Causes of PTSD: Bullying
With an estimated prevalence rate of 32% in schools and 30% in workplaces, bullying remains a complicated and devastating epidemic in the UK – and it’s prevalence is further increasing through cyberbullying.
Experts agree that bullying generally entails three key elements:
- an intent to harm
- a power imbalance
- repeated acts or threats of aggressive behaviour
and can be defined as a ‘long-lasting and systematic form of interpersonal aggression where an individual is persistently and over time exposed to negative actions from superiors, co-workers or other students, and where the target finds it difficult to defend her-/himself against these actions.’
These negative actions can take the form of verbal hostility, aggressive behaviour, threats, physical violence, inappropriate comments, spreading rumours, social exclusion, and much more.
Many people view childhood bullying as ‘just teasing’ or ‘something to just ignore’ despite the severe long-term effects of bullying being relatively well documented.
Research has shown that 40.5% of girls and 27.6% of boys show PTSD symptoms at the time of being bullied, and approximately 20% of people who have been bullied experience some kind of mental health problems later in life, and an increased risk of suicide and substance abuse.
How can bullying cause PTSD?
Post-Traumatic Stress Disorder (PTSD) is a condition that some people develop after experiencing or witnessing a traumatic event. The defining characteristic of a traumatic event is its capacity to provoke fear, helplessness, or horror in response to the threat of injury or death and therefore can affect anyone, including victims of bullying.
Studies have shown that ‘experiencing bullying is the strongest predictor of developing PTSD symptoms. This surpassed physical abuse, neglect, and exposure to community violence. Another literature review examining 29 relevant studies on bullying and harassment found that 57% of victims scored above the threshold for meeting PTSD criteria.’
‘When you are a victim of bullying or harassment, you can experience a wide range of emotions, ranging from mild embarrassment to extreme fear as a result of being in danger where your safety is compromised. Bullying is a distinct social stressor because it represents a systematic form of interpersonal aggression coupled with intense feelings of powerlessness and defencelessness’ – a ‘perfect storm’ for PTSD to develop.
‘When a person is repeatedly bullied or harassed, they experience continued negative reinforcement, systematic abuse of power, and ongoing intimidation and emotional pain. And those who are bullied as children tend to have a greater risk of being bullied in their adult lives. The characteristic symptoms that develop as a result of bullying (feelings of powerlessness, helplessness, anger, fear) are also strongly correlated with that of PTSD, making it more likely that a person who was bullied would develop the disorder.’
It’s worth noting too, that PTSD can also be caused by an ‘accumulation of many small, individually non-life-threatening incidents’ – which is sometimes the case with bullying – and this is often referred to as Complex PTSD (C-PTSD). ‘With complex PTSD, victims are “held captive” by their situations. Children who are subject to regular bullying may not have any way out of what they perceive as a trapped situation. Reporting incidents to teachers or other authority figures can be a daunting prospect, as this sort of “tattletale” behaviour is so apt to exacerbate the bullying instead of halting it.’
How to spot PTSD in children as a result of bullying
While PTSD symptoms are similar in adults and children, there are a few things that are different – especially if it’s a result of bullying.
School-Aged Children (Ages 5–12)
‘Children often do not have flashbacks or problems remembering parts of the trauma or bullying the way adults with PTSD often do. But, they might put the events of the bullying in the wrong order. Kids also might believe that there were signs that the bullying was going to happen. As a result, they believe that if they pay attention they can avoid future issues of bullying. This belief can cause hypervigilance.
Sometimes kids will show signs of PTSD in their play. For instance, they might keep repeating a part of the trauma over and over while playing. While they may be playing this way to try to overcome or make sense of what they experienced, they will not be successful in alleviating their distress. Unfortunately, this type of play will rarely diminish their worries. Kids also may fit parts of the trauma into their daily lives. For example, a child might carry a baseball bat to school for protection especially if a bully threatened him with a baseball bat.
Teens (Ages 12–18)
Because teens are approaching adulthood, some PTSD symptoms in teens begin to look like those of adults. For instance, they may have upsetting thoughts or memories, recurring nightmares, flashbacks, and strong feelings of distress when reminded of the event. The one difference is that teens are more likely than younger children or adults to show impulsive and aggressive behaviours. What’s more, even though kids may be plagued by thoughts of painful experiences, this does not mean they are easily observable. In fact, kids often suffer in silence.
In addition to PTSD, children, and teens often experience other effects of bullying including fear, worry, sadness, anger, loneliness, low self-worth, inability to trust others, depression, and sometimes even thoughts of suicide.’
Bullying in the workplace
As we’ve mentioned, bullying doesn’t just affect children at school – and as adults, it can be dismissed or excused so easily by people saying things like ‘it’s just his robust management style’ to ‘it’s just a bit of banter’.
Workplace bullying is defined as ‘repeated, unreasonable actions of individuals (or a group) directed towards an employee (or a group of employees), which are intended to intimidate, degrade, humiliate, or undermine; or which create a risk to the health or safety of the employee(s). It is a systematic campaign of interpersonal destruction that can jeopardise your health, your career and your confidence.’
A recent survey sponsored from TUC found that ‘1 in 3 employees felt they had been bullied at work and 30% have witnessed bullying in the workplace. Bullying currently causes the loss of 18 million working days every year at a cost of £13.75 billion a year to the UK economy, from sickness related absences, staff turnover and the reduction of productivity.’
Treatment for PTSD following bullying
It is possible for PTSD and C-PTSD to be successfully treated many years after the traumatic event occurred, which means it is never too late to seek help, even if your PTSD is a result of bullying when you were much younger.
For some, the first step may be watchful waiting, then exploring therapeutic options such as individual or group therapy. NICE guidance (updated in 2018) recommends trauma-focused psychological treatments such as EMDR, and trauma-focused cognitive behavioural therapy (CBT). You may also want to explore holistic non-pharmacological therapies, or talk to your doctor about treatment with appropriate prescription drugs.
Traumatic events can be very difficult to come to terms with, but confronting and understanding your feelings and seeking professional help is often the only way of effectively treating PTSD and C-PTSD.
It’s worth noting too, that many victims of bullying with PTSD also benefit from ‘complementary therapy methods that help improve their sense of self-esteem and well-being’. Generally, this is because ‘bullying and harassment can severely impact a person’s confidence, it is essential that they learn the appropriate tools for rebuilding a positive perception of themselves’ alongside getting treatment for their PTSD.
What should I do if I think I, or my child, has PTSD?
The only way to know for sure, and get a formal diagnosis of PTSD is to talk to a medical professional.
In the UK, this usually begins with a trip to your GP. They will ask about your symptoms, how you’ve been feeling, and perhaps ask a little about your trauma (if you feel comfortable discussing it).
Your GP will be mindful of PTSD if you’ve experienced a trauma and have:
- re-experiencing symptoms
- avoidance symptoms
- arousal and reactivity symptoms
- cognition and mood symptoms
If they suspect PTSD, it’s likely they would then refer you to your local community mental health team for an appointment to get a full diagnosis and to discuss treatment options further. There are a number of mental health specialists you may see if you have PTSD, such as a psychologist, community psychiatric nurse or psychiatrist. Find out more about what to do if you think you have PTSD here.
You can get more information about PTSD in children here.
What can be done to prevent bullying?
It goes without saying that prevention of bullying in schools and workplaces can reduce traumatic experiences and therefore PTSD development.
In terms of schools, ‘this takes a vigilant approach on the part of parents and especially on the part of school administrators, as school is the most common place that children experience the harassment of bullying.’
Additionally, it’s important to note that if bullying reports go ignored or dismissed, children may also feel they have no support from teachers, parents, or other authority figures. As PTSD is more likely to develop if the trauma produces feelings of helplessness it’s vital that any reports are investigated and dealt with as quickly as possible.
With regards to workplaces, one study showed ‘43% of those bullied at work reported that harassment stemmed from a line manager, with 38% saying that it came from colleagues. One in five had suffered bullying from a senior manager or chief executive’ so it can feel very difficult to report bullying to your employer.
As bullying affects the overall “health” of an organisation, fostering ‘a culture that is free from bullying behaviour is vital and needs to come from the top down. Management commitment is the most important component of preventing bullying in the workplace and is best demonstrated through a robust policy structure which is communicated to all staff.
Bullying and harassment can be verbal, non verbal, written, or physical so your policy should be comprehensive and one that covers a range of incidents, from bullying and harassment to physical violence.’
For more information and support from bullying, there are a variety of charities and organisations including:
BullyingUK is a leading anti-bullying charity in the UK. The charity provides practical information and advice to young people and their parents through its website and via email. Their support includes work with schools, youth organisations, police forces and health trusts, running workshops and speaking at conferences.
ChildLine is the UK’s free, 24-hour confidential helpline for children and young people who need to talk. Trained counsellors are there to provide comfort, support and advice about any problem that’s on your mind. Contact them 24 hours a day, every day, by phone or via their website. Helpline: 0800 1111 (calls are free from all existing networks – landline and mobile)
The Cybersmile Foundation offers support, advice and guidance to people of all ages who have been affected by cyberbullying and online hate campaigns. Their services are used by schools, parents and young people all over the world and the helpline is open 24 hours.
BulliesOut was established in May 2006, we are one of the UK’s most dedicated and ambitious anti-bullying charities. Our award winning work is delivered across the UK and each year, through our work with individuals, schools, youth and community settings and the workplace, we provide education, training and support to thousands of people. Through our innovative, interactive workshops and training programmes, we use our experience, energy and passion to focus on awareness, prevention, building empathy and positive peer relationships all of which are crucial in creating a nurturing environment in which young people and adults can thrive.
Idsoe, T., Dyregrov, A. & Idsoe, E.C. Bullying and PTSD Symptoms. J Abnorm Child Psychol 40, 901–911 (2012). https://doi.org/10.1007/s10802-012-9620-0
Morten Birkeland Nielsen, Tone Tangen, Thormod Idsoe, Stig Berge Matthiesen, Nils Magerøy, Post-traumatic stress disorder as a consequence of bullying at work and at school. A literature review and meta-analysis, Aggression and Violent Behavior, Volume 21, 2015, Pages 17-24, ISSN 1359-1789, https://doi.org/10.1016/j.avb.2015.01.001.
Plexousakis, S. S., Kourkoutas, E., Giovazolias, T., Chatira, K., & Nikolopoulos, D. (2019). School Bullying and Post-traumatic Stress Disorder Symptoms: The Role of Parental Bonding. Frontiers in public health, 7, 75. https://doi.org/10.3389/fpubh.2019.00075
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Treatments for PTSD
It is possible for PTSD to be successfully treated many years after the traumatic event occurred, which means it is never too late to seek help. For some, the first step may be watchful waiting, then exploring therapeutic options such as individual or group therapy – but the main treatment options in the UK are psychological treatments such as Eye Movement Desensitisation Reprogramming (EMDR) and Cognitive Behavioural Therapy (CBT).
Traumatic events can be very difficult to come to terms with, but confronting and understanding your feelings and seeking professional help is often the only way of effectively treating PTSD. You can find out more in the links below, or here.