Signs of PTSD
Although many people associate PTSD with service in the military, it can actually stem from any type of trauma. That might include an abusive relationship, or being the victim of or witnessing a violent crime.
PTSD is more prevalent than you might think. An estimated 60% of men and 50% of women will experience some form of trauma in their lives. Not all of them will then go on to develop PTSD, though. Despite the large percentage of the population who will face trauma, only approximately 6% of Americans will go through trauma that results in PTSD, according to the National Center for PTSD.
No two people experience PTSD in the same way. The signs may be subtle, or they may be acute. Below are some of the PTSD symptoms to look for if you suspect that you or someone you care about is suffering from this mental health condition after experiencing severe trauma in life.
“If you have experienced a traumatic event, it’s normal to have some trauma symptoms for a period of time following the event. Post-traumatic stress (PTS) is a normal reaction to an abnormal event. PTS can eventually lead to acute stress disorder, which, left untreated, may turn into diagnosable post-traumatic stress disorder.”
— Ashley Ertel, Licensed Clinical Social Worker (LCSW), BCD, C-DBT
Main Symptoms of PTSD
NIMH reports symptoms of PTSD typically start about 3 months after experiencing trauma. That said, PTSD doesn’t follow all rules, and symptoms can emerge much, much later — sometimes even years — after the trauma occurs.
According to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), the main criteria for diagnosed PTSD states that symptoms must be:
- Present for at least 1 month
- Severe enough to disrupt daily life functioning
- Unrelated to another illness, substance use, or prescription medications
By now it should be pretty clear that PTSD causes can vary from person to person. As you may expect, recovery can greatly differ, too. Some people recover within 6 months, some take up to a year, and some never fully get back to their pre-trauma mindset and ability to function.
Post-traumatic stress disorder is also associated with co-occurring conditions, including depression, alcohol and drug use or abuse, and one or more other anxiety disorders.
The main symptoms of PTSD can be divided into four categories. Note that not everyone will experience PTSD symptoms in every category.
Re-experiencing symptoms
Re-experiencing symptoms will include flashbacks and reliving a traumatic event over and over. This might happen in dreams or when unexpected (and unwelcome) thoughts suddenly come to the surface. Sounds, sights, and even smells can trigger a flashback.
Re-experiencing symptoms can occur any time, any place, without warning. Any of the following might trigger a flashback:
- Sounds
- Sights
- Smells
- A song
- A scene in a movie
- A place
- A person
- Words or conversations
- Noises
Avoidance symptoms
Avoidance symptoms are seen when someone with PTSD takes extreme measures in an effort to not be reminded of the trauma. This often leads to them ultimately becoming withdrawn and isolated.
“Of all of the symptoms of PTSD, I think it’s important to identify that the avoidance cluster of symptoms are often the ones that sustain the rest of the symptoms. Learning how to avoid avoidance is the best way to decrease the impact of the rest of the PTSD symptoms.”
— Ashley Ertel, Licensed Clinical Social Worker (LCSW), BCD, C-DBT
Avoidance symptoms can involve:
- Not going to a certain place
- Taking a new route to get somewhere
- Avoiding a person or relationship
- Not being in crowds
- Trying to avoid loud noises
Hyperarousal symptoms
Hyperarousal symptoms include being alert to danger at all times, even when a hypervigilant stance is unwarranted. It’s a constant state of alert that can lead to a “fight or flight” response. Over time, this can lead to health issues. These symptoms can also cause someone to have trouble focusing, be unable to sleep well, or become easily startled by loud noises.
Hyperarousal symptoms can cause someone to be:
- Jittery
- On alert
- Irritable
- Easily angered
- Have aggressive behavior
- Have regular outbursts
Cognition & mood symptoms
The fourth cluster of PTSD symptoms affects a person’s memory and emotions. Sometimes people with PTSD might not recall the traumatic event they experienced. They also may feel guilty about what happened and blame themselves, even if being at fault is impossible or illogical. This can cause them to alienate from others, including people they care a great deal about.
Cognition & mood symptoms might be less obvious, but they can involve:
- Lack of joy in life
- Negative thoughts about self or others
- Fear about others’ motives
- Extreme guilt and shame
- Being convinced that bad things are going to happen
Symptoms in Men vs Women
While men and women both can experience similar PTSD symptoms, including an extreme sense of shame, there are some differences in how their symptoms show up.
We don’t have a lot of research looking at how PTSD affects men vs. women, but there are a few things we do know. For example, women are more inclined to exhibit feelings of guilt than men are. While both sexes have anger over the trauma they went through, men are usually more outwardly aggressive and visibly angry.
“All humans can experience the symptoms of PTSD equally. However, culture plays a large role in how the symptoms may express themselves based on gender norms and stereotypes.”
— Ashley Ertel, Licensed Clinical Social Worker (LCSW), BCD, C-DBT
PTSD symptoms in men
According to one recent study, men tend to experience more anger and rage with PTSD than women do. They’re also likely to express their PTSD symptoms with more aggression than women. It’s more common for men to be irritable with PTSD. Studies show there’s also a higher chance that they’ll turn to excessive drug and alcohol use to self-medicate when trying to cope with the realities of living with PTSD.
PTSD symptoms in women
While women can also be (rightfully so) angry about their trauma, they might express less rage. However, they’ll often feel a lot more guilt and shame than men do. One study found that women with PTSD are more likely to feel anxious and depressed than men. At times, an anxiety disorder can even coexist with PTSD.
For both sexes, PTSD can wreak havoc on relationships. Divorce rates are high among those with PTSD. Some research shows that the divorce rate is up to three times higher for veterans with PTSD than it is for those without.
What Causes PTSD?
What can cause PTSD? Post-traumatic stress disorder is often associated with war veterans who see terrible acts of violence. However, first responders, emergency room doctors, or anyone else who’s exposed to trauma can just as easily develop PTSD.
Post-traumatic stress disorder can happen anytime we experience a violent, unexpected, or shocking act that’s difficult to process. It can occur whether you actually experience a trauma first hand, or if it’s something you simply witnessed, even from a distance.
What constitutes “traumatic” will differ from person to person, so when trying to discern: what is the leading cause of PTSD, there really aren’t any tried and true standards we can look to. However, it’s not uncommon for PTSD to occur as the result of someone who’s involved with or has witnessed any of the following 19 most common causes of PTSD:
- Fire
- Execution
- Road rage
- Electrocution
- Being robbed
- Imprisonment
- Marital infidelity
- Traumatic childbirth
- Sexual assault or rape
- An automobile accident
- The death of a loved one
- Surviving a natural disaster
- Kidnapping or hostage-situations
- Political or civil unrest
- Witnessing others being killed or hurt
- Being diagnosed with a terminal disease (or having someone close to you being diagnosed)
- Physical assault, bullying, or harassment
- Military combat or any type of violent fighting
- A loved one’s death by suicide
PTSD can happen to anyone, at any age. It can affect children, war veterans, police officers, medical personnel, or anyone else who experiences or witnesses a tragic act. In general, any event that makes you fear for your, or a loved one’s, life, sanity, or safety can result in post-traumatic stress disorder.
“When thinking about the common causes of PTSD, it’s important to note that not all people who experience traumatic events go on to develop full PTSD symptoms, but they may experience aspects of these symptoms. There is help available for everyone who has experienced a traumatic event — no one should struggle alone with their concerns.”
— Jill Daino, Licensed Clinical Social Worker (LCSW-R), BC-TMH
Risk Factors for PTSD
The National Center for PTSD reports that more than 7% of Americans will likely develop PTSD at some point in life. Women are more likely than men to develop it, and genetic factors may also make some people more likely to develop it than others.
It’s true that most people who experience a traumatic event will not develop PTSD. However, some risk factors that might make you more likely to experience this mental health condition can include:
- Exposure to multiple dangerous or traumatic events
- Physical, emotional, or sexual abuse
- Neglect during childhood
- History of alcohol or substance abuse
- Witnessing a dead or mutilated body
- History of mental health conditions
- Lacking social support
- Genetic predisposition
Some research shows you’re more likely to develop PTSD if you have to deal with extra stress after a traumatic event, such as enduring pain or injury, loss of a job, or the death of a loved one.
“While there are important risk factors that contribute to the development of PTSD, it’s also important to know that getting support and reaching out to communities that can help will make a difference. For example, a veteran who attends a group with other veterans can connect with others who have experienced similar situations and decrease their isolation while connecting with other people experiencing similar symptoms — there can be significant healing within a shared community.”
— Jill Daino, Licensed Clinical Social Worker (LCSW-R), BC-TMH
What Are the Different Types of PTSD?
Everyone responds to stress in their own way. Two people who experience the same trauma can have vastly different reactions and recovery processes.
It’s important to note that not everyone who experiences trauma will eventually develop PTSD. It’s also important to point out that many people with PTSD may not even recognize they have it. The first step is exploring the different forms of PTSD, which include:
- Uncomplicated PTSD
- Complex PTSD
- Co-morbid PTSD
However, it’s necessary to first look at the normal stress and acute stress responses.
“PTSD has really evolved over time as we continue to learn more through research. It started with ‘shell shock’ and originally applied to mostly military personnel and veterans. Now, we know that it’s more and that it’s not population specific. With that, treatment for PTSD has evolved to accommodate the evolution of this diagnosis.”
— Minkyoung Chung, Licensed Mental Health Counselor (LMHC), MS
Normal stress response
It’s natural to go through periods of stress during life, and each stressor can elicit a wide range of responses. If you’ve experienced a traumatic event recently (or even in your past), you might begin to notice several symptoms throughout your healing.
Common symptoms of a normal stress response can include:
- Emotional numbness
- Painful memories
- Dissociation
- Starting to feel like you want to avoid anyone or anything that reminds you of the experience
Your stress response is part of your internal protection system. When you feel stress or trauma, your body naturally enters fight-or-flight mode. This causes your senses to shift into high gear as you prepare to either run away (flight) or attempt to face whatever the threat is (fight). Once the threat is gone, your body returns to normal. The effects of the stressor are soon lessened or forgotten, and they won’t continue affecting your daily life.
While it’s true that the onset of PTSD can begin with a normal stress response, this doesn’t mean a normal stress response will lead to an intense form of PTSD. Most often, you can recover from a normal stress response in just a few weeks.
Acute stress response
Acute stress responses are severe reactions to stress that begin very quickly but don’t generally last very long. These strong stress reactions usually occur relatively soon after an unexpected trauma, like a car accident or losing a loved one.
Acute stress response symptoms can be psychological or physical.
Psychological symptoms might include:
- Depressed mood
- Poor sleep
- Anxiety
- Irritability
- Emotional numbness
- Inability to concentrate
- The desire to be alone
- Recurrent dreams
- Nightmares
- Flashbacks
Physical symptoms can also be present and often include things like:
- Heart palpitations
- Upset stomach
- Headache
- Difficulty breathing
Research shows that acute distress disorder explains the different types of acute stress reactions (ASRs) that may occur. These reactions typically happen in no less than three days and no more than about four weeks after an experience.
In contrast, when reactions continue for a longer period of time, say more than four weeks, they may meet some of the criteria needed for a post-traumatic stress disorder (PTSD) diagnosis. There are three types of PTSD that all generally share similar symptoms characterized by intrusion, avoidance, heightened arousal and marked changes in mood and cognition. However, each has its own nuances and situations that put each in their own category.
1. Uncomplicated PTSD
Uncomplicated PTSD is a commonly diagnosed and highly treatable mental health condition. It typically results after experiencing one single traumatic event, like being in a car accident or experiencing a violent assault for instance. The major distinction of this form of PTSD is that it exists without other mental health conditions, like anxiety or depression.
Common symptoms of uncomplicated PTSD can include:
- Mood swings
- Feeling unsafe
- Irritability
- Avoiding anything to do with or memory of the situation
Uncomplicated PTSD is often the simplest form of PTSD to diagnose. It’s typically treatable with talk therapy (psychotherapy) modalities, including cognitive behavioral therapy for PTSD (CBT).
2. Complex PTSD
Complex PTSD is the most severe form of the condition. It occurs in individuals who have experienced prolonged and intense forms of trauma. Often, the trauma may have lasted for months or even years, and it could stem from physical, verbal, or sexual abuse — or, in some cases, a combination of types of abuse. CPTSD often includes other diagnoses like substance use and eating disorders. It is also commonly misdiagnosed as a personality disorder.
Treatment for complex PTSD can take much longer than uncomplicated PTSD. A well-structured management plan including CBT, exposure therapy, or another form of psychotherapy, possibly along with carefully-monitored prescription medications, are typically required to combat this debilitating mental health condition. Recovery can take months, or in some cases, years.
3. Co-morbid PTSD
Co-morbid PTSD refers to post-traumatic stress disorder symptoms that are present along with other mental health conditions. It’s really not uncommon to have PTSD with one or more other conditions. In fact, according to research, other psychiatric disorders often co-occur with post-traumatic stress disorder (PTSD).
Epidemiological survey data from the Medical University of South Carolina study shows that a large number of people living with PTSD also meet the criteria for one or more additional psychiatric disorders. Further, a healthy percentage have three or more other psychiatric conditions.
Co-occurring conditions
Some of the more common co-occurring conditions that might present along with PTSD can include:
- Panic disorder
- Anxiety disorder
- Substance abuse disorder
- Major depressive disorder
Treatment for co-morbid PTSD typically involves CBT or another form of psychotherapy, PTSD medication, a desire to improve the situation, and a willingness to make certain lifestyle changes that support, encourage, and positively impact recovery.
When to Seek a Professional
If you check for all or more of these symptoms, the next step is to get a PTSD diagnosis. After getting an official diagnosis, it’s important you learn how to treat PTSD properly. The good news is there are very effective treatments for PTSD. In-person/online therapy and PTSD medication have both been proven effective for many people.
When should you seek help? The National Center for PTSD recommends you seek a treatment option if you’ve had at least 1 re-experiencing symptom, 3 avoidance symptoms, and 2 hyperarousal symptoms within one month. Too often people with PTSD symptoms wait to get treatment and suffer unnecessarily.
Consulting a therapist can be a great first step in determining the best PTSD treatment for you or a loved one. An experienced therapist can guide you and provide further education around cognitive behavioral therapy (CBT), eye movement and desensitization and reprocessing therapy (EMDR), and other techniques that are known to be effective in treating PTSD. A therapist can also help determine the cause of your PTSD. Once you find the source of trauma, you can work towards dealing with PTSD.
If you suspect you’re showing signs of PTSD, learn more with a self PTSD test from Talkspace.
