Publication:

Post - 2021-07-21

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Children are vulnerable to post-traumatic stress

COMMENT

DR ANUSHA LACHMAN Lachman is a child psychiatrist and board member with the South African Society of Psychiatrists.

THE continuous civil unrest, looting and violence gripping parts of our country could see a spike in post-traumatic stress disorder (PTSD) among children, even those not directly impacted. Children are highly susceptible to fear and feeling overwhelmed, as they witness the unsettling current events through social media and the news, and through adult conversations. Parents and caregivers play the most crucial role in assisting children to deal with the current uncertainty. They need to recognise that children, simply hearing about the violence and observing adults’ responses to the situation, could cause a child to become more anxious and traumatised. Feeling out of control There is ongoing trauma, fear and helplessness across the country. Parents are traumatised by what is happening, and are largely helpless onlookers to the destruction and violence. The trouble is that, amid the sense of helplessness, people look for ways to be more in control. One of the ways is to “doom scroll”, seeking constantly to be informed, sharing videos, voice notes, photos, etc, anything that is recording and keeping track of the ongoing unrest. However, these constant reminders can re-traumatise parents. It reinforces their sense of a lack of control because they are unable to act. Not being able to prevent, and to witness people getting away with, the destruction becomes more traumatising. Many parents and grandparents recall the same kind of helplessness and fears, leading up to the 1994 unrest and curfews in KZN, as well as fears of civil unrest around the first democratic elections. Witnessing the current riots and looting could result in flashbacks for many adults. The challenge for parents is how to remain vigilant without re-traumatising themselves – and thereby exposing their children to trauma. Adults can limit exposure to news, social media updates and WhatsApp messages doing the rounds and, importantly, recognise the role they play in their children’s lives. As the caregivers, they are meant to buffer children and adolescents, filtering news and supporting children to prevent further trauma. This is challenging if parents are themselves traumatised. However, there should be an awareness that children need to be restricted from controllable exposures, such as the news and social media. While they cannot be protected or prevented from witnessing things in the environment, they can be prevented from hearing about it or seeing it on other platforms. As parents continue to talk and express distress about that which is out of their control, there must be an active attempt to prevent children from being traumatised unnecessarily. What is PTSD PTSD is triggered during a traumatic event, such as the reality in our country at the moment, and can manifest either immediately after or during a stressful event, or even after six months or more. It can also result in anxiety and depression in the long term. PTSD is a result of something happening to a child, to someone close to them or being exposed to adult conversation, social media, news, or through a video. It’s important to note that children do not have to be directly involved in the events for them to be traumatised and that heightened anxiety is not only limited to those children physically exposed to the violence and disruption. Children and adolescents may feel a lot of emotional and physical distress when exposed to situations of trauma or reminders of traumatic events. They may relive these events, even if they were not directly involved, as a result of repeated exposure to reminders on television, adults talking about the situation or through social media. PTSD symptoms include nightmares, flashbacks, poor sleep, disturbing memories and anxiety-related behaviour, such as being more clingy, jittery, nervous, more alert or on guard. Other behaviours include feeling depressed, being grouchy, having trouble focusing, worrying about safety, fearing death, having trouble feeling affectionate, aggression, or avoiding going outside or staying away from situations that can trigger memories of the trauma. Not every child or teenager, exposed directly or indirectly to trauma, will suffer from PTSD. Diagnosis by a mental health professional is only made once the symptoms present themselves for a month or more. However, they can experience acute stress reactions and symptoms can persist for months after the trigger. What can parents do to prevent PTSD during this stressful time? Admit that the event happened. Acknowledge the reality of being scared, worried or upset. Do not pretend that this is all normal. Rather, focus on the positives, such as the help from police and other groups, how communities are working together and supporting each other, and that the situation is improving. Even though, as an adult, you might feel frustrated that the help and protection offered is perhaps not enough or quick enough, it is helpful to communicate the optimism of support, especially as children rely on adults to take care of them. Share that the situation is anxietyprovoking for everyone and be supportive that there is expected anxiety and fear. Offer support/help/ counselling through connections such as the South African Depression and Anxiety Group, a psychologist or your GP. Provide structure. Children are already lacking routine due to the lockdown and extended school closures. Try to provide structure by scheduling activities indoors, such as watching a movie together, building puzzles, cooking, baking, and arts and crafts – so as to move them away from focusing on the trauma. Encourage children to express their fears openly by talking, drawing and writing, and encourage connection online with friends and family. Focus on the positive. You and your child/children are safe, they have a home/shelter and food. If they worry about food shortages, focus on everyone being in the same situation and remind them that there are many organisations/NPOs and people across the country that are stepping in to help and keep children safe and fed. Allow children to feel that they can also help. They can post creative messages of care, collect food for donations or join you as you assist with clean-ups in communities impacted. To foster a sense of purpose, children can also collect toys, games and stationery for less privileged children, and distribute these in communities most hard-hit. Look after your own mental health. If you need help, seek assistance from your GP or other professional or a close friend. Do not share your anxiety with your children. Rather be the one seeking help and become a role model for your child in acknowledging the need for help. Take concerns of depression, suicide and anxiety seriously, and contact a professional immediately for support.

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