Post-traumatic stress disorder (PTSD) is an anxiety disorder that comes with difficult symptoms that interfere with everyday life. Some of these symptoms involve remembering or avoiding trauma associated with the cause of the person’s PTSD. This disorder comes with other symptoms as well, such as anxiety, nervousness, and negative thoughts.
It is common knowledge that physical trauma can cause PTSD. This could be the result of experiences such as war, physical assault, or sexual assault. It’s also possible for a natural disaster or other traumatic experiences to cause PTSD.
Yet, physical trauma is not the only cause of this disorder. PTSD can also develop due to emotional abuse and other emotion-based experiences. Professional treatment can help PTSD caused by any type of trauma.
But certain factors appear to make some people more likely to develop PTSD.
It’s not fully understood why some people develop the condition while others do not.
PTSD develops in about 1 in 3 people who experience severe trauma.
Types of events that can lead to PTSD include:
Post-traumatic stress disorder (PTSD) can develop after a very stressful, frightening or distressing event, or after a prolonged traumatic experience.
There may also be a genetic factor involved in PTSD. For example, having a parent with a mental health problem is thought to increase your chances of developing the condition.
If you have had depression or anxiety in the past, or you do not receive much support from family or friends, you may be more likely to develop PTSD after a traumatic event.
Why does it develop?
Although it’s not clear exactly why people develop PTSD, a number of possible reasons have been suggested.
Survival mechanism
One suggestion is that the symptoms of PTSD are the result of an instinctive mechanism intended to help you survive further traumatic experiences.
For example, the flashbacks many people with PTSD experience may force you to think about the event in detail so you’re better prepared if it happens again.
The feeling of being “on edge” (hyperarousal) may develop to help you react quickly in another crisis.
But while these responses may be intended to help you survive, they’re actually very unhelpful in reality because you cannot process and move on from the traumatic experience.
High adrenaline levels
Studies have shown that people with PTSD have abnormal levels of stress hormones.
Normally, when in danger, the body produces stress hormones like adrenaline to trigger a reaction in the body.
This reaction, often known as the “fight or flight” reaction, helps to deaden the senses and dull pain.
People with PTSD have been found to continue to produce high amounts of fight or flight hormones even when there’s no danger.
It’s thought this may be responsible for the numbed emotions and hyperarousal experienced by some people with PTSD.
Changes in the brain
In people with PTSD, parts of the brain involved in emotional processing appear different in brain scans.
One part of the brain responsible for memory and emotions is known as the hippocampus.
In people with PTSD, the hippocampus appears smaller in size.
It’s thought that changes in this part of the brain may be related to fear and anxiety, memory problems and flashbacks.
The malfunctioning hippocampus may prevent flashbacks and nightmares being properly processed, so the anxiety they generate does not reduce over time.
Treatment of PTSD results in proper processing of the memories so, over time, the flashbacks and nightmares gradually disappear.
Overview
Post-traumatic stress disorder (PTSD) is a mental health condition that’s triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.
Most people who go through traumatic events may have temporary difficulty adjusting and coping, but with time and good self-care, they usually get better. If the symptoms get worse, last for months or even years, and interfere with your day-to-day functioning, you may have PTSD.
Getting effective treatment after PTSD symptoms develop can be critical to reduce symptoms and improve function.
Symptoms
Post-traumatic stress disorder symptoms may start within one month of a traumatic event, but sometimes symptoms may not appear until years after the event. These symptoms cause significant problems in social or work situations and in relationships. They can also interfere with your ability to go about your normal daily tasks.
PTSD symptoms are generally grouped into four types: intrusive memories, avoidance, negative changes in thinking and mood, and changes in physical and emotional reactions. Symptoms can vary over time or vary from person to person.
Intrusive memories
Symptoms of intrusive memories may include:
- Recurrent, unwanted distressing memories of the traumatic event
- Reliving the traumatic event as if it were happening again (flashbacks)
- Upsetting dreams or nightmares about the traumatic event
- Severe emotional distress or physical reactions to something that reminds you of the traumatic event
Avoidance
Symptoms of avoidance may include:
- Trying to avoid thinking or talking about the traumatic event
- Avoiding places, activities or people that remind you of the traumatic event
Negative changes in thinking and mood
Symptoms of negative changes in thinking and mood may include:
- Negative thoughts about yourself, other people or the world
- Hopelessness about the future
- Memory problems, including not remembering important aspects of the traumatic event
- Difficulty maintaining close relationships
- Feeling detached from family and friends
- Lack of interest in activities you once enjoyed
- Difficulty experiencing positive emotions
- Feeling emotionally numb
Changes in physical and emotional reactions
Symptoms of changes in physical and emotional reactions (also called arousal symptoms) may include:
- Being easily startled or frightened
- Always being on guard for danger
- Self-destructive behavior, such as drinking too much or driving too fast
- Trouble sleeping
- Trouble concentrating
- Irritability, angry outbursts or aggressive behavior
- Overwhelming guilt or shame
For children 6 years old and younger, signs and symptoms may also include:
- Re-enacting the traumatic event or aspects of the traumatic event through play
- Frightening dreams that may or may not include aspects of the traumatic event
Intensity of symptoms
PTSD symptoms can vary in intensity over time. You may have more PTSD symptoms when you’re stressed in general, or when you come across reminders of what you went through. For example, you may hear a car backfire and relive combat experiences. Or you may see a report on the news about a sexual assault and feel overcome by memories of your own assault.
When to see a doctor
If you have disturbing thoughts and feelings about a traumatic event for more than a month, if they’re severe, or if you feel you’re having trouble getting your life back under control, talk to your doctor or a mental health professional. Getting treatment as soon as possible can help prevent PTSD symptoms from getting worse.
If you have suicidal thoughts
If you or someone you know has suicidal thoughts, get help right away through one or more of these resources:
- Reach out to a close friend or loved one.
- Contact a minister, a spiritual leader or someone in your faith community.
- Contact a suicide hotline. In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. Services are free and confidential.
- Make an appointment with your doctor or a mental health professional.
When to get emergency help
If you think you may hurt yourself or attempt suicide, call 911 or your local emergency number immediately.
If you know someone who’s in danger of attempting suicide or has made a suicide attempt, make sure someone stays with that person to keep him or her safe. Call 911 or your local emergency number immediately. Or, if you can do so safely, take the person to the nearest hospital emergency room.
There is a problem with information submitted for this request. Review/update the information highlighted below and resubmit the form.
From Mayo Clinic to your inbox
Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health.
ErrorEmail field is required
ErrorInclude a valid email address
To provide you with the most relevant and helpful information, and understand which information is beneficial, we may combine your email and website usage information with other information we have about you. If you are a Mayo Clinic patient, this could include protected health information. If we combine this information with your protected health information, we will treat all of that information as protected health information and will only use or disclose that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail.
Thank you for subscribing!
You’ll soon start receiving the latest Mayo Clinic health information you requested in your inbox.
Sorry something went wrong with your subscription
Please, try again in a couple of minutes
Causes
You can develop post-traumatic stress disorder when you go through, see or learn about an event involving actual or threatened death, serious injury or sexual violation.
Doctors aren’t sure why some people get PTSD. As with most mental health problems, PTSD is probably caused by a complex mix of:
- Stressful experiences, including the amount and severity of trauma you’ve gone through in your life
- Inherited mental health risks, such as a family history of anxiety and depression
- Inherited features of your personality — often called your temperament
- The way your brain regulates the chemicals and hormones your body releases in response to stress
Risk factors
People of all ages can have post-traumatic stress disorder. However, some factors may make you more likely to develop PTSD after a traumatic event, such as:
- Experiencing intense or long-lasting trauma
- Having experienced other trauma earlier in life, such as childhood abuse
- Having a job that increases your risk of being exposed to traumatic events, such as military personnel and first responders
- Having other mental health problems, such as anxiety or depression
- Having problems with substance misuse, such as excess drinking or drug use
- Lacking a good support system of family and friends
- Having blood relatives with mental health problems, including anxiety or depression
Kinds of traumatic events
The most common events leading to the development of PTSD include:
- Combat exposure
- Childhood physical abuse
- Sexual violence
- Physical assault
- Being threatened with a weapon
- An accident
Many other traumatic events also can lead to PTSD, such as fire, natural disaster, mugging, robbery, plane crash, torture, kidnapping, life-threatening medical diagnosis, terrorist attack, and other extreme or life-threatening events.
Complications
Post-traumatic stress disorder can disrupt your whole life ― your job, your relationships, your health and your enjoyment of everyday activities.
Having PTSD may also increase your risk of other mental health problems, such as:
- Depression and anxiety
- Issues with drugs or alcohol use
- Eating disorders
- Suicidal thoughts and actions
Prevention
After surviving a traumatic event, many people have PTSD-like symptoms at first, such as being unable to stop thinking about what’s happened. Fear, anxiety, anger, depression, guilt — all are common reactions to trauma. However, the majority of people exposed to trauma do not develop long-term post-traumatic stress disorder.
Getting timely help and support may prevent normal stress reactions from getting worse and developing into PTSD. This may mean turning to family and friends who will listen and offer comfort. It may mean seeking out a mental health professional for a brief course of therapy. Some people may also find it helpful to turn to their faith community.
Support from others also may help prevent you from turning to unhealthy coping methods, such as misuse of alcohol or drugs.
