PTSD Can Lead to Aggression in Teens

PTSD is becoming increasingly common among teen populations, with studies showing that anywhere from 15-43% of children experience at least one trauma in their lives. Of these children, 3-15% of girls and 1-6% of boys develop PTSD. PTSD has been linked with aggressive and impulsive behavior that can have harmful impacts on all its victims, so it’s essential to learn what to look for and how to help your teens through this difficult period.

What is PTSD and how does it develop?

PTSD is a recognized condition under the Diagnostic and Statistical Manual of Mental Disorders that stems from experiencing some type of trauma. It can be defined as a set of symptoms such as feeling jittery, having sleeping problems, or trouble concentrating after experiencing something that is upsetting, harmful, or terrifying.

There are many different types of traumatic experiences that can be the catalyst for developing PTSD in teens. PTSD can develop after someone is seriously injured or threatened with injury or death, and it can also develop after witnessing something traumatic such as an unexpected death or violent injury to a close family member or friend. Other common traumatic events include violent assault, physical or sexual abuse, natural disasters, and car accidents. PTSD can also happen through something called traumatic stress, which is ongoing exposure to traumatic events or environments such as growing up in a dangerous neighborhood or living in poverty.

When someone experiences a stressful or dangerous situation, the body responds by producing hormones and chemicals that are triggered by the human “fight or flight” response. Typically once the danger has subsided, the body returns to its normal state. However, when someone who experiences trauma develops PTSD, her response system doesn’t return to normal as it should after the perceived threat goes away, resulting in a constant state of hypervigilance.

If your child has developed PTSD in response to experienced trauma, he is most likely working through extreme emotional, physical, and mental distress. Symptoms of PTSD can emerge right away after the trauma, as soon as three months after the event, or it can take several years for symptoms to emerge. Three common categories of symptoms teens with PTSD may experience are re-living the trauma, avoidance, and increased agitation.

For teens re-experiencing their trauma, they may continue to mentally relive the event over and over again. This can include having intense flashbacks or nightmares of the experience and can even include hallucinations in which he can experience smells or sounds from the event. PTSD individuals cannot escape these intrusive thoughts and they may feel the need to verbally hash out the event or subconsciously engage in similar experiences. Conversely, some PTSD victims may deliberately avoid any thoughts, locations, people, or experiences that may remind them of the trauma. In this case, teens may have difficulty remembering details about the event as their brains may have repressed the experience. These teens often become numb to their feelings and experiences as a coping mechanism.

Lastly, a major symptom of PTSD in teens can be increased agitation. This can make teens feel constantly on guard in case the trauma were to happen again or another dangerous situation were to occur. Related symptoms include being easily startled or frightened, struggling to fall and stay asleep, difficulty concentrating on routine tasks, and experiencing outbursts of anger. This increased agitation can lead to aggressiveness and other behavioral issues in teens.

How PTSD leads to aggression and other behavioral issues

Due to neurological changes in the brain, some individuals with PTSD can engage in aggressive and other equally damaging behavior as a way to process their trauma. A 2020 study by JNeursci found that traumatic stress can cause aggression by strengthening two brain pathways involved in emotion. Trauma can cause unknown changes to the amygdala, which is an almond-shaped structure that plays an essential role in emotion, social behaviors, and aggression. When the amygdala circuits are changed in the brain, aggressive activity is found to increase both in frequency and length of attacks.

While researchers are unable to determine the cause of amygdala modification, they have postulated that this aggressive behavior is a direct response to the fight or flight response. When teens with PTSD become hyper-aroused due to perceived threats in their environment, they are likely to feel trapped or anxious and their survival mode instincts kick in. This can present as outbursts of anger, self-destructiveness, or verbal threats as a way to protect their own safety. Teens who experience this facet of PTSD will often report that these behaviors feel out of their control and that they weren’t intending to hurt themselves or others.

Research has supported the link between PTSD symptoms and aggression particularly among victims of interpersonal trauma such as abuse or assault, but a 2017 study concluded that this reaction can occur in non-violent trauma experiences as well such as a natural or manmade disaster. For 135 children who survived a residential fire, data analysis supported the hypothesis that those who re-experience trauma with higher severity are predictive of higher levels of aggression.

In addition to more aggressive behavior, PTSD can also increase the risk of additional behavioral issues in teens. Teens with PTSD are more prone to impulsive behavior in general, which occurs when teens act without thinking about it, without being able to control it, and without being able to understand what will happen as a result of the behavior. Serious impulsive behaviors can include extreme overeating, using alcohol and drugs, and deliberate self-harm or suicide.

Eating disorders are common among people who have lived through traumatic experiences and developed PTSD. Childhood sexual abuse is one of the most likely types of trauma that can put teens at risk for this type of behavior. Those with PTSD are 3 times as likely to develop bulimia nervosa. Bulimia involves impulsive periods of binge eating following my compensatory methods of purging such as vomiting, using laxatives, or excessive exercise. Anorexia can also occur, in which teens experience deliberate daily starvation and an intense fear of gaining weight.

Another common impulsive behavior found in teens with PTSD is substance use and abuse. One study found that almost 50% of those with PTSD also struggled with some type of alcohol or substance disorder. Researchers suggest that this can be the case as victims of PTSD try to self-medicate to avoid intense and distressing symptoms of their disorder.

Lastly, teens with PTSD can engage in self-destructive behaviors including self-harm and attempted suicide. Those who self-harm impulsively cause damage to their bodies but they aren’t trying to end their lives. Types of self-harm can include cutting and burning. People with PTSD also have a higher risk of attempting or committing suicide because of the constant fear, isolation, and depression they experience. Due to the massive risks associated with PTSD in teens, it’s crucial to get them treatment and support as soon as possible.

Ways to help your teen struggling with PTSD

There are many strategies you and your teen can use to help him manage the anger and impulsive feelings he’s experiencing as a result of his PTSD. Try these tips to help reduce aggressive and irritable thoughts and behaviors:

1. Build an anger management toolbox – Anger can be very difficult to manage, especially if you feel out of control. Rather than trying to push the anger aside, it can be helpful to learn useful anger management techniques such as exercise, practicing mindfulness, and finding a trusted confidant to talk things out with.

2. Take “Time-Outs” – Work with your child to take self-directed time-outs when they feel themselves starting to get angry. This includes developing a time-out plan where they have specific steps to take when feeling anger to prevent doing and saying things they’ll regret.

3. Seek support groups – Talking with peers who have experienced similar traumas can help teens get their emotions out, prevent anger from building up inside, and help them see various perspectives. Support groups for PTSD are widely available in most areas and can be a great way to help your teen through her emotional challenges.

4. Validate angry feelings – Instead of trying to rid your teen of all anger, validate that anger is a normal human response, particularly after experiencing trauma. The goal of managing anger should be for teens to make peace with it and use it in a healthy way. These feelings deserve to be explored, not punished.

Teens who are experiencing PTSD can also benefit tremendously from wilderness treatment facilities like Trails Carolina.

Trails Carolina can help

Trails Carolina is a renowned wilderness therapy program that was established to provide clinical excellence along with a therapeutic wilderness setting to deliver lasting, positive change for families. Our program is based on three foundational beliefs that guide everything we do: A wilderness setting enhances the benefits of therapy, lessons learned in this environment teach adaptability and resilience, and families benefit from the involvement in the therapy process.

We have programs designed for pre-teens ages 10-13, adolescents ages 13-17, and young adults 18-25. Our clinically proven methods work exceptionally well with depression, anxiety, trauma, social isolation, and substance abuse. Our programming is designed around transitions and healing the entire family. We want your child to practice their newfound skills in a variety of challenging environments, building resilience that will allow them to easily carry these positive behaviors into the real world. For more information about how Trails Carolina can help, please call 828-372-4725.

Avatar of Jeremy Whitworth

Jeremy Whitworth

As Executive Director at Trails Carolina, a leading wilderness therapy program for youth and teens, I oversee operations and collaborate with our leadership team. Since 2022, I've also hosted the Common Ground Podcast for parents: With a background in Wilderness Leadership and Experiential Education, I've managed adventure-based therapeutic programs across the US and Canada. My experiences in competitive athletics and adventure sports have honed my leadership, risk assessment, and decision-making skills, which I apply to running a successful business like Trails Carolina.

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Great life changing experience for our son. After becoming addicted to gaming during covid he was very depressed. At Trails he experienced the wilderness, Science Steve, learning survival skills and top notch therapy and support etc… I highly recommend! This gave our son and our family a renewed family bond full of love and excitement about his bright future.

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