Understanding, Diagnosing and Treating PTSD

Post Traumatic Stress Disorder, which can affect anyone at any age, can be difficult to diagnose because there may be a lag between the start of symptoms and the triggering traumatic event.  In fact, it is not uncommon for symptoms to start slowly and increase in frequency and/or severity over time.  This is one reason that understanding the signs and symptoms of PTSD

Heed these warning signs that your teen may have PTSD (photo credit: BigStockPhoto.com)

Heed these warning signs that your teen may have PTSD (photo credit: BigStockPhoto.com)

is crucial for anyone who has experienced trauma or who has a loved one that has been through a traumatic event.  The key to managing and overcoming the disorder is timely diagnosis and treatment which underlines the importance of knowing what to look for and knowing when it is time to seek help.

There are many challenges for those living with and working with PTSD.  Diagnosis can be challenging because symptoms do not present the same way in every person.  The start of symptoms may not seem to link back to the trauma which can also lead to missed or misdiagnosis.  Because there is still much we don’t know about the disorder, it is difficult to predict who will experience it and who won’t.  There are, however, some common risk factors that seem to make people more susceptible to PTSD.

  • Previously experiencing a traumatic event
  • History of mental illness
  • Lack of social support following the trauma
  • Being injured in the course of the event

Diagnosis is made by a qualified mental health practitioner based on a discussion with the person experiencing the symptoms.  In order to be diagnosed with PTSD, the National Institute of Mental Health indicates that a person must be experiencing at least one of the following for a month or more:

  1. One or more re-experiencing symptoms which include nightmares, flashbacks, and frightening thoughts
  2. Three or more avoidance symptoms like avoiding places, objects, or events that are similar to the traumatic event, experiencing a consistent feeling of being numb, losing interest in favorite activities, and difficulties with memory related to the event
  3. Two or more hyperarousal symptoms like being easily startled, feeling tense, feeling on edge all the time, and having angry outbursts
  4. Other symptoms that make it difficult to participate in daily life

While PTSD is treatable, it rarely resolves itself without the assistance of professional help.  Most people with the condition recover fully after treatment.  The most common forms of treatment are therapy and medication.  A variety of therapeutic approaches have been used successfully to treat the disorder including cognitive behavior therapy, talk therapy, and exposure therapy.  Most treatment plans use a mix of these methods to achieve the best overall result.  When medication is used as part of the treatment plan, it’s job is often to alleviate the symptoms of other underlying conditions like depression or anxiety that can exacerbate the symptoms of PTSD and make recovery more challenging.

If you are concerned that your teen is suffering from PTSD, don’t wait to schedule an appointment with a qualified mental health practitioner.  Remember that PTSD is treatable and complete recovery is possible, but getting help is the fastest path to those outcomes.

7 Signs Your Teen May Be Having Suicidal Thoughts

Do you know the warning signs that your teen may be thinking about suicide? (photo credit: BigStockPhoto.com)

Do you know the warning signs that your teen may be thinking about suicide? (photo credit: BigStockPhoto.com)

When it comes to teen suicide, there is no such thing as being too cautious, too concerned, or too vigilant.   According to the National Alliance on Mental Illness (NAMI), more than 2 million adolescents in the U.S. attempt suicide each year and 2,000 succeed.  With an estimated 2.6% of students exhibiting suicidal behavior that required treatment from a doctor or nurse, it is very important that parents, educators, and others take any threat of suicide seriously.

As any parent knows, the teen years are full of changes, struggle, confusion, pressure, and stress.  And that is under normal circumstances.  When the normal challenges of the teenage years are exacerbated by other circumstances like being bullied, parents who are divorcing, having to move, or a mental illness, teenagers can see suicide as a way to solve their problems.  The good news is that treatment can be very effective at alleviating these thoughts.

The key to helping your teen is to know what the signs are, recognize the signs, and get help.  Here are 7 of the signs that your teen may be having suicidal thoughts.

1.     Suicidal Talk

One of the hallmarks of someone who is contemplating suicide is that they will talk about it openly.  Be alert for suicidal statements or a sudden preoccupation with death or dying.  Suicidal talk can also include making statements about being a bad friend, being a bad person, or other negative self-talk that revolves around how much better others would be if they were gone.   Suicidal talk may also be more subtle, consisting of defeatist statements like “nothing matters,” “soon it will all be over,” and “I won’t cause problems for other people for long.”

2.     Saying Goodbye/Letting Go

Another sign that someone may be thinking about suicide is that they start letting go of their life and saving goodbye to loved ones.  This can manifest as giving away treasured belongings, pulling away from friends and family, or seeming to put things in order by cleaning their room and telling loved ones how they feel about them.

3.     Ceasing to Care

Ceasing to care about things like personal appearance, recognition, or anything at all can also be a warning sign that suicidal thoughts are present.  If your teenager suddenly stops caring about their physical appearance or hygiene or seems locked in a place of sadness where they feel worthless, guilty, or irritable, or becomes completely indifferent to everything good or bad in their life, they may be struggling with suicidal thoughts.

4.     Acting Out

When teenagers act out, expressing aggressive or hostile behavior towards others and participating in risky behavior, it may be a warning sign that they are struggling with suicidal thoughts.  Pay attention to things like running away from home, driving recklessly, participating in self-harm, or engaging in sexually promiscuous behavior.

5.     Significant Personality or Behavior Changes

While many teenagers experience rapid changes in their behavior or personality as a normal part of adolescence, these changes can also be a sign of suicidal thoughts.  If someone experiences an extreme personality shift, a significant change in lifestyle habits like eating or sleeping, or shows symptoms of depression or other mental health conditions, they may be experiencing or at risk for suicidal thoughts.

6.     Risk Factors

In addition to the signs above, parents should be aware that there are some factors that may increase the risk for suicidal thoughts.  These risk factors include:

  • Mental health conditions like depression, bipolar disorder, anxiety disorders, borderline personality disorder, schizophrenia, and problems with substance abuse
  • A parent or family member with a mental health condition
  • A parent or other family member dealing with substance abuse
  • A previous attempt at suicide
  • Having someone in their life like a friend, family member, or role model who recently committed suicide
  • A history of sexual abuse or growing up in an abusive environment
  • Participating in self-harm behavior

 7.     Triggering Events

In addition to the signs and risk factors listed above, parents need to be aware that there are some events that have been associated with an increased risk of suicide.  These triggering events include the loss of a parent or other family member, divorce, substance abuse, experiencing a major disappointment, dealing with a chronic illness, struggling with sexual identity or orientation, being bullied, and experiencing problems at school.

Helping Teens Feel Safe in an Unsafe World

The school shooting in Newtown, Connecticut was a tragedy beyond measure.  When events like this occur, it shakes the foundation on which all our lives are built.  This is as true for our teenagers as it is for us parents.  Everyone searches for some way to make sense of the awful events of that day, even those of us who live in different towns, cities, and states.  We do this because we need to be able to explain what happened in order to be able to convince ourselves it can never happen to us.  In these difficult times, being able to restore our own sense of safety and security is of the utmost importance and seeking these kinds of answers is one of the ways we do that.  However, even as we seek these answers and explanations for ourselves, we need to be conscientious about how we are communicating about this tragedy with our children.  Here are some tips for how you can help your children through this and other tragic events.

1.     Consider How to Communicate

As we saw with the media coverage in the hours and days after the shooting, confusion, misinformation, and distress are common in the aftermath of tragedy.  If the trained journalists reporting on TV can get things wrong, think of how hard it can be for your teen to decipher fact from fiction and determine truth from sensation.  This is one reason that communicating effectively with your teen is even more important at these times.  Make sure you use age appropriate language and don’t overwhelm your children with information they don’t need or may not know how to deal with.  Stick to the facts, be clear, and keep things simple.

2.     Answer Tough Questions

One of the things everyone wants to know when something terrible happens is why it happened.  Children and teens are no exception.  The search for reason in an unreasonable situation is how we try to make sense of senseless acts.  The challenge for parents is to help their children understand that these things happen for a variety of reasons like mental illness, religious or political fanaticism, or simple hatred without turning any specific group into the “bad guy.”  For example, while some of the people who have been responsible for mass shootings have suffered from mental illnesses, not everyone with a mental illness can or would hurt other people.

3.     Stress Safety

Another of the most common questions we all ask at times like these “is will it happen again” or more importantly, “how can I make sure it never happens to me?”   The truth is, random acts of violence will always happen and there is no way to protect ourselves from each and every eventuality.  People do terrible things and there is no way to ensure it will never happen to you.  Despite this, even teens need to re-establish a sense of security, to find a way to feel safe in their world.  The best way to do this is to focus on ways to make ourselves safer rather than on our inability to control the random acts of others.

How Writing Helps Teenagers Manage Stress

Being a teenager in today’s world comes with the same stresses teens have always faced plus a wide range of new stresses their parents and grandparents never faced.  According to the American Academy of Child and Adolescent Psychiatry, teens are stressed because of academic demands, high expectations, jam-packed schedules, safety concerns, family problems, peer relationships, and financial instability.  Because stress can come from every area of their lives, teens can easily become overwhelmed and many do not have the tools they need to manage that stress on their own.

When teens are stressed and overwhelmed and unable to change their situation it can lead to unhealthy behavior patterns like aggression, withdrawal, depression, anxiety, cutting, acting out, and substance abuse. For parents, this means that helping teens develop adequate stress management techniques is a key component in protecting their mental health.

While there are many different techniques and strategies for managing stress, one of the most effective tools for teenagers is writing.  Many key stressors for a teenager revolve around their feelings.  How do other people make them feel?  How do they feel about other people?  How do they feel about themselves?  With so much going on around them, it can be hard to work through all the different feelings and emotions as they are being bombarded by them all day long.  Writing provides a safe, quiet, accessible, and most importantly, private way to sort out that jumble and get their emotional selves back on solid ground.

Here are some of the ways that the simple act of writing can position teens to manage and alleviate the stress in their lives.

A Safe Place to Vent

Sometimes, you just need to blow off steam and your teens feel this way too.  Unfortunately, they don’t have access to the same outlets you do.  They may feel like they can’t talk to their friends because they will make someone mad, hurt someone, or sound like a crazy person.  They may feel like they can’t talk to you because you won’t understand or you will overreact.  Writing can provide a safe place to vent, to let the energy behind their emotions out so that it doesn’t build up and push them into unhealthy behaviors.

A Space to Sort Things Out

Today’s world moves fast and we can easily become overwhelmed when the things we need to take in, outpace our ability to do so.  When the things we need to manage are too many to be manageable, it can be difficult to think clearly, make decisions, or know where you stand or how you feel.  When teens write, they can slow down the pace of their thoughts.  Bounded by the time it takes to physically commit ink to the page, writing can help create space for them to sort out their emotions, formulate their thoughts, and reconnect with themselves.

Writing isn’t a perfect fit for every teen, but for many it can be a core stress management strategy.  Writing for a certain amount of time everyday can help keep stress from building up and overwhelming them.


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Stressed Out Parents Create Stressed Out Kids

Stressed out.  Anxious.  Worried.

If you were asked which members of your family are experiencing high levels of stress and anxiety, which would you choose?  Most of us would choose ourselves, our spouses, or our partners.  We, the parents, are the ones who are worried about paying bills, anxious over the economy and stressed out from being overworked, underpaid, or unemployed.  If you picked yourselves, you are definitely right and possibly wrong at the same time.   By picking yourselves, you are indicating that you are part of the 33% of adults that are routinely experiencing a high level of stress and who would know better than you, right?  However, you may also need to pick your kids, especially if you are one of the 33%.  Because whether you believe it or not, if you are stressed, your stress is rubbing off on your kids.

Do you know how your kids act when they are stressed out?  If you are like most parents, you probably don’t.  The majority of us don’t think our children are overly stressed or worried, even though 1 in 5 of them is experiencing a high degree of stress.  This disparity between what parents think children are feeling and what children are actually feeling is one of the key findings from the 2010 Stress in America survey published by the American Psychological Association .

The APA survey also found that almost 70% of parents feel their own stress has little to no effect on their children.  The children’s responses, however, tell a different story.  When asked how they feel when their parents are stressed, tweens and teens indicated that they feel sad, depressed, worried, frustrated, annoyed, and helpless.

Our kids are also better at reading us than we are at reading them.   You may not be able tell when they are stressed, but you can be sure that they know how you act when your stress begins to boil over.  Almost all children can point to the specific behaviors their parents exhibit when they are stressed out and worried.  Teens cite things like yelling, arguing with others, having no patience, irritability, and being too busy to spend time with them as signs of parental stress.

Signs You Are Stressed

You may think you know how to tell when you are stressed out but the signs are not the same for everyone and there may be subtle cues on the way from stressed to burned-out that you are missing.  The keys to helping everyone in your family reduce their stress level and learn to manage stress more effectively are to understand how stress affects each family member and to help each other see the signs before stress boils over and becomes burn-out.  Here are some of the most common signs of stress in both adults and children.

  1. Attitudes about work or school change becoming more critical and comments about work or school are sarcastic and/or cynical.
  2. Patience decreases or disappears.  Things like traffic, waiting in line, or delays cause immediate responses and angry outbursts.
  3. Everything irritates you.  From the sound of the clock ticking in the kitchen to the way your husband clanks the ice cubes in his glass together when he drinks puts you on edge.
  4. You feel lethargic and don’t seem to have the energy you need to do housework, schoolwork, participate in sports, exercise, visit with friends, or do other activities you normally enjoy.
  5. Things feel hopeless.  Everything seems to be an insurmountable obstacle from a chemistry test to weeding the garden.
  6. Everyone keeps asking you if you are ok.
  7. Even good things don’t make you happy.
  8. Your sleeping and/or eating habits have changed.  You are either sleeping too much or too little, eating more than you should or not at all.

Make stress management a family affair and talk to your kids about the signs of stress, what is stressing them out, and ways you can all work on managing the stress of the family together.  Just remember, talking about stress and how to manage it isn’t a license to discuss all your adult problems with your kids.  You can work as a family to learn to manage stress better without stressing your kids out more by unloading all of your adult problems onto them.

  • Helping Teens with Holiday Stress (doorwaysarizona.com)
  • Stressed women know it. Stressed men … not so much. (psychologytoday.com)
  • Help For Stressed Out Families (fulleryouthinstitute.org)

Helping Teens with Holiday Stress

In the frenzy of planning, shopping, wrapping, decorating, entertaining, and visiting that often punctuates the holiday season, it is no wonder that many parents find the time between Thanksgiving and New Year’s Day to be one of the most stressful of the entire year.  Unfortunately, as our stress level increases, we often increase the stress level of those around us while also becoming less able to see the signs of stress the other members of our families’ exhibit.  Without some blatant flashing sign like a school suspension, angry outburst, or emotional meltdown, we may be too wrapped up in our own holiday stress to notice that our teens are having a tough time too.

Teenagers have their own set of holiday stress, especially if they are part of a family that is struggling financially, dealing with a separation or divorce, or facing the holidays without a loved one for the first time.  Stress impacts teens in many of the same ways it impacts adults.  They can experience physical symptoms like headaches and insomnia.  They can struggle emotionally and suddenly have a short fuse and be quick to anger.  They may turn to unhealthy behaviors like binge eating as a way to cope with their stress.

What Can Parents Do to Help?

The first and most important thing is to notice if your teenager is stressed.  According to the American Psychological Association’s Stress in Americastudy(http://www.apa.org/news/press/releases/stress/national-report.pdf) , while almost half of teens report being more stressed out from one year to the next not even 30% of parents noticed.  Pay attention for the signs that your teen is worried and then work together to determine the source of their stress.  Sometimes, just knowing that they aren’t alone can make a huge difference in how much stress they are experiencing.

Here are some other strategies parents can use to put the whole family on a stress-reduction diet for the holidays.


Be honest, but be reassuring.  It may be tempting to take this opportunity to over share with your teen and unload all your adult problems, worries, and concerns onto your teens.  Resist that temptation by remembering that even if they are taller than you or have a moustache, they aren’t adults yet and don’t need to be burdened with adult issues.


Institute a 2 minute breathing break a couple times a day where the whole family gets together and focuses on breathing.  Just a couple minutes of deliberate, mindful breathing can wash away worry and alleviate accumulated stress.


With all the holiday hustle and bustle, it is easy for everyone to get out of the habit of exercising.  Since exercise is great for soothing stress, get everyone moving by turning on their favorite music and daring them to dance.  Get off the couch and go for a walk or rearrange the living room, just get everyone moving and burning off some of their stress.


The holidays are a time of giving, but often that means giving presents.  Holiday stress over how many presents they will get, who will get the most, what they want that they won’t get, and feeling guilty for wanting things the family cannot afford can be soothed with a simple shift in priorities.  Take time out of shopping and shipping to volunteer as a family at a soup kitchen, homeless shelter, nursing home, or any other venue that allows everyone in your family to give some of themselves and change their outlook on the holiday season.