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.
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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.
Those who develop posttraumatic stress disorder as a result of experiencing trauma often suffer from nightmares, flashbacks, anxiety, hypervigilance, and/or depressed mood. They may also go through periods of heightened irritability, hostility, and self-destructive behavior. But the question is when? Jessica Tappana, a licensed clinical social worker who specializes in treating PTSD, says it can vary as the illness often takes an unpredictable course.
An Unpredictable Course
Tappana says the greatest honor of her career is helping her clients work toward healing from PTSD. “Memories of and hope for new clients whose fear and PTSD was so significant that they could barely function in their day-to-day life who find healing, meaning, and freedom from their PTSD symptoms is exactly what brings me to work each and every day,” Tappana explains. This passion as well as her experience allows her to delve into the course and development of PTSD below:
“When someone experiences something traumatic, it’s expected that they will show signs of PTSD initially. You may feel like you’re looking over your shoulder, worry about going out at night, or double check the locks on the door for a few weeks. PTSD is what develops when a person gets stuck and those symptoms develop or continue down the road. We usually say PTSD is present when the symptoms are interfering with a person’s life for more than three months after the stressful event.
PTSD can get either better or worse over time. What I see with clients in my own practice is that for a while, they are able to ignore thoughts, feelings, and reminders of the trauma so they say they’re coping really well. The trauma doesn’t impact their life on a day to day basis and life moves on. However, at some point it becomes nearly impossible to keep stuffing down the feelings associated with the experience. Maybe something happens in your personal life that reminds you of what you went through or you are just feeling really stressed. Whatever the reason, your PTSD symptoms start to get worse. On the other hand, some people notice that their PTSD symptoms gradually start to go away over time without any significant intervention. You slowly start to rejoin areas of your life, focus on self-care, and notice that your anxiety and fear about the situation start to dissipate.
For many people, some sort of PTSD specific treatment is needed for PTSD to go away. The good news is that PTSD treatments work! We have a variety of evidence-based PTSD treatments that we know help people get better. These treatments include EMDR, Prolonged Exposure (PE), Cognitive Processing Therapy (CPT), and Trauma-Focused Cognitive Behavior Therapy (TF-CBT). It’s common to tell yourself that your symptoms will get better later or that you aren’t ready to face the trauma you experienced. Unfortunately, however, the only way over the fear you’re experiencing is to face it and a skilled trauma therapist can help you do so.”
Learning to Cope With PTSD: 5 Techniques
1) Deep-breathing. To prevent anxiety from continuing or progressing, take some deep breaths. Start by breathing in through your nose and then letting out a big sigh through the mouth. Do it again, but this time count to three before you let that breath back out. You can repeat again and again, increasing the length of time with each repetition, until a calmness comes over.
2) Progressive Muscle Relaxation. This is another great strategy for combatting unwanted stress and anxiety, and its technique is simple: you tense and relax different muscles in the body to bring greater attention to a feeling of relaxation. You can start by finding a quiet place and squeezing the muscles in your right hand. Squeeze, release, squeeze, release. Exhale as you release the tension and focus on the relief you feel.
3) Mindful meditation. Reduce negative feelings and tune into the present moment—which is often difficult for those with PTSD—by practicing mindful meditation. All this technique requires is that you shift your focus to right now: Where are you? Who are you with? What are you doing? How are you feeling? If your mind wanders to the past or future, gently guide it back to the present.
4) Hobbies. This one’s simple: get back to doing what you love to do. If you like to cook, make a new dish. If you like to work out, go to the gym or outside for a run. If you like to paint, get busy on your next masterpiece. Making time for engaging in our favorite hobbies can do us more good than most of us realize!
5) Socializing. And finally, spend time with your loved ones. Dedicating at least a little bit of time each day to catch up with an old friend, chat with your parents, or even just hang out with a few people from work can go a long way, as socializing has proven to boost feelings of wellbeing and decrease feelings of depression—two benefits that’ll certainly help one battle the harmful effects of PTSD.
