Posttraumatic Stress Disorder

Posttraumatic Stress Disorder (PTSD) is a psychological condition that can occur after you have experienced or witnessed a traumatic event. The traumatic event that triggers PTSD could involve physical harm or the threat of physical harm to you personally, to a loved one, or even to strangers. Such traumatic experiences may be single events, known as acute traumas. Examples of acute traumatic events include motor vehicle accidents, incidents of physical or sexual violence, natural disasters, and terrorist attacks. When a person experiences multiple traumatic events or when traumas are recurring or longstanding, the trauma is known as chronic. Examples of chronic trauma include childhood sexual abuse, combat exposure and other military experiences, domestic violence, and the buildup of any combination of traumatic experiences. What these and other traumatic events have in common are the belief that your life or the lives of others are in danger, the experience of intense fear, and the feeling of having no control over what is happening.

More than half of adults experience at least one traumatic event during their lifetime, but not everybody who endures trauma develops PTSD. While symptoms of PTSD usually begin soon after the traumatic event, they may not show up until months or even years later. Symptoms may also come and go over many years, sometimes triggered by news stories, anniversaries of the trauma, or major life events such as illness/injury or relationship beginnings/endings. If the symptoms last for several weeks and cause you great distress and disruptions in your functioning, you may be struggling with some level of PTSD.

People with trauma histories also commonly struggle with other mental health problems such as depression or substance abuse. But PTSD involves distinct symptoms. The four types of PTSD symptoms are: re-experiencing, avoidance, negative changes in thoughts and feelings, and arousal.

Four Types of PTSD Symptoms

Re-Experiencing

Re-experiencing symptoms involve being reminded of, or re-living the event. You may experience:

Nightmares
Flashbacks: feeling like you’re going through the event again
Intense fear and horror when reminded of the event
Extreme reactivity when “triggered” by stimuli related to your trauma, such as similar sights or sounds

Avoidance

Avoidance means purposefully staying away from things that remind you of the event. You might find yourself:

Avoiding people and places that trigger memories of the traumatic event
Avoiding situations and conversations that remind you of the event
Avoiding thoughts or feelings related to the event, for instance by staying extra busy
Avoiding help-seeking behaviors such as therapy

Negative changes in thoughts and feelings

Negative changes in thoughts and feelings refers to an alteration in how you think about yourself, others, and the world as a result of the trauma. This symptom has many aspects, including:

Having difficulty experiencing positive emotions
Feeling alienated from others and creating distance in relationships
Losing interest in activities you used to enjoy
Forgetting about parts of the traumatic event
Feeling horror, anger, guilt or shame on a persistent basis
Having strong negative feelings about yourself, including a belief that you are permanently damaged
Thinking the world is completely dangerous, trusting nobody

Arousal

Arousal is when your body is keyed up. You may experience:

Anger or irritability
Difficulty sleeping
Problems with concentration
Hypervigilance: feeling “on-guard” or on the lookout for danger
Excessive startle response
Reckless or self-destructive behavior

What to do if you have experienced trauma or think you have Posttraumatic Stress Disorder (PTSD)

Educate yourself. Learn more about trauma reactions from the online resources linked to this page.
Talk to someone whose support you can trust. A good friend, a family member, or a religious leader may help you find the care you need.
Consider seeking an evaluation by a mental health professional. This will involve answering questions about your trauma and your reactions to it.
Take care of yourself physically. Do your best to eat well, exercise, and get adequate sleep.
Avoid the use of excessive alcohol or drugs. The temporary relief will worsen your symptoms and your situation in the long run.
Find new and effective ways to manage your stress. High levels of stress often prompt and/or intensify trauma symptoms.
If you choose not to pursue evaluation and treatment, you may take a wait-and-see approach. Your symptoms may subside, and you won’t need treatment. If you don’t feel better after several weeks, or if your symptoms interfere with your functioning at school, work, or home, you would be wise to seek help.