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Expert Q&A

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Could first-grade traumas cause PTSD?

Asked by Elissia Cave, Nebraska

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I was bullied when I was in the first grade really badly, and on the last day that year (the end of the year was when it was at the worst), my sisters and I were taken from school and put into foster care for over a year because our parents had been neglecting us. I've been researching it, and I think I'm exhibiting symptoms of post-traumatic stress disorder. Would what happened to me be traumatic enough to cause PTSD?

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Mental Health Expert Dr. Charles Raison Psychiatrist,
Emory University Medical School

Expert answer

Dear Elissia,

Your question reminds me of a line from one of my favorite poets, Rainer Maria Rilke, who said, "Don't think that fate is more than the density of childhood." I know many people both personally and professionally who have spent their adult lives haunted by the pains of childhood. Increasingly, psychiatry is recognizing that these types of everyday -- but horrible -- experiences can lead to post-traumatic stress disorder, depending on their severity and the vulnerabilities of the people involved.

Your case is especially painful to hear because I am sure that the horrors of the bullying you experienced were heightened immeasurably by the fact that your parents were unable to provide the type of support, both practical and emotional, that might have made all the difference. That you were placed in foster care unequivocally demonstrates that their lack of support was no figment of your childhood imagination.

We now know beyond a shadow of a doubt that childhood is a time of especial vulnerability to stress and that stress encountered during this period has the ability to program a person's brain and body to be on "high alert" for the rest of their lives.

This high alert status might have been protective in the distant past, when a painful childhood honestly signaled that the rest of one's existence was likely to be a dangerous one. Nowadays, however, this high alert status doesn't seem to be of any benefit and, in fact, exacts a terrible cost in terms of all sorts of mental disturbances and physical illnesses.

I do a great deal of research with foster children, and I can tell you from this experience and from many other lines of evidence that the experience of going into foster care can be a horrendously stressful experience in and of itself. Even if parents are neglectful, children are programmed by nature to cling to them. In fact, the more neglectful the parents, the more clingy the kids and the more painful the separation, even if that separation is needed for the child's safety.

So I can tell from your brief question that you have a great deal of pain in your childhood. Whether the troubles you struggle with now are best considered as PTSD or as depression or another condition is a question for your mental health professional. The important point for now is that you should not be surprised that you are still struggling with the losses and hurts of your early years. Finally, the good news is that a number of effective treatments exist that won't fix the past but can markedly improve the future.

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