Post-traumatic stress disorder (PTSD)
Post-traumatic stress disorder (PTSD) develops in some people who have experienced a shocking, scary, or dangerous event. Any person, at any age, can experience PTSD.

It is natural to feel afraid during and after a traumatic situation. Fear is a part of the body’s “fight-or-flight” response, which helps us avoid or respond to potential danger. People may experience a range of reactions after trauma, and most people recover from initial symptoms over time. Those who continue to experience problems may be diagnosed with PTSD.

About 6.8% of American adults develop PTSD in their lifetime, according to the National Institute of Mental Health. PTSD can occur at any age, including childhood. Women are more likely to develop the disorder than men, and there is some evidence that it may run in families. PTSD is frequently accompanied by depression, substance use disorder, and anxiety disorders. When other conditions are appropriately diagnosed and treated, the likelihood of successful treatment increases.

Signs and symptoms

  • Flashbacks—reliving the traumatic event, including physical symptoms, such as a racing heart or sweating
  • Recurring memories or dreams related to the event
  • Distressing thoughts
  • Physical signs of stress, such as increased blood pressure and heart rate, fatigue, muscle tension, nausea, joint pain, headaches, back pain, and other types of pain

Thoughts and feelings can trigger these symptoms, as can words, objects, or situations that are reminders of the event.

  • Staying away from places, events, or objects that are reminders of the experience
  • Avoiding thoughts or feelings related to the traumatic event

Avoidance symptoms may cause people to change their routines. For example, some people may avoid driving or riding in a car after a serious car accident.

  • Easily startled
  • Tense, on guard, or on edge
  • Difficulty concentrating
  • Difficulty falling asleep or staying asleep
  • Irritable
  • Angry or aggressive outbursts
  • Risky, reckless, or destructive behavior

Arousal symptoms are often constant. They can lead to feelings of stress and anger and may interfere with daily life, such as sleeping, eating, or concentrating.

  • Trouble remembering key features of the traumatic event
  • Negative thoughts about oneself or the world
  • Exaggerated feelings of blame toward oneself or others
  • Ongoing negative emotions, such as fear, anger, guilt, or shame
  • Loss of interest in previous activities
  • Feelings of social isolation
  • Difficulty feeling positive emotions, such as happiness or satisfaction

Cognition and mood symptoms can begin or worsen after the traumatic event. They can lead people to feel detached from friends or family members.

Types

The normal stress response (pre-PTSD) occurs in healthy adults who’ve endured a traumatic event in the recent past. The response could be bad memories, panic attacks, emotional numbing, dissociation, or isolation. This response can often be overcome in a few weeks with support and therapy.
An acute stress response is also pre-PTSD and stems from a catastrophic event. It is characterized by panic reactions, cognitive issues, dissociation, insomnia, distrust, and the inability to maintain basic self-care, work, and relationships. With treatment it can be resolved before developing into PTSD.
Uncomplicated PTSD is the result of experiencing a single traumatic event. Symptoms include a strong aversion to triggering situations, nightmares, flashbacks, irritability, mood swings, and change in perception of current relationships and the feeling of safety.
Complex PTSD is present in individuals who’ve endured intense and prolonged abuse, often from a childhood in a dysfunctional family, or who have persistent exposure to war, horrific deaths, or community violence. It is often present with personality or dissociative disorders. Behavioral issues include impulsivity, eating disorders, substance abuse, emotional issues (e.g., rage, depression, panic), and cognitive problems.
PTSD that is comorbid with other symptoms is common. PTSD is often associated with other psychiatric disorders, such as depression, substance abuse, panic disorders and other anxiety disorders. It can result from trying to self-medicate for PTSD symptoms. Treat them together for best results.

When to see a doctor

It is important for anyone with PTSD symptoms to work with a licensed mental health professional who has experience treating PTSD to receive a diagnosis. The main treatments are psychotherapy, medications, or a combination of psychotherapy and medications. A mental health professional can help people find the best treatment plan for their symptoms and needs.

Some people with PTSD, such as those in abusive relationships, may be living through ongoing trauma. In these cases, treatment is usually most effective when it addresses both the traumatic situation and the symptoms of PTSD. People who experience traumatic events or who have PTSD also may experience panic disorder, depression, substance use, or suicidal thoughts. Treatment for these conditions can help with recovery after trauma. Research shows that support from family and friends also can be an important part of recovery.

Resources