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Expert Q&A

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Should I force my teen to get help after trauma?

Asked by Aurora Benson, St. Louis, Missouri

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My 17-year-old son, Will, lost his best friend two weeks ago; his friend killed himself in a very, very unexpected suicide. His friend was on the phone with my son, and evidently the friend told my son that he was going to kill myself. My son tried to stop him, but the kid shot himself. My son heard it all. My son is showing signs of PTSD along with depression -- nightmares, anger and irritability -- and he's had at least two panic attacks. I know he needs help that I can't provide, but he adamantly refuses. What can I do? Should I force him to see a psychologist?

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

Expert answer

Dear Aurora,

I am so sorry to hear about the pain both you and your son have had to endure. This is a real triple tragedy when the death of your son's friend is taken into account.

Not everyone will agree with me on this, but I think that yes, you should probably force your son to go see a mental health professional. Even though he is almost an adult, he is likely not to be in the most reasonable state of mind, given what he's been through, and this is a time when it is so imperative for him to get help.

When something this horrible and traumatic happens to someone, there is a fairly predictable sequence of symptoms that emerge. First comes a condition known as acute stress disorder -- typified by many of the symptoms you describe in your son, but also feelings of spaciness and unreality. If not resolved, these symptoms often progress to post-traumatic stress disorder, or PTSD, which is a chronic condition characterized by re-experiencing the traumatic event, avoiding reminders of the trauma, and increased anxiety and emotional arousal.

The reason I urge you to intervene in your son's situation is because the longer his symptoms persist, the more likely he is to develop long-term, disabling difficulties. Treating PTSD-type symptoms as rapidly and as fully as possible is absolutely the best way to deal with the situation. In fact, recent studies suggest that medications that block the stress response can actually prevent PTSD symptoms from developing in the first place, if they are given immediately after the trauma.

Given what has happened to your son, he well need both therapy and medication treatment. He will need to work through what happened to put it behind him. But given how significant his symptoms are, he will most likely to benefit from medications that can turn down the heat of his heartbreak and upset.

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