Grief and Loss and Trauma
Unfortunately, PTSD and grief often go hand in hand. Five years ago, I was referred a client for an anxiety disorder. However, it became clear pretty quickly that she was actually dealing with PTSD. She had a separate therapist for grief because she had lost her father to cancer. Tragically, his illness had been a long and difficult battle. At times, he wasn’t aware of who his family members were. He experienced many physical indignities, some of which were witnessed by his children. Sadly, it was cancer at its worst.
Eventually, this client’s PTSD symptoms began to show. They were connected to witnessing the suffering her dad endured. So, not only did she have tremendous grief to work through, but she also experienced nightmares, startle responses, avoidance, and hypervigilance related to the healthcare system. One day, a grandparent went into the hospital. When the client came to her therapy session, she had a complete panic attack at the thought of visiting.
When your teen is dealing with trauma related to the situation that caused a loss, they may struggle to even begin the grieving process. Sometimes, the act of grieving can trigger a trauma response, making it difficult for your teen to process either experience.
What Causes PTSD?
By technical definition, PTSD can occur when someone witnesses an event involving immense suffering or the potential death of themselves or someone close to them. A traumatic response can develop after the event, with symptoms typically appearing within the first few months.
For the first month after a traumatic event, the condition is called Acute Stress Disorder. If symptoms continue beyond that point, the diagnosis may become PTSD.
If your teenager loses someone close to them, they may develop PTSD related to the circumstances surrounding the death. However, most teenagers do not develop PTSD after losing someone they love, so it is important not to assume they are traumatized just because they have lost someone. Grief is a natural response to loss, while trauma involves a more intense and ongoing stress response that continues after the event.
What Are Some Symptoms of PTSD?
Adolescents with posttraumatic stress can experience a mixture of symptoms. Common ones include nightmares, flashbacks, hypervigilance, panic attacks, trouble sleeping, difficulty concentrating, and guilt or shame.
One of the first things I notice as a therapist who treats PTSD is strong avoidance of certain situations. For example, in the case of the client from the beginning of this post, she strongly avoided doctor’s offices and especially hospitals.
For a teen experiencing PTSD and grief, these symptoms can make the grieving process even more difficult. They may want to remember and talk about the person they lost, but reminders of the loss can also bring up the traumatic experience.
What Do I Do If My Teen Has Grief and Traumatic Stress?
You get help. When PTSD and grief occur together, things can become complicated. PTSD responds to treatment, but treatment can be complex, especially when your teen is also trying to process a major loss.
Thankfully, when a therapist helps your teen calm their mind and body instead of remaining stuck in a constant stress response, they can begin the grieving process. Working through some of the grief can also reduce the guilt and anxiety that often come with PTSD.
How Is PTSD Treated?
There are several effective approaches for treating PTSD. At Teen Therapy OC, we primarily use EMDR, Cognitive Processing Therapy, and Flash Treatment. The best approach depends on your teen’s symptoms, personality, history, and comfort level with treatment.
First, we use EMDR, which is usually provided by Carrie Johnson. EMDR helps the brain process traumatic memories so they no longer feel as immediate, overwhelming, or emotionally charged. The goal is to help your teen develop new ways of understanding and responding to the trauma rather than becoming stuck in the same painful emotional patterns.
Second, we use CPT, or Cognitive Processing Therapy. Veterans with PTSD often use CPT, but it can also be effective for people who have experienced trauma outside of military service. CPT focuses on the thoughts and beliefs that can develop after trauma, including guilt, shame, self-blame, anger, and mistrust. As these thoughts become less powerful, PTSD symptoms may begin to decrease. Teens who complete the CPT protocol often show significant improvement in their PTSD symptoms. At Teen Therapy OC, Lauren or Mark provides this type of therapy.
Finally, we use Flash Treatment, which is provided by Diana Hong. Flash Treatment helps reduce the emotional intensity connected to a traumatic experience. It works quickly, is very gentle, and is highly effective.
PTSD and Grief Can Both Be Treated
When a teenager is dealing with PTSD and grief, it can be difficult for both the teen and their family to know where to begin. Your teen may be trying to cope with the loss of someone they love while also dealing with fear, anxiety, avoidance, nightmares, or panic. The good news is that your teen does not have to work through this alone. With the right support, they can begin to feel safer, process the trauma, and make room for their grief. Therapy cannot change what happened or take away the pain of losing someone. However, it can help your teen feel less controlled by the trauma and more able to remember, grieve, and move forward.
Call If You’re Unsure
If you are reading this post, your family may have been through something incredibly difficult. Our hearts go out to you and your teen.
If you are unsure whether your teen is experiencing acute grief, PTSD, or both, please feel free to call and talk with us about your situation. We can help you consider whether therapy may be appropriate for your family.
Helping teens grow and families improve connection,
Lauren Goodman, MS, MFT