Every time an unexpected loss occurs or a frightening situation is encountered, one thing that should not be overlooked is psychological healing. Dr. Thiraphon Tangjitthiporn, a pediatric psychiatrist at the Child Health Center, Phyathai 3 Hospital, says that besides taking care of physical health as usual, caring for the mental state of those who have experienced traumatic events, whether children or adults, is equally important. Attention must also be given to the mental state of family members, friends, and others involved in the event.
What is PTSD?
Dr. Thiraphon explains that PTSD (Posttraumatic Stress Disorder) is a mental disorder that occurs after a person experiences a traumatic event, either as a victim or a witness, which impacts their own life, close ones, or through hearing about it from others. The symptoms last for more than one month after the event.
What symptoms qualify as PTSD?
People with this disorder will have the following psychological symptoms:
- Vivid memories or feeling as if the event is still happening (Re-experience) – may be expressed through drawing, playing, talking, recurring nightmares about the event, or related symbolic stories that may not be the exact event.
- Avoiding anything related to the event (Avoidant) – avoiding thinking or talking about the event, refusing to go to certain places. Therefore, asking children to recount the event directly or frequently questioning them about it may cause distress.
- Negative changes in mood and thoughts (negative in cognition) – loss of interest in play or activities, lack of interest in studying, irritability, feelings of guilt, or low self-esteem.
- Hyperarousal – problems with sleep, physical discomfort such as headaches, stomachaches, palpitations, numbness.
Which children are at higher risk of PTSD?
Dr. Thiraphon explains that children with higher risk factors include females, those who have previously experienced violence or severe violence, those with prior mental health issues, children with poor adjustment, and those lacking social support.
Symptoms vary due to these factors
Dr. Thiraphon says that when children experience frightening events, their emotional reactions differ depending on:
- The nature of the stressor causing the problem, such as stress or natural disasters. If the stress is manageable or perceived as low, emotional problems may be less severe.
- The child’s environment, such as family interactions, social support, and media, which can either help or worsen emotional problems.
- Individual factors of the child, such as personality, adaptability, and problem-solving skills. For example, in the Tham Luang cave incident, children’s emotional reactions ranged from being able to manage emotions, experiencing stress and adjustment disorders, developing PTSD, or major depressive disorder.
How to provide initial help and treatment
Initial help involves creating a calm environment to provide psychological stability, preventing re-traumatization, listening calmly, teaching stress-relief techniques, diverting attention from symptoms and the event, and ensuring the child is not alone but supported by family or friends.
Regarding treatment, Dr. Thiraphon says the medical principle is trauma-focused cognitive behavioral therapy. Medication is not necessary for every case; doctors will consider it based on symptoms affecting each child.
Dr. Thiraphon Tangjitthiporn
Pediatric Psychiatrist
Child and Adolescent Health Center, Phyathai 3 Hospital
