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What Is Secondary PTSD? Recognizing It In Teens


teen with PTSD

Post-traumatic stress disorder (PTSD), as defined by the Mayo Clinic “is a mental health condition that’s triggered by a terrifying event—either experiencing it or witnessing it.” PTSD listed in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) under the new category called Trauma- and Stressor- Related Disorders. Secondary PTSD, also known as vicarious trauma, secondhand trauma and PTSD by proxy, is the emotional distress that results when a teenager hears about the first-hand trauma experience of another person (e.g. family member, close friend, neighbor, stranger on the news, etc.). Teenagers are highly emotional beings, and as such can experience deep and powerful feelings, especially in connection to indirect exposure to trauma. 

Risk Factors

Some adolescents are more likely to suffer from secondary PTSD than others. Common risk factors include, but are not limited to the following, as provided by National Child Traumatic Stress Network (NCTSN):

  • Mental health complications prior to hearing about the trauma
  • Greater geographical proximity to the event
  • Gender: females are at increased risk
  • Lacking social support networks
  • Acquaintance with those involved in the trauma
  • Emotional dysregulation 

It is important bear in mind that not all teens with one or more of the above risk factors will undoubtedly go on to develop secondary PTSD. 

Signs and Symptoms

There are many possible signs and symptoms that could manifest as a result of secondary PTSD. Some examples could include, but are not limited to, any combination of the following, as provided by the Boston Children’s Hospital:

  • Fear
  • Sleeplessness
  • Anger
  • Hopelessness
  • Chronic exhaustion
  • Physical ailments
  • Agitation
  • Depression 
  • Reckless behaviors
  • Regressions
  • Irritability
  • Isolation
  • Hyper vigilance
  • Irregular sleep
  • Difficulty with physical contact
  • Anxiety
  • Difficulty concentrating
  • Low self-esteem
  • Constant feelings of fear and worry
  • Experiencing crying spells
  • Tense muscles
  • Social anxiety

They signs and symptoms associated with secondary PTSD typically mimic those that present with post-traumatic stress disorder. 

Next Steps

If you feel that your teen is struggling from secondary PTSD it is best to obtain guidance from a qualified mental health provider. Often the symptoms of secondary PTSD can interfere with a teen’s ability to function in his or her daily life. There are several coping strategies (e.g. writing in a journal, engaging in regular exercise, listening to music, spending time with friends, etc.) that could help a young person learn to assuage his or her symptoms of secondary PTSD. For teens that may require additional support, meeting with a therapist could be advantageous. At Pacific Teen Treatment, we work with the teen to create a tailored treatment plan to help heal all aspects of the teenager. The main types of psychotherapy that are commonly used to treat both PTSD and secondary PTSD include cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), expressive arts therapy, and talk therapy. If your teen is experiencing secondary PTSD, he or she is likely in need of more effective coping strategies, and treatment with a mental health professional can help your teen cultivate these needed skills.  

For Information and Support

Seeking help is never easy, but you are not alone! If you or someone you know is in need of mental health treatment, we strongly encourage you to reach out for help as quickly as possible. It is not uncommon for many mental health difficulties to impact a person for the long term. The earlier you seek support, the sooner you and your loved ones can return to happy, healthy and fulfilling lives.

Our admissions team is available to answer any general questions regarding mental health issues, treatment, and/or specific questions about the program at Pacific Teen Treatment and how we might be able to help your family. We can be reached by phone 24/7 at 800-531-5769. You can also contact us via email at

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