What You Need To Know About PTSD

Post-traumatic stress disorder (PTSD) is a mental health condition that emerges after witnessing or experiencing a traumatic experience.

Your body has different ways of reacting to scary and life-threatening situations. One major way is to trigger the fight or flight response. Here, your body increases arousal.

Your blood pressure, heart rate, and other nervous system mechanisms are raised to ensure you can fight or flee from danger or stressful situations.

For most people, only a little time is required to shake off the effects of the stressful or, in some cases, traumatic experience. Other times, however, the consequences of these events can be long-lasting. When you repeatedly experience arousal symptoms after the stressful or traumatic event has passed, this could indicate PTSD. 

What triggers PTSD?

If you’ve ever experienced a natural disaster, car accident, sexual assault, or other events that caused you to fear for your well-being, these events may increase the risk of developing PTSD.

Likewise, people who have lived through military combat, abuse, a terror attack, or another stressful event may display signs of post-traumatic stress disorder in the coming days, weeks, months, or longer.

Following the traumatic experience, prompts that provide reminders of this negative event can trigger PTSD. For example, if you’ve been in a car accident, the smell of burning rubber can trigger a strong trauma response. Likewise, sudden, loud sounds can trigger military service members who lived through combat situations.

These triggers provide a sensory reminder of the event. They can be a smell, sound, temperature, or even the look of a similar scene.

PTSD versus acute stress disorder (ASD)

When your body is first introduced to a stressful event, we’ve seen that the fight or flight response is triggered. While your body should typically return to a pre-arousal state when the danger has passed, this doesn’t always happen.

Where your body remains in a heightened state of arousal after these events, it can be due to one of two things.

You may be experiencing acute stress disorder (ASD) if your body is still having reactions to trauma three days after the event occurs. With ASD, these stress reactions will usually stop no later than four weeks after the life-threatening episode. 

In comparison, where your body’s stress response symptoms persist for longer than four weeks, this is most likely a case of post-traumatic stress disorder

Types of PTSD

People have unique responses to trauma. There are different ways PTSD may manifest after experiencing a dangerous situation. These include:

PTSD with dissociative symptoms

If you’ve had firsthand experience of a dangerous, stressful encounter, you’ll understand how overwhelming this type of event can be.

For some people, the emotional and physical response to a dangerous, stressful incident can be too much to bear. As a way to cope, the mind can go into a state of detachment to offer mental and emotional protection from the dangerous reality at hand.

Dissociative PTSD occurs when a person becomes mentally detached from the emotional content of the stressful occurrence and the events that occur shortly after. This avoidance symptom helps the mind step outside the traumatic episode. Dissociation can block the development of traumatic memories of the incident, which works to prevent the affected person from the emotional pain triggered by memories later on.

A person with this form of PTSD may show signs of either of the following:

Derealization

After going through a dangerous event, the world around you may begin to take on a dreamlike form. Your surroundings can begin to feel unreal or distorted. This persistent feeling is a direct result of trauma. Derealization is different from the effects of alcohol-related blackouts or other effects of other substances that can be responsible for a similar distortion of reality. 

Depersonalization

PTSD can greatly influence how reality is perceived. Following a traumatic encounter, you may feel like time moves slowly and feel a sense of unreality of the self or your body.

PTSD and other comorbid disorders

When your body is placed in a heightened, stressful state because of PTSD, this often has a domino effect on other aspects of your emotional health. Around 80% of people with PTSD have at least one comorbid disorder.

These may be psychiatric disorders like depression or anxiety disorders. Alcohol or other substance abuse are also common co-occurring disorders. A person with a comorbid disorder will suffer symptoms of these conditions alongside the signs of PTSD.

Uncomplicated PTSD

When a person has PTSD, expected reactions such as agitation, emotional detachment, hypervigilance, and nightmares, among other symptoms, are expected. But while people with comorbid PTSD experience trauma-related symptoms along with the symptoms of other disorders, a person with uncomplicated PTSD usually has to deal only with symptoms of PTSD.

Statistics

Most people will experience trauma in their lifetime. An estimated six out of every 10 men and five out of every 10 women will live through one traumatic event. 

However, this number is reduced when recording cases that advance into PTSD. About six out of every 100 people will develop PTSD in their lives. In the United States, about 12 million adults experience PTSD within a year.¹ 

Who is more likely to experience this condition?

While anyone can have prolonged reactions to trauma, women tend to be more prone to PTSD.

It has been observed that 8 out of every 100 women will experience PTSD at some point in their lifetime. In comparison, only 4 out of every 100 men will live with PTSD after a distressing event.¹

  1. PTSD: National center for PTSD | U.S. Department of Veterans Affairs

Symptoms

Post-traumatic stress disorder is a serious condition that can negatively affect daily life. There are tell-tale signs to indicate that a person may be living with PTSD. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) lists how this disorder can manifest. They include the following:

Intrusion

When you experience an event distressing to your well-being, the last thing you want is to face constant reminders of the incident. 

With PTSD, however, intrusive memories of the event are a common symptom of the disorder.

In some cases, bad dreams which follow the theme of a stressful experience can be a frequent complaint.¹

People have also reported having very vivid flashbacks of the traumatic episode. Here, it isn’t uncommon to feel that the event is happening in the present moment, despite it already being in the past.

If you have intrusive symptoms of PTSD, you may experience extreme distress when you are exposed to any triggers that simulate the stressful encounter.¹

Avoidance

Accidents, assaults, terror attacks, combat, and other stressful encounters are hard to bear witness to.

To protect oneself from repeatedly recalling a traumatic event, some people cope by avoiding cues that trigger memories. 

If you display this symptom of PTSD, you’ll put extra effort into avoiding any memories, thoughts, or feelings that might provide reminders of the stressful event.

Another avoidance symptom is outright staying away from outside reminders like people, places, activities, or even conversations. Anything that might spark a recollection of the trauma is shunned to avoid reliving it.¹

Arousal and reactivity

After experiencing a dangerous event that alters your body’s nervous response, it’s possible to observe changes in emotional and other reactions. 

These changes will usually happen right after or can worsen following the dangerous event.

You may begin to experience angry outbursts or general irritability towards others. This may take the form of verbal or physical aggression and can be a provoked or unprovoked reaction. 

Following a traumatic event, it isn’t uncommon to slip into self-destructive behavior. Developing an alcohol issue or using drugs are known to occur with PTSD. You might find that you are hypervigilant or prone to being excessively startled when surprised. Trouble sleeping or concentrating are also signs of this disorder.

If you have noticed at least two of these changes after a stressful encounter, you may be living with post-traumatic stress disorder. 

Cognition and mood

Another sign of PTSD is an obvious change in how the mind processes the traumatizing event. You may find that you have negative emotions or thoughts about the incident. Your idea of the factors responsible for your trauma may also be distorted.

Most of the time, dissociative amnesia, known to happen during stressful events, can limit how well you remember a crucial part of the incident.

You may also have constant negative thoughts or expectations about yourself. You may begin to feel personal blame and can even label yourself as bad. You may see the world and your surroundings in an excessively negative manner. You might begin to consider everywhere unsafe and dangerous.

PTSD complications

Post-traumatic stress disorder can lead to very serious physical, emotional, and mental consequences. If you live with PTSD, you are at risk of experiencing any of the following complications:

  • Mood disorders

  • Anxiety disorders

  • Panic disorder

  • Substance abuse disorders

Reports have shown that 51.9% of men with PTSD often abuse alcohol. This usually leads to dependence and alcohol use disorder. Trauma can also increase the chances of suicidal ideation or even attempts to end your life.²

In some cases, dementia may set in due to the effects of the trauma on the brain. There may also be a change in how your brain functions due to the dangerous event.

Because PTSD often comes with comorbidities, these complications can contribute to how chronic the disorder can be.²

  1. DSM-5 Diagnostic criteria for PTSD | National Institute of Health

  2. Posttraumatic stress disorder | StatPearls

Causes

A wide variety of factors may cause PTSD. They include:

PTSD due to a medical problem or illness

If you are exposed to the threat or actual danger, PTSD can result from this experience. The thought of death or personal injury from this event can produce symptoms of this disorder. Sometimes, even a worrying medical diagnosis can cause trauma.

When you experience or are diagnosed with a life-threatening illness like HIV or a stroke, your body may process this as a traumatizing incident. 

Living through serious physical illness or a long and unpleasant surgical procedure can lead to PTSD.

Medical trauma can lead to anxiety, feelings of helplessness, and a loss of control.

Postpartum PTSD

Childbirth can be a life-changing experience for a woman. If there are complications during pregnancy and/or delivery, women can develop PTSD. Around one-third of all women will classify their birthing experience as traumatic.

A distressing birth or stressful events around your pregnancy can cause mental health challenges in the postpartum period.

These experiences can act as triggers for PTSD. Many women of childbearing age (10.4–13.8%) can suffer from this disorder. 

If you had traumatizing childbirth, this might strain the mother-child bond following delivery. Stressful birthing experiences can sometimes discourage mothers from having any more children.¹ 

Complex PTSD

If you are continuously experiencing traumatizing events, this can produce symptoms of complex PTSD. Complex trauma occurs in children and adults and results from recurring exposure to stressful events like violence, neglect, and sexual or physical assault.

Complex or c-PTSD is known for producing signs that resemble more severe PTSD. You may experience feelings of shame, social withdrawal, despair, sleep challenges, or a noticeable shift from your pre-trauma personality. 

Diagnosis

If you lived through a traumatic event, there’s no specific test to determine whether the behaviors you exhibit afterward signal PTSD.

To make an accurate PTSD diagnosis, it’s important to visit a mental health professional like a psychiatrist or psychologist. These professionals will determine if your behaviors meet the diagnostic criteria stipulated by the DSM-5.

You may be living with PTSD if you are exposed to the threat of death, injury, or sexual violence in any of the following ways:

  • Directly experiencing the event

  • Watching others suffer through a traumatic incident

  • Becoming aware that a close family member or friend experienced an event that led to death, the threat of death, or other serious harm

  • Routine exposure to traumatic events. This may happen with military personnel or police officers who regularly witness distressing events in the line of duty.

Prevention

Traumatic events often occur without any warning. This makes planning for and against them next to impossible. However, if you witness a serious distressing event, certain measures are available to reduce the risk of developing PTSD.¹

Psychological interventions

Research has shown that trauma-focused therapy can be a useful measure to assist in symptom reduction following a traumatic event. This is usually targeted at people that experience a single stressful event like a car accident or physical assault. Where early symptoms of PTSD begin to manifest, these specific therapies can prevent more severe outcomes.

If you receive non-targeted preventative treatment like psychoeducation or individual/group counseling, these may be ineffective for managing trauma symptoms.¹

Social support

There is little evidence supporting technical interventions for large-scale traumatic events. Terrorist events or natural disasters often occur without the availability of specialized treatments for those affected. But while this may be true, there is growing evidence backing social support during such events.

Being surrounded by supportive parents, friends, and other loved ones can offer protective benefits against PTSD.¹

Treatments

Living with the outcomes of a traumatic event can be very daunting. But there are evidence-based treatment options available to manage the symptoms of PTSD. These options may also encourage a gradual return to normal daily life. 

Psychological, pharmacological, and other therapies can manage the effects of trauma.

Exposure therapy

Experiencing a traumatizing event can force you to avoid the scene, memories, or other reminders of the incident. In other cases, extreme fear may occur if you are placed in situations that remind you of the episode.

For example, riding in a car can become a terrifying thought after an accident. Likewise, going to the hospital following a grueling surgery can become an impossible task.

Exposure therapy can help you confront your fears. Using verbal or written communications, a mental health professional will guide you while you give a detailed retelling of the event.¹ 

Through approaches such as prolonged exposure therapy, you will receive psychoeducation about reactions to trauma. This process teaches breathing exercises for relaxing. You are also assisted in overcoming your fears by being placed in situations or places associated with the traumatic event.¹

Cognitive therapy

After living through a traumatizing experience, it’s easy to see danger everywhere you turn. One mugging can make every street feel unsafe. Airplanes can become a no-go after losing a loved one to a crash.

These understandable but extreme reactions can disrupt daily life. Cognitive therapy can help to modify any feelings that cause you to magnify the current threats in situations associated with your trauma.

Cognitive therapy can also help to adjust your beliefs about the trauma, particularly around any negative personal role you believe you played in the event.¹

A subtype, cognitive processing therapy, teaches ways to examine and change upsetting thoughts you may have because of a stressful experience. Changing how you think can positively influence how you feel.

Because PTSD can cause difficulties in carrying out everyday activities, another option — present-centered therapy — can be helpful. This treatment targets daily difficulties you might face because of trauma or PTSD symptoms. 

Other options like family therapy can help family members and loved ones learn and help with your recovery process from PTSD.

Medication

Medicine is another trusted method to manage PTSD symptoms. If you’re considering or have been prescribed drugs to manage this disorder, it may be because of one of these reasons:²

  • You decide not to try trauma-focused therapy.

  • Psychological measures may be ineffective because the trauma is ongoing (e.g., trauma brought on by current domestic violence, life in a warzone, etc.)

  • Little benefit was received when you first tried psychological treatments.

  • You live with a mental health condition like depression that can hinder the effects of psychological methods.

The SSRI medications paroxetine and sertraline are the only drugs approved by the Food and Drug Administration (FDA) to manage PTSD. Antidepressants improve mood and can manage associated symptoms of depression and anxiety following PTSD.²

Combination treatment

While psychological interventions manage the way you process and live with the aftermath of a traumatic event, medicine can improve the way your brain responds to this incident.

Both measures are useful for alleviating symptoms of PTSD, together with a return to normal functioning.

By combining their effects, there are better treatment outcomes for people with PTSD. This is especially important if you live with a comorbid condition like anxiety or depression.

Coping with PTSD

Experiencing or learning about a traumatic event can be very frightening. Your brain may process this incident in ways that make moving on incredibly hard.

As a way to cope with PTSD, adopting the following practices in your daily routine can help to manage the recovery process. They include:

  • Talking with others about your feelings

  • Using meditation or deep breathing exercises to boost relaxatio

  • Making sure you get enough sleep and eat a balanced diet

  • Where possible, avoiding alcohol and drugs

  • Working your way back to a daily routine to encourage a return to normalcy

  • Reaching out for professional help if PTSD symptoms persist or worsen

Doctors & specialists

When you experience a frightening event, it’s normal to have upsetting thoughts or feelings shortly after. Typically, these thoughts and feelings wind down after a few days or weeks. However, if you continue to have disturbing feelings or worse symptoms four weeks¹ after the event, it is necessary to visit a doctor to assess what may be wrong.

Which type of doctors/specialists treat PTSD?

To get the best treatment, it’s important to visit a doctor who has experience managing mental health challenges. This can be a psychiatrist or a psychologist who can diagnose PTSD.

  1. Post-traumatic stress disorder | National Institute of Health


Clinical trials for ptsd

Actively recruiting
A Study to Test Whether Taking BI 1358894 for 8 Weeks Helps Adults With Post-traumatic Stress Disorder
AR, CA, FL, GA and 6 more locations (US)
Actively recruiting
Kappa Opioid Receptor Antagonism for the Tx of AUD and Comorbid PTSD
AL, CT, MI (US)
Actively recruiting
Trauma Informed Guilt Reduction Therapy
CA, MA, RI, TX (US)