What Happens If PTSD Goes Untreated?

Some medical conditions can be treated with chicken soup, a few days in bed, and perhaps a course of antibiotics. However, this isn’t the case for most psychological conditions, including post-traumatic stress disorder (PTSD).

Without some form of treatment, the symptoms of PTSD will worsen over time, potentially damaging not only your health but also your relationships and your ability to work.

What is PTSD?

PTSD¹ is a psychological condition you can develop after experiencing a traumatic event such as a war, a physical attack, psychological abuse, a near-fatal accident, or a natural disaster. However, not everyone who experiences a traumatic event necessarily goes on to develop PTSD.

It’s completely normal to experience some degree of psychological upheaval after a traumatic event, but if the symptoms last longer than a month and start to interfere with your daily functioning, you might have PTSD.

Symptoms of PTSD include:

• Upsetting thoughts, flashbacks, or nightmares about the event

• Avoiding places, sensory input, or people who remind you of the trauma

• Numbing of general responsiveness

• Increased irritability and hypervigilance

• Problems sleeping

How is PTSD usually treated?

The American Psychological Association (APA)² strongly recommends cognitive behavior therapy (CBT) to treat PTSD. This therapy focuses on learning how to challenge and modify unhelpful beliefs, thoughts, or behavior patterns.

It focuses on current problems and symptoms that you might be experiencing and teaches you how to approach trauma-related memories, feelings, and situations.

The APA also conditionally recommends eye movement desensitization and reprocessing (EMDR) therapy, narrative exposure therapy, and the following medications:

• Sertraline

• Paroxetine

• Fluoxetine

• Venlafaxine

Psychological effects of untreated PTSD

Without treatment, the psychological symptoms of PTSD are likely to worsen over time. Along with severe depression and anxiety, other serious outcomes may include:

• Increased suicidal ideation

• Problems managing anger and aggression

• Substance abuse

PTSD and suicidal ideation

PTSD is strongly linked to an increase in suicidal thoughts, behaviors, plans, attempts, and actual suicides. For example, a nationwide study³ in Sweden found that people with PTSD were twice as likely to commit suicide than those without PTSD.

PTSD and uncontrolled anger and aggression

More than any other anxiety disorder, PTSD has been linked to difficulties managing anger and aggression.

Anger, irritability, and severe agitation are symptoms of PTSD frequently seen in military veterans. Studies⁴ have shown that veterans with PTSD demonstrate higher levels of anger than veterans without the condition.

One difficulty with anger and PTSD is that anger may interfere with the effectiveness of PTSD treatments, highlighting the importance of early intervention and treatment.

PTSD and substance abuse

Many studies⁵ documents the strong link between PTSD and substance use disorders (SUD). Roughly 40% of people with PTSD also have SUD.

The self-medication theory, which is backed by a fair amount of empirical support, states that people with PTSD are at greater risk of developing SUD because they drink alcohol or use drugs to cope with the distressing symptoms of the disorder.

This theory is supported by evidence that PTSD typically develops before co-occurring SUD.

Physiological effects of untreated PTSD

The comorbidities (co-existing conditions) for PTSD aren’t limited to psychological conditions. Physical comorbidities such as obesity, diabetes, and metabolic syndrome are common in people living with PTSD.

Epidemiological studies⁶ (long-term studies to trace the origin of diseases and how they spread)have also found a link between PTSD and an increased risk of cardiovascular and autoimmune diseases. A possible explanation is that the excessive stress associated with PTSD causes systemic inflammation.

Several studies have shown that people living with PTSD have significantly elevated levels of inflammatory markers in their blood. Increased inflammation can also affect cognitive function, and PTSD is associated with impaired verbal memory/learning, working memory, attention, and executive functions.

Neuroimaging has shown that some people with PTSD have structural and functional abnormalities in regions of the brain that control cognitive function, such as the hippocampus and prefrontal cortex.

Social effects of untreated PTSD

The combination of the psychological and physiological effects of untreated PTSD can have a profound impact on your daily functioning and how you relate to others. Possible socioeconomic consequences of untreated PTSD include:

• The strain on your relationships with loved ones

• Social isolation and loneliness

• Inability to keep a job or work at all

• Difficulty carrying out daily tasks that involve public spaces or interactions with others

• Risky or aggressive behaviors that might result in arrest

• Financial difficulties as a result of being unable to work

How to manage PTSD

The first steps in managing your PTSD are getting professional help and following your treatment plan.

You can also take the following steps to make treatment more effective:

• Engage in activities to reduce stress, such as exercise and mindfulness practices

• Try to maintain routines for meals, exercise, and sleep

• Spend time with family or friends and make them aware of things that might trigger your PTSD symptoms

• Avoid using drugs or alcohol

Where to seek help

Use the Behavioral Health Treatment Services Locator⁷ to find mental health treatment facilities and programs in your state.

If you’re having thoughts about suicide or are considering hurting yourself, you can call the National Suicide Prevention Lifeline⁸ toll-free at 1-800-273-TALK (8255). You also can text the Crisis Text Line⁹ (HELLO to 741741) or use the Lifeline Chat on the National Suicide Prevention Lifeline website.

If you’re a veteran suffering from PTSD, the US Department of Veterans Affairs¹⁰ (VA) has a dedicated crisis hotline and psychological care services.

The lowdown

PTSD is a complicated psychological condition that requires early intervention and treatment. If you suspect you have PTSD, seek professional help as soon as possible.

Without treatment, you might develop a range of psychological and physiological comorbidities that will profoundly impact your daily functioning, relationships with others, and long-term health.