How many traumatic events within 12 months can a person endure or tolerate before becoming overwhelmed and developing mental illness

Table of Contents Show

Preschool Children
Elementary School Children
Middle and High School Children
The Body's Alarm System
Healthy Steps Kids Can Take to Respond to the Alarm
Impact of Trauma
Get Help Now
Remember To:
Symptoms of PTSD
Causes of PTSD
How common is PTSD?
Managing PTSD
Treatment and support for PTSD
Help for family & friends

Recognize the signs of child traumatic stress with the informative infographic developed by SAMHSA’s National Child Traumatic Stress Initiative (NCSTI).

Child trauma occurs more than you think.

More than two thirds of children reported at least 1 traumatic event by age 16. Potentially traumatic events include:

Psychological, physical, or sexual abuse
Community or school violence
Witnessing or experiencing domestic violence
National disasters or terrorism
Commercial sexual exploitation
Sudden or violent loss of a loved one
Refugee or war experiences
Military family-related stressors (e.g., deployment, parental loss or injury)
Physical or sexual assault
Neglect
Serious accidents or life-threatening illness

Fast Facts

At least 1 in 7 children have experienced child abuse and/or neglect in the past year, and this is likely an underestimate. In 2019, 1,840 children died of abuse and neglect in the United States.

Each day, more than 1,000 youth are treated in emergency departments for physical assault-related injuries.

In 2019, about 1 in 5 high school students reported being bullied on school property in the last year.

8% of high school students had been in a physical fight on school property one or more times during the 12 months before the survey.

Each day, about 14 youth die from homicide, and more than 1,300 are treated in emergency departments for violence-related injuries.

It’s important to recognize the signs of traumatic stress and its short- and long-term impact.

The signs of traumatic stress may be different in each child. Young children may react differently than older children.

Preschool Children

Fear being separated from their parent/caregiver
Cry or scream a lot
Eat poorly or lose weight
Have nightmares

Elementary School Children

Become anxious or fearful
Feel guilt or shame
Have a hard time concentrating
Have difficulty sleeping

Middle and High School Children

Feel depressed or alone
Develop eating disorders or self-harming behaviors
Begin abusing alcohol or drugs
Become involved in risky sexual behavior

The Body's Alarm System

Everyone has an alarm system in their body that is designed to keep them safe from harm. When activated, this tool prepares the body to fight or run away. The alarm can be activated at any perceived sign of trouble and leave kids feeling scared, angry, irritable, or even withdrawn.

Healthy Steps Kids Can Take to Respond to the Alarm

Recognize what activates the alarm and how their body reacts
Decide whether there is real trouble and seek help from a trusted adult
Practice deep breathing and other relaxation methods

Impact of Trauma

The impact of child traumatic stress can last well beyond childhood. In fact, research has shown that child trauma survivors may experience:

Learning problems, including lower grades and more suspensions and expulsions
Increased use of health and mental health services
Increase involvement with the child welfare and juvenile justice systems
Long-term health problems (e.g., diabetes and heart disease)

Trauma is a risk factor for nearly all behavioral health and substance use disorders.

There is hope. Children can and do recover from traumatic events, and you can play an important role in their recovery.

A critical part of children's recovery is having a supportive caregiving system, access to effective treatments, and service systems that are trauma informed.

Get Help Now

SAMHSA Behavioral Health Treatment Services Locator

The National Child Traumatic Stress Network: Get Help Now

Healthcare Toolbox: Basics of Trauma-Informed Care

Not all children experience child traumatic stress after experiencing a traumatic event. With support, many children are able to recover and thrive.

As a caring adult and/or family member, you play an important role.

Remember To:

Assure the child that he or she is safe.
Explain that he or she is not responsible. Children often blame themselves for events that are completely out of their control.
Be patient. Some children will recover quickly while others recover more slowly. Reassure them that they do not need to feel guilty or bad about any feelings or thoughts.
Seek the help of a trained professional. When needed, a mental health professional trained in evidence-based trauma treatment can help children and families cope and move toward recovery. Ask your pediatrician, family physician, school counselor, or clergy member for a referral.

Visit the following websites for more information:

Trauma and Violence
The National Child Traumatic Stress Network

Additional resources:

Post-traumatic stress disorder (PTSD) can develop in response to traumatic situations, especially very shocking, extreme or sudden events.
People with PTSD relive the traumatic event in some way, avoid reminders of it, and might feel vigilant or on edge a lot of the time.
People living with PTSD can benefit from self-care strategies and psychological support that is safe and empowering.
It is possible to live a full and meaningful life even if a person has experienced PTSD.

Post-traumatic stress disorder (PTSD) is a type of mental health issue that can develop after a traumatic event. A traumatic event is generally something shocking or overwhelming, such as being exposed to injury, death, or violence. Even learning about these types of events can be traumatic for people, especially if they happen to a close family member or friend, or hear extreme details over time.

People affected by PTSD may feel anxious and highly vigilant, and have intrusive thoughts and memories of the trauma. It can be extremely distressing and interfere with day-to-day-life, such as work and relationships.

People with PTSD may also experience other mental health issues, such as depressive disorders, anxiety disorders, personality disorders, and substance use disorders (1).

Symptoms of PTSD

Feeling strong reactions such as fear, anger or sadness are natural after a traumatic event. For most people, these feelings will pass with time and support from friends and family. For people who develop PTSD, these feelings are intense, distressing and, if left untreated, can last for a long time. 

PTSD can take years to develop. Childhood trauma can continue to affect adults many years after the traumatic event happened.

To receive a diagnosis of PTSD after a traumatic event, a person must have experienced the following symptoms for at least one month (2):

Intrusive reminders of the event. These may be involuntary and distressing memories, dreams, or flashbacks of the event. As well as strong emotions, there may be physical symptoms such as sweating, heart palpitations or panic attacks.

Avoiding reminders of the event. Avoiding activities, places, people, thoughts or feelings associated with the event.

Mood and thought changes. Difficulty remembering parts of the event, negative beliefs, feelings of guilt, fear or shame, low mood, or feeling detached.

Physical and behavioural changes. Feeling anxious, ‘jumpy’, or irritable. Acting recklessly, sleep disturbances, or difficulty concentrating.

Some people also experience dissociation as part of their PTSD – a feeling of being disconnected from reality.

Causes of PTSD

PTSD is caused by traumatic events. Trauma can lead to PTSD in several ways:

Memories of traumatic events are processed differently to other memories. They are not 'filed away' like most memories, and instead can come up unexpectedly with strong emotions.
A traumatic event can change a person's idea of what is safe, meaning they are constantly on edge and anticipating danger.
Going through a trauma can cause intense negative emotions that are hard to handle, and people can try to cope in ways that are ineffective or unsafe.

It can be hard to predict who might develop PTSD after a traumatic event. People are more likely to develop PTSD if the traumatic event was particularly sudden, intense, shocking or impactful. But this can also vary based upon:

genetic factors
environmental factors, such as cultural norms
support systems and safety
the age a person experienced trauma

personality and coping styles
how the person views the events personally (3).

How common is PTSD?

It’s estimated that 2-20% of all people who have experienced traumatic events develop PTSD (4).

In Australia, around 1-2% of adults experience PTSD each year, while approximately 12% experience PTSD in their lifetime (5).

Managing PTSD

There are strategies people can use to help with symptoms and recovery from PTSD:

Learning ways to soothe the mind and body when going through flashbacks or intrusive memories.
Learning about the idea of a ‘window of tolerance’ (here is a helpful video)
Taking part in activities that are meaningful or fun.
Avoiding isolation – developing a support network of trusted friends or family members, and reaching out to them when you need help.
Taking care of physical health by getting enough sleep and staying active.

Sharing and connecting with others who have had similar experiences – for example, joining a peer support group.

Treatment and support for PTSD

If someone is concerned about symptoms of PTSD, it is a great idea to talk to a GP. A GP can support people with information and referral options to support services or mental health professionals.

Ideally, any treatment for PTSD should be trauma-informed – this means it is safe, trustworthy, empowering and collaborative (6).

Often treatment for PTSD involves some form of psychological therapy. Psychological therapies that might be helpful for PTSD include trauma-focussed cognitive behavioural therapy (CBT), cognitive therapy, eye-movement desensitisation and reprocessing (EMDR), and exposure therapy (7).

Therapy should usually first involve creating a safe environment. From this place of safety people can learn skills to manage distress and traumatic memories or flashbacks. Over time, treatment with a therapist might also involve processing unresolved aspects of the trauma

Treatment and therapy can also focus on other parts of a person’s life - building up self-esteem, self-compassion, and focusing on strengths and goals.

Other treatment options include medication, such as antidepressants. Medication can be used in combination with psychological therapies, or may be helpful when other mental health issues are present, such as depressive disorders (7).

Help for family & friends

The family and friends of someone who has experienced PTSD need care and support too — it’s okay for family and friends to set boundaries, and to prioritise their own physical and mental health.

There are many other people out there who share similar experience, and many services designed to help carers of people with mental health issues. Check out our Guide for Families and Friends for more info.

Effective support and treatment is available, and a person who is experiencing PTSD can live a fulfilling life.

To connect with others who get it, visit our online Forums. They’re safe, anonymous and available 24/7.

VISIT FORUMS

Resources

1. Galatzer‐Levy IR, Nickerson A, Litz BT, Marmar CR. Patterns of lifetime PTSD comorbidity: A latent class analysis. Depress Anxiety. 2013;30(5):489–96.

2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.; DSM-5). In: 5th ed. American Psychiatric Association; 2013.

3. Phoenix Australia. Trauma and trauma reactions. In: Australian Guidelines for the Prevention and Treatment of Acute Stress Disorder (ASD), Posttraumatic Stress Disorder (PTSD) and Complex PTSD. 2020.

4. Kessler RC, Aguilar-Gaxiola S, Alonso J, Benjet C, Bromet EJ, Cardoso G, et al. Trauma and PTSD in the WHO World Mental Health Surveys. Eur J Psychotraumatol [Internet]. 2017 Oct 27;8(sup5):1353383. Available from: https://doi.org/10.1080/20008198.2017.1353383

5. Australian Bureau of Statistics. National Survey of Mental Health and Wellbeing: Summary of Results [Internet]. 2008. Available from: https://www.abs.gov.au/statistics/health/mental-health/national-survey-mental-health-and-wellbeing-summary-results/latest-release

6. Phoenix Australia. Complex PTSD. In: Australian guidelines for the prevention and treatment of acute stress disorder, posttraumatic stress disorder and complex PTSD. 2020.

7. Phoenix Australia. Treatment recommendations. In: Australian guidelines for the prevention and treatment of Acute Stress Disorder, Posttraumatic Stress Disorder and Complex PTSD. 2020.

This factsheet was last updated in February 2022 by representatives from SANE’s content and clinical governance teams.