Symptoms of post-traumatic stress disorder (PTSD)

PTSD develops differently from person to person. If you’ve lived through a traumatic incident, your symptoms may appear within hours or days of the event, or they may take weeks, months, or even years to develop. Symptoms can arise suddenly, gradually, or come and go over time.

There are three main types of PTSD symptoms:re-experiencing the traumatic event, avoiding reminders of the trauma and symptoms of hyper-arousal or heightened anxiety. In the days or months following a traumatic event, you may find yourself alternating between re-experiencing the event and avoiding reminders of it, with symptoms of increased arousal as the common backdrop.

Re-experiencing the traumatic event

The most disruptive symptoms of PTSD involve the flashbacks, nightmares, and intrusive memories of the traumatic event. You may be flooded with horrifying images, sounds, and recollections of what happened. You may even feel like it’s happening again. These symptoms are sometimes referred to as intrusions, since they involve memories of the past that intrude on the present.

If you have PTSD, you may re-experience the traumatic event or intrusion in several ways:

Intrusive memories of the traumatic event
Bad dreams about the traumatic event
Flashbacks or a sense of reliving the event
Feelings of intense distress when reminded of the trauma
Physiological stress response to reminders of the event (pounding heart, rapid breathing, nausea, muscle tension, sweating)

These distressing symptoms can appear at any time, sometimes seemingly out of the blue. At other times, they are triggered by something that reminds you of the original traumatic event: a noise, an image, certain words, a smell.

Examples of PTSD Triggers
For an auto accident survivor: The smell of gasoline
For a combat veteran: The sound of a helicopter or firecrackers
For a rape victim: The sight of a person suddenly appearing around the corner
For a carjacking victim: The song that was playing on the radio at the time of the assault
The intrusions or flashbacks that result from these PTSD triggers are terrifying, disorienting, and unpleasant. The natural response is to protect yourself by avoiding them. This leads to the second major cluster of PTSD symptoms.

Symptoms of avoidance
Symptoms of avoidance are prominent in PTSD. You may persistently avoid situations that remind you of the traumatic event you experienced, minimize the event’s significance, or push all thoughts of it out of your mind. Avoidance can also take the form of detachment and apathy.

Symptoms of avoidance include:

Avoiding thoughts, feelings, or conversations associated with the trauma
Avoiding activities, places, or people that remind you of the trauma
Inability to remember important aspects of the trauma
Loss of interest in activities and life in general
Feeling detached or estranged from other people
Feeling emotionally numb, especially toward loved ones
Sense of a limited future (you don’t expect to live a normal life span, get married, have a career)
Symptoms of increased arousal
PTSD can cause you to feel and react as if you’re constantly in danger. In this state of chronic hyper-arousal, your mind and body is on constant red alert, making it impossible to fully relax, be productive, or enjoy life.

The PTSD symptoms of increased arousal and anxiety include:

Difficulty falling or staying asleep
Irritability or outbursts of anger
Difficulty concentrating
Hyper-vigilance, or being constantly “on guard”
An exaggerated startle response, or jumpiness
Other common symptoms of PTSD
In addition to the PTSD symptoms of intrusion, avoidance, and hyper-arousal, you may also experience a number of other distressing symptoms. If you survived an event that killed others, you may feel guilt that you lived while others died. You may also blame yourself for what happened or suffer from feelings of shame and hopelessness. You may also experience an array of physical symptoms linked to PTSD, including headaches, stomach problems, and chest pain.

Over the long-term, PTSD can also lead to many complicating problems, including depression, panic attacks, and other psychological issues. Substance abuse is another common complication, especially if you’re turning to alcohol and drugs in an attempt to handle the symptoms of PTSD.

Symptoms of PTSD in children and adolescents
In children—especially those who are very young—the symptoms of PTSD can be different than the symptoms in adults. Symptoms in children include:

Fear of being separated from parent
Losing previously-acquired skills (such as toilet training)
Sleep problems and nightmares without recognizable content
Somber, compulsive play in which themes or aspects of the trauma are repeated
New phobias and anxieties that seem unrelated to the trauma (such as a fear of monsters).
Acting out the trauma through play, stories, or drawings.
Aches and pains with no apparent cause
Irritability and aggression

Post-traumatic stress disorder (PTSD) causes and risk factors
Most people who live through a traumatic or life-threatening event experience some symptoms at first, such as anger, shock, and anxiety. However, not everyone goes on to develop PTSD. While it’s impossible to predict who will develop PTSD in response to trauma, there are certain risk factors that appear to increase a person’s vulnerability to it.

Many risk factors revolve around the nature of the traumatic event itself. Traumatic events are more likely to cause PTSD when they involve a severe threat to your life or personal safety: the more extreme and prolonged the threat, the greater the risk of developing PTSD in response. Intentional, human-inflicted harm—such as rape, assault, and torture— also tends to be more traumatic than “acts of God” or more impersonal accidents and disasters. The extent to which the traumatic event was unexpected, uncontrollable, and inescapable also plays a role.

Getting help for post-traumatic stress disorder (PTSD)
If you think that you or a loved one has PTSD, it’s important to seek help right away. This is particularly important if your symptoms are interfering with your work or home life. The faster PTSD is diagnosed and treated, the better the long-term outlook. There are many places you can turn for help, including your family doctor or a mental health professional such as a psychiatrist or counselor.

Unfortunately, many people with PTSD don’t seek out the treatment they need. Some resist treatment because they’re worried what others will think or believe that they should be able to get over the problem on their own. Others aren’t ready to face the trauma and the strong emotions associated with it.

Why Should I Seek Help for PTSD?

Early treatment is better
Symptoms of PTSD may get worse. Dealing with them now might help stop them from getting worse in the future. Finding out more about what treatments work, where to look for help, and what kind of questions to ask can make it easier to get help and lead to better outcomes.

PTSD symptoms can change family life
PTSD symptoms can get in the way of your family life. You may find that you pull away from loved ones, are not able to get along with people, or that you are angry or even violent. Getting help for your PTSD can help improve your family life.

PTSD can be related to other health problems
PTSD symptoms can worsen physical health problems. For example, a few studies have shown a relationship between PTSD and heart trouble. By getting help for your PTSD you could also improve your physical health.

If you’re reluctant to seek help, keep in mind that PTSD is not a sign of weakness, and the only way to overcome it is to confront what happened to you and learn to accept it as a part of your past. This process is much easier with the guidance and support of an experienced therapist or doctor.

Finding a therapist for PTSD
When looking for a therapist for PTSD, seek out mental health professionals who specialize in the treatment of trauma and PTSD. Beyond credentials and experience, it’s important to find a therapist who makes you feel comfortable and safe, so there is no additional fear or anxiety about the treatment itself. Finding the right treatment provider can take time, but a good place to start is with your doctor. You may also want to ask trusted friends or family members for recommendations. You can also call a local minister, mental health clinic, psychiatric hospital, or counseling center.

Source: The National Center for PTSD, at

PTSD At A Glance

Posttraumatic stress disorder (PTSD) is an emotional illness that was first formally diagnosed in soldiers and war veterans and is caused by terribly frightening, life-threatening, or otherwise highly unsafe experiences.

PTSD symptom types include re-experiencing the trauma, avoidance, and hyperarousal.
PTSD has a lifetime prevalence of seven up to 30%, with about 5 million people suffering from the illness in any one year. Girls, women, and ethnic minorities tend to develop PTSD more than boys, men, and Caucasians.

Complex posttraumatic stress disorder (C-PTSD) usually results from prolonged exposure to traumatic event(s) and is characterized by long-lasting problems that affect many aspects of emotional and social functioning.

Symptoms of C-PTSD include problems regulating feelings, dissociation or depersonalization; persistent depressive feelings, seeing the perpetrator of trauma as all-powerful, preoccupation with the perpetrator, and a severe change in what gives the sufferer meaning.

Untreated PTSD can have devastating, far-reaching consequences for sufferers' medical and emotional functioning and relationships, their families, and for society. Children with PTSD can experience significantly negative effects on their social and emotional development, as well as their ability to learn.
Although almost any event that is life-threatening or that severely compromises the emotional well-being of an individual may cause PTSD, such events usually include experiencing or witnessing a severe accident or physical injury, getting a frightening medical diagnosis, being the victim of a crime or torture, exposure to combat, disaster or terrorist attack, enduring any form of abuse, or involvement in civil conflict.

Issues that tend to put people at higher risk for developing PTSD include female gender, minority ethnicity, increased duration or severity of, as well as exposure to, the trauma experienced, having an emotional condition prior to the event, and having little social support. Risk factors for children and adolescents also include having any learning disability or experiencing violence in the home.
Challenges for assessment of PTSD in children and adolescents include adult caretakers' tendency to be unaware of the extent of the young person's symptoms and the tendency for children and teens to express symptoms of the illness in ways that are quite different from adults.

Directly addressing the sleep problems that are associated with PTSD has been found to help alleviate those problems, thereby decreasing the symptoms of PTSD in general.

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