What’s New in VA Caregiving?

When a Child’s Parent has PTSD
Submitted by:
Sonya Norman, Ph.D.
Director, PTSD Consultation Program
National Center for PTSD, White River Junction, VT
Assistant Professor, University of California San Diego School of Medicine

What is PTSD?
Post-Traumatic stress disorder, or PTSD, can occur after someone goes through, sees, or learns about a traumatic event like:

• Combat exposure
• Sexual assault/harassment
• Physical assault
• Child sexual or physical abuse
• Serious accident
• Natural disaster
• Terrorist attack

Most people have some stress-related reactions after a traumatic event. If the reactions don’t go away over time and they disrupt your life, you may have PTSD.

How might a parent’s PTSD symptoms affect his or her children?
PTSD includes a range of symptoms that can have an impact on family members. The following are some examples of how certain kinds of PTSD symptoms can affect children.

Re-experiencing symptoms
People who have PTSD often "re-experience" traumatic events through memories or dreams. This can happen quickly and can seem to come out of nowhere. These symptoms often come with strong feelings of grief, guilt, fear, or anger. Sometimes the experience can be so strong it may feel like the trauma is happening again. These symptoms can be scary for the person with PTSD and for their children. Children may not understand what is happening or why it is happening. They may worry about their parent or worry that the parent cannot take care of them.

Avoidance and numbing symptoms
Because the re-experiencing symptoms are so upsetting, people with PTSD try not to think about the event. People with PTSD may also try to avoid places and things that remind them of the trauma. Or they may not feel like doing things that used to be fun, like going to the movies or your child’s event. It can also be hard for people with PTSD to have good feelings. They may feel "cut off" from family and children. As a result, children may feel that the parent with PTSD does not care about them.

Hyperarousal symptoms
People with PTSD tend to be anxious and "on edge." With PTSD, people may have trouble sleeping or paying attention. They may be grouchy or angry much of the time. They may be easily scared, or overly worried about their safety or the safety of their loved ones. It is easy to see how these problems can affect family members. For example, acting grouchy can make a parent seem mean or angry. Since they do not understand the symptoms of PTSD, children may wonder whether the parent loves them.

How do children respond?
A parent’s PTSD symptoms are directly linked to their child’s responses. Children usually respond in certain ways:

• A child might feel and behave just like their parent as a way of trying to connect with the parent. The child might show some of the same symptoms as the parent with PTSD.
• A child may take on the adult role to fill in for the parent with PTSD. The child acts too grown-up for his or her age.
• Some children do not get help with their feelings. This can lead to problems at school, sadness, anxiety (worry, fear), and relationship problems later in life.

Children of Veterans with PTSD

Social and behavior problems
Some research shows that children of Veterans with PTSD are more likely to have problems with behaviors, school, and getting along with others. Their parents see them as more sad, anxious, aggressive, and hyper than children of Veterans who do not have PTSD. Some research has also found that PTSD in a parent is related to violence in the home and to children acting violent. But it is important to note that most Veterans have homes without violence.

How can Caregivers help?
Parents can help children by using the information provided in this fact sheet and other resources. Parents or professionals can talk to family members about the possible impact of a parent’s PTSD on children. It can help for family members to learn how traumatic reactions can be passed from parent to child.
 
A good first step in helping children cope with a parent’s PTSD is to explain the reasons for the parent’s difficulties. Be careful not to share too many details of the event(s) with the child. How much you say depends on your child’s age and maturity level. It is important to help children see that your symptoms are not their fault. Some parents want help with what to say to their children, and a counselor could help with this.

Treatment options
There are many treatment options. Treatment can include individual treatment for the Veteran or adult with PTSD as well as family therapy. Family therapy is where members of a family meet together with a trained clinician to obtain new information and skills to address difficult situations being faced by the family. Families often work on improving communication and solving problems so everyone will benefit.
 
Children may benefit from their own therapy as well, which might differ based on the child’s age. Each family is different, and decisions about what kind of treatment to seek, if any, can be hard. The most important thing is to help each member of the family, including the children, say what he or she needs.
 
More information on this topic is available at http://www.ptsd.va.gov/public/pages/children-of-vets-adults-ptsd.asp.