all ages. However, tragically, 25 % of teens in the U.S. are now thought to have had at least one experience before age 16 that could result in a traumatic response. Youth with early trauma are 3 times more likely to develop substance problems. This seems in part related to an effort to self-medicate unresolved trauma issues.
PTSD in Teenage Years
PTSD, or Post-traumatic Stress Disorder, is a clinical condition that occurs after exposure to an overwhelming adverse incident. Not everyone who experiences overwhelming events will develop the disorder, however. Some seem to have greater vulnerability than others, and it is likely that everyone’s vulnerability and resilience fluctuate from time to time. Therefore, developing PTSD after an adverse event may be in part a result of being in the wrong place at the wrong time for one’s resiliency.
PTSD is basically the same condition in children, teens, and adults. It also is caused in all ages by an experience in which one’s own physical integrity is violated or threatened; one’s life is endangered; one sees another in such situations, or witnesses another’s death. Additionally, one must experience terror or horror and a sense of helplessness in face of the adversity.
Also, PTSD can be caused by hearing about such events involving a loved one, or the sudden death of a loved one. Naturally, young people may interpret some events very differently than adults, and they can be traumatized by experiences or information in part because of their immature understanding and coping strategies.
Symptoms manifest in age and developmentally governed ways. For example, children may cling to others in their fear and anxiety while adults are naturally more independent. Also, youth tend to have less ability to understand trauma symptoms than adults do typically. Having insight is often helpful in symptom management so younger people may not always have access to that coping strategy.
Some of the symptoms of PTSD in teens are:
- Distressful memories
- Intrusive thoughts
- Nightmares and other sleep disturbances
- Hypervigilance—watching for threat or danger
- Hyper-startle responses—being easily startled by sights, sounds, movement, etc.
- Flashbacks in which it seems the adverse event is happening again
- Dissociation—a break from reality and the present moment
- Emotional numbing
- Mood volatility and instability
- Physiological symptoms of hyperarousal such as rapid heartbeat, shallow breathing, hypertension, perspiration
- Inability to recall the event or portions of it, or time periods before or after the event
- The avoidance of triggers to remember the event
- Social withdrawal
- Chronic anxiety, fear and/or panic
- Disorganization in daily routines
- Poor work and school performance
- Difficulty following through with tasks
- Poor concentration and distractibility
- Irritability, easy frustration
This is not an exhaustive list of the difficulties teens experience after a traumatizing event, but it demonstrates how disabling and disempowering such symptoms can be in the life of any adolescent.
Complicated and Complex Teen Trauma
One adverse event or situation can cause PTSD. Some of those can involve, for example:
- The sudden death of a loved one—for example, teens that lose a parent, sibling, or guardian abruptly through violence or accident are at risk for PTSD.
- Learning about a loved one’s exposure to threat or endangerment—teens whose parents have had traumatic exposure, for example, may learn the details of, say, combat or other severe adversity their parents experienced and be traumatized by that information.
- Physical or sexual abuse/assault—such violations can be life-threatening or perceived as such, but all are violations of one’s physical and psychological integrity.
- Neglect and abandonment—neglect of a teen’s survival needs by parents or guardians; being abandoned to fend for one’s self, or left with other caregivers through failed parental/guardian responsibility can cause PTSD for teens. Young people are still dependent upon adults in many ways and these conditions can cause survival endangerment as well as be psychologically overwhelming.
- Parental domestic violence—witnessing parental violence can cause a teen to fear for the physical integrity and survival of victims, and to be exposed to the results of violence. Feelings of immense helplessness to intervene successfully, and perhaps even to be safe from violence themselves, are other traumatizing situations related to domestic violence.
- Parental addiction—parental addiction is fraught with potential adversity for teens through medical emergencies, legal problems, financial difficulties, inadequate survival resources, loss of parental support and aid, potential violence, and vulnerability due to poor supervision.
- Other forms of parental impairment or absence—parental mental illness or disability of other sorts can adversely impact a teen. Also, absences through situations such as parental incarceration or military deployment can be traumatizing.
- Community violence—many communities are burdened with violence that uninvolved people witness or are directly targeted by. Teens are usually mobile in their communities and can be affected by such violence in several ways.
PTSD becomes complicated and complex when more than one traumatic experience continues to have a negative effect on mental health and daily functioning. Many teens have experienced various traumatic reactions over time. Some traumatic events and situations tend to occur in clusters. For example, parental addiction, impairment, absence, and domestic violence are frequently found in the same family. These situations can create a cascade of issues for teens including abuse, neglect, poverty, and lack of survival resources. When a teen cannot heal from one traumatic experience before another occurs, their PTSD is considered complicated or complex and is more difficult to resolve. Also, such multiple traumas are more debilitating in the long run, causing multiple developmental issues such as interrupted maturation of healthy coping skills and relationships as well as deteriorated learning academically, for instance.
The Role of Substances in Teen Trauma
Teens with PTSD are at great risk for substance use and developing Substance Disorders. In fact, trauma histories are so prevalent among adult addicts that rehabs routinely assume each client has such issues until they are ruled out through assessment. Clearly, there is a powerful and intricate relationship between substance problems and traumatic experiences. This happens for various reasons, but among the causes are:
- Attempts to self-medicate physiological arousal such as ‘being on edge’ with adrenaline related effects such as easy startle responses and rapid heartbeat.
- Attempts to self-medicate burdensome mental experiences such as intrusive thoughts, distressful memories, and flashbacks.
- Attempts to reduce anxiety, panic, and fear.
- For overall relaxation, easier social engagement, better sleep.
- To numb painful feelings, or to become more enlivened from emotional numbing.
Treatment for Teen PTSD and Substance Problems
Treatment for teens who have PTSD and substance problems is called dual diagnosis treatment. Dual diagnoses are the simultaneous experience of a substance problem and a co-occurring mental health problem. Because they co-occur and naturally influence one another, the best medical practice is that they are treated simultaneously. This gives the best chance of resolving both and beginning a stable recovery. Otherwise, if one is treated only, chances of relapse for both are greatly increased.
Teens with such dual issues can be treated in a range of treatment programs and settings. These lay along a continuum from least intensive services to the highest intensity. Outpatient services, for example, involve scheduled appointments in an office setting with no regular contact in between appointments between client and treatment professional. This arrangement requires that the teen benefit well enough from the treatment schedule to make progress toward resolution of both the substance problem and the trauma symptoms.
At the other end of the spectrum of dual treatment is the residential program in which teens stay at a facility for a course of treatment. Such treatment stays typically occur in 30-day increments such as 30, 60, 90 or longer, depending upon the teen’s need. In between outpatient and residential treatment are other options such as:
- Intensive outpatient services—these programs allow the teen to live at home while participating, but to attend several hours of treatment weekly, usually on 2 or more days of the week. Such programs provide far more support and structure than outpatient treatment services and are often used as aftercare from a residential stay.
- Partial hospitalization programs—these services are similar to intensive outpatient ones but are typically attended for more days of the week and for more hours of each day. They, too, are often used for residential aftercare and benefit those teens who require more support and structure as they return to home life and usual daily routines.
Finding Help for the Teen in Your Life
It can be difficult to find the right help for your struggling teen if you have never done it before. The treatment options available are not all appropriate for a teen with the dual issues of PTSD and substance use. The best medical practice recommendations state that a treatment program for such issues should employ professionals who are specially trained in treating adolescents with dual disorders, as well as specially trained in treating adolescent PTSD itself.
If you are seeking services for your teen, your search can be less cumbersome and more effective by using Elite Rehab Placement services. A trained specialist can talk with you via phone to assess your situation and make appropriate suggestions to meet the teen’s needs as well as the needs of your family. Having a teen struggling with these issues can be overwhelmingly stressful for the entire family. A referral service can dramatically lessen the confusion of sorting through treatment information available through Internet listings or by contacting facilities yourself. Elite Rehab Placement has collected information about programs and services around the country and can help you cut through the confusion to get your teen the help he or she needs.