What Is Post-Traumatic Stress Disorder (PTSD)?

Post-traumatic stress disorder (PTSD) is a mental health condition where people struggle to recover long after they experience or witness a deeply terrifying event.

In the past, the symptoms that comprise PTSD have been called "shell shock," "battle fatigue," and other names. It is now understood that any trauma–not war trauma alone–can cause the syndrome that is now called PTSD. Events that can lead to PTSD include a natural disaster, accident, combat, or sexual violence.

In this article, learn more about PTSD, including symptoms to look out for, what causes it, how to receive a diagnosis, treatment options, means of coping, and more.

What Is PTSD?

Post-traumatic stress disorder is a psychiatric disorder that may develop after a person has experienced, seen, or been threatened by a traumatic event.

If you're living with PTSD, you may have flashbacks and nightmares, avoid situations that bring back unwanted memories, and struggle with anxiety, sadness, or anger.

You might feel like it's harder to connect with others or keep up with school or work like you used to.

PTSD is not a sign of weakness but a mental health condition that can be diagnosed and treated. With the help of a mental health professional, you or your loved one can begin to heal.

Types of PTSD

Clinicians have described several distinct types of PTSD:

Acute Stress Disorder (ASD): While PTSD is typically diagnosable four weeks following a trauma, acute stress disorder is diagnosable immediately following a trauma and up to four weeks after. People with ASD have a higher chance of developing PTSD, but if given appropriate treatment, those with ASD might be able to prevent PTSD.

Uncomplicated PTSD: Uncomplicated PTSD occurs when there are no other co-occurring mental health disorders, such as depression or anxiety.

Complex PTSD (C-PTSD): C-PTSD usually results from a prolonged traumatic period, such as child abuse or neglect, and often stems from interpersonal trauma. Treatment for C-PTSD may involve the same things as for other types of PTSD but might take a longer time to recover from.

Dissociative PTSD: In dissociative PTSD, individuals might experience dissociation, which includes depersonalization and/or derealization. They may feel as though they are re-experiencing the trauma. It is more likely in those who experience trauma early in life.

PTSD Symptoms

It’s common to experience distressing memories and feelings immediately after a traumatic event and occasionally as life progresses.

However, for people living with PTSD, these intrusions last longer and disrupt your ability to function in day-to-day life. 

Symptoms of PTSD fall into four categories and include:

Intrusive symptoms:

• Repeated, unwanted memories of the traumatic event 
• Recurrent nightmares
• Flashbacks as if you’re re-living the traumatic experience 
• Severe distress when you’re reminded of the event 
• Physical reactions to reminders of the event, such as increased heart rate or sweating

Avoidance:

• Avoiding thoughts or feelings of the traumatic event 
• Staying away from reminders of trauma, such as people, places, objects, or situations 
• Resisting conversations about what happened or how you feel about it 

Increased arousal:

• Being easily startled or fearful 
• Struggling with irritability or angry outbursts 
• Having trouble concentrating 
• Having difficulty falling or staying asleep 
• Behaving recklessly or self-destructively 
• Being overly aware of your surroundings and potential threats to safety

Changes in thoughts and feelings:

• Struggling to remember important parts of the traumatic event
• Ongoing, distorted beliefs about yourself or others (such as “I’m a bad person” or “No one can be trusted”) 
• Recurrent feelings of fear, horror, anger, guilt, shame, or hopelessness 
• Loss of interest in once enjoyable activities 
• Feeling detached from others or struggling to maintain close relationships 
• Having difficulty experiencing positive feelings like joy or satisfaction

Often, people with PTSD also have other physical and mental health problems, including depression and substance abuse. Symptoms of PTSD can waver in intensity or become worse over time.

PTSD in Different Populations

About half of American adults experience at least one traumatic event. While many people have a difficult time coping in the wake of trauma, only a small portion go on to develop PTSD.

In the United States, an estimated 7-8% of people live with PTSD at some point in their lives, and people who are Latinx, Black, or American Indian are disproportionately affected by this condition. Women are two to three times more likely to develop PTSD than men.

Women often have different PTSD symptoms, including a tendency to respond by seeking social support. Men tend to take a problem-solving approach to their PTSD symptoms.

The DSM-5 has, for the first time, set diagnostic criteria for young children experiencing PTSD. Younger children are more likely to exhibit signs of PTSD through play.

Diagnosis

When PTSD symptoms listed above last for more than a month and cause significant distress or impairment, you may be diagnosed with PTSD. Usually, mental healthcare providers will diagnose PTSD, including psychiatrists, psychiatric nurse practitioners, psychologists, social workers, and counselors. Family medicine doctors, also known as primary care physicians, can also diagnose the condition.

Remember that there's no need to check off every box for a diagnosis of PTSD. You only need to experience a certain number of symptoms from each category for an official diagnosis from a qualified mental health professional.

They'll review your symptoms and history with you to determine your diagnosis and what you need to cope and recover.

Causes

People may develop PTSD after experiencing or being exposed to an exceptionally stressful event that involves someone’s death or the threat of it, serious injury, or sexual violation. 

It’s unclear exactly why some people develop PTSD and others don’t. As is true for many mental health conditions, there is likely a slew of potential causes at the root of this condition, including:

• Stressful life experiences, including how much trauma you’ve experienced and how severe it was
• A family history of mental health conditions such as anxiety or depression
• Your temperament or inherited personality traits
• The way your brain regulates chemicals and hormones when you experience stress

Certain risk factors could also increase your chances of developing PTSD, such as:

• Having experienced intense or prolonged trauma
• Previous experiences of trauma, such as childhood abuse
• Having a job that increases your risk of exposure to trauma (such as military personnel or first responders)
• Having other mental health conditions, such as anxiety or depression 
• Having problems with substance abuse 
• Not having a solid support system

Treatment

Fortunately, many research-backed treatments can help people living with PTSD cope with symptoms and begin to recover. Effective treatments for PTSD include:

Cognitive Behavioral Therapy  

Cognitive behavioral therapy (CBT) helps you learn how to recognize thought patterns that fuel negative beliefs about yourself, deal with reminders and emotions associated with the trauma, and help reduce maladaptive behaviors associated with PTSD.

Exposure Therapy 

Exposure therapy repeatedly exposes you to memories and reminders of trauma to learn how to cope effectively with distressing symptoms of PTSD like anxiety and avoidance.

Eye Movement Desensitization and Reprocessing 

Eye movement desensitization and reprocessing (EMDR) allows you to process traumatic memories in a new way with the help of guided eye movements. 

Medication 

Medication can help ease symptoms of PTSD and may improve your ability to participate in psychotherapy.

You may be prescribed antidepressants such as selective serotonin reuptake inhibitors (SSRI) like Zoloft (sertraline) or Paxil (paroxetine), anti-anxiety medications (though generally only for a short period due to the potential for dependence or abuse), or other medications to help reduce sleep disturbances like nightmares. 

Psychedelic Therapy

Certain psychedelic agents, such as ketamine, psylocibin, and MDMA, show promise in the treatment of PTSD. These medications change the way the brain processes fear, and can also help treat co-existing mental health disorders such as depression.

Complementary Therapies 

Additionally, there are several promising alternative therapies to consider adding to your treatment regimen, such as animal-assisted therapy and trauma-sensitive yoga.

Coping

Learning to cope with symptoms of PTSD can be challenging, which is why seeking treatment and developing healthy ways of managing your symptoms is essential. 

Here are a few coping strategies to add to your skillset:

• Learn how to deal with distressing thoughts and memories of trauma. 
• Find ways to cope with reminders of trauma and flashbacks.
• Address sleep problems related to PTSD. 
• Learn how to cope with related mental health conditions, such as anxiety, depression, and substance abuse. 
• For more help and community, consider joining a support group.

Complications

People with PTSD are more likely than others to experience other mental health problems, including depression, anxiety, substance use disorder, and suicidal thoughts. Some evidence even shows it can reduce overall lifespan, although more research needs to be done to determine the mechanism of these findings.

Summary

After experiencing trauma, people are at increased risk of developing PTSD. Symptom types include intrusive symptoms (nightmares and flashbacks), avoidance (staying away from reminders of the trauma), increased arousal (being startled easily, trouble concentrating, or difficulty sleeping), and changes in thoughts or feelings (believing you are "bad" or loss of interest in activities you used to enjoy).

A healthcare professional can make a diagnosis by reviewing your history and symptoms, and by using questionnaires. Treatment can include talk therapy, medications, and other interventions such as eye movement desensitization and reprocessing (EMDR) and exposure therapy. Speak to a healthcare provider if you or a loved one is experiencing troubling symptoms.