Last reviewed:
Nov 22nd 2022
PharmD, BCPS
Post-traumatic stress disorder, or PTSD, is a serious mental condition that can occur in people who experience or witness a traumatic event. Typical symptoms of the disorder include avoidance, heightened reactivity, and intrusive thoughts. This common disorder affects roughly one in 11 people at some point in their lives[1] but is highly treatable, particularly with cognitive behavioral therapy and medication.
We all experience traumatic events in our lives. These events trigger our fight or flight response - a state of heightened reactivity in which our heart pounds, breathing is rapid, and stress hormones cause muscles to tense for quick action.[2]
For most of us, though, these physiological changes occur in passing. Once the threat of danger is gone, so is the stress response. However, other people continue experiencing stress response symptoms long after the event. In some cases, the severity of symptoms reaches the level of a PTSD diagnosis.
PTSD goes well beyond a typical stress response and involves debilitating symptoms.[3] People with PTSD might experience flashbacks to the event, difficulty sleeping, and feelings of being constantly on edge. Likewise, PTSD might include disproportionate feelings of self-blame, avoidance of specific locations or events, and angry outbursts.
The DSM-V doesn’t specify different types of post-traumatic stress disorder. However, categorizing PTSD according to specific sets of common symptoms and experiences is helpful for understanding how it might affect other people. Each of these levels of PTSD features different symptoms:
Acute stress disorder shares many symptoms with PTSD. However, acute stress disorder is not a long-term condition like PTSD. Instead, it lasts a few days, weeks, or up to one month and might affect anyone that has directly or indirectly experienced trauma
Symptoms might include flashbacks, an inability to experience positive emotions, and an inability to sleep. Angry outbursts, difficulty concentrating, and heightened reactivity to loud noises might also occur. Treatments for acute stress disorder include individual or group therapy and medication.[4][5]
Uncomplicated PTSD occurs after a single, specific traumatic event, such as the death of a loved one. Symptoms include mood changes, flashbacks or nightmares, and avoidance of people, places, and events that remind the person of the trauma. Anyone can experience uncomplicated PTSD, but psychiatric therapy or medication can help manage it.[4]
Complex PTSD occurs after multiple traumatic events, such as repeated instances of abuse or violence. The symptoms are essentially the same as uncomplicated PTSD, though substance abuse, impulsivity, and aggression can also occur.
Furthermore, some people with complex PTSD have comorbid conditions, such as dissociative disorder, borderline personality disorder, or antisocial personality disorder.[4] Common treatments for complex PTSD include eye movement desensitization and reprocessing (EMDR) and trauma-focused cognitive behavioral therapy (CBT).[6]
Comorbid PTSD refers to a situation in which PTSD presents with at least one other mental health concern, commonly a substance use disorder, anxiety disorder, or mood disorder.[4] Comorbid PTSD includes typical symptoms related to hyper-alertness, irritability, and flashbacks. These symptoms present alongside the signs of the comorbid condition.
For example, someone with PTSD and a depressive disorder might have feelings of worthlessness, a loss of interest in enjoyable activities, and suicidal ideation. Cognitive behavioral therapy and medication are the most common treatments and are most effective when used together.[7]
PTSD is a common psychological disorder with symptoms within three months after a traumatic event. However, everyone experiences trauma differently, so some won’t present PTSD symptoms until much later, perhaps years after the initial trauma.[3]
PTSD symptoms occur in four clusters: intrusion, avoidance, cognition and mood, and arousal and reactivity. The outline below lists common symptoms within each:[8]
Intrusion PTSD symptoms:
Avoidance PTSD symptoms:
Cognition and mood PTSD symptoms:
Arousal and reactivity PTSD symptoms:
Children under six years of age might experience different PTSD symptoms than older children and adults. Clinicians often look for the following as signs of childhood PTSD:
Symptoms of PTSD can persist for several months or years, depending on the person. In some cases, PTSD becomes a chronic, lifelong disorder.
Symptoms can also worsen without effective treatment, causing even more significant impairment in daily functioning. Fortunately, PTSD is highly treatable with therapy, medication, or a combination.
PTSD can develop as a result of virtually any traumatic situation. What’s more, what one person finds traumatic, another person might not, so the threshold for “traumatic” is different for each of us.
Common traumatic events that might lead to PTSD include:[6]
There are risk factors associated with the development of PTSD as well, meaning someone with one or more of the following is more likely to develop PTSD:[3]
Likewise, people that experience stressful events after the traumatic event (e.g., a death in the family after living through a hurricane) are more likely to develop PTSD symptoms.
Though researchers have identified these risk factors as increasing the likelihood of developing PTSD, the precise cause is as yet unclear. Genetics and neurobiology are two potential causes of interest to psychological researchers.[9]
The first steps in diagnosing post-traumatic stress disorder include a physical examination and a psychological evaluation. A physical exam is necessary to determine if symptoms result from a bodily injury, such as head trauma. A psychological evaluation helps develop a clearer picture of the presenting condition and how the symptoms might be classified.
A DSM diagnosis requires that the person exhibits symptoms from each of the four symptom clusters (as outlined in the PTSD symptom section above) for one month or more.[8] This includes:
Additionally, the expression of these symptoms must cause clinically significant distress, such as difficulty in social situations, daily functioning, or work settings. For example, a person’s inability to sleep might cause their performance at work to deteriorate to the point of being fired.
Another condition must not better explain the symptoms. For example, some medical conditions, substance abuse, and medications can cause symptoms similar to PTSD.
No matter who you are, you will experience trauma at some point in your life. When these events occur, it’s common to experience PTSD-like symptoms for a short time. The goal is to prevent these normal post-trauma feelings from developing into something more serious and long-lasting.
The list below summarizes approaches you can take to stave off PTSD. Keep in mind that these techniques are not guaranteed to prevent PTSD. Instead, literature reviews support the efficacy of these approaches in preventing PTSD in most people:[10]
You must start early if you use one or more of these approaches or work on your recovery through other means. The sooner you begin processing your feelings and emotions, the less likely you will develop PTSD.
PTSD treatment usually falls into two categories: therapy and medication.
Like many diagnosable mental health conditions, the best course of action is often a combination of therapy and medication. The list below describes some of the most common approaches to treating PTSD:
Medications for PTSD include:[11]
Therapies include:[1]
If you’re experiencing PTSD symptoms, the best self-care approach you can implement is to seek help. As noted above, avoiding the trauma and your feelings you more likely to develop PTSD. In addition, getting support from friends, family, and a mental health provider dramatically increases your chances of feeling better sooner.
Other self-care strategies you can implement include:[12]
If you know someone with PTSD, one of the most important things you can do to help is be supportive. People with PTSD might not ask you for help (and might actively resist it), but your support can be an integral component of their recovery.
Consider helping someone with PTSD by doing the following:[3]
PTSD can significantly impact one’s ability to function in daily life, including changes in personal and work relationships, ability to regulate mood, and seeking relief from symptoms by using drugs or alcohol as coping mechanisms. In addition, feelings of powerlessness, fear, and anxiety can lead to isolation and avoidance, disturbed sleep, and loss of appetite.
Approximately one in 11 people are diagnosed with PTSD in their lifetime.[1] Roughly 12 million American adults have PTSD each year,[13] and approximately 3.6 percent of the world’s population experiences PTSD in a given year.[14]
Where PTSD is a diagnosable mental health disorder often requiring treatment, PTS is a normal, situation-specific response to trauma or danger. PTS might be best described as the fight-or-flight response, which prepares us to act in the face of threats but subsides when the situation no longer poses a danger.
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