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Written by:Ashley Ertel, LCSW, BCD

Published On: October 17, 2019

Medically reviewed by: Cynthia V. Catchings, LCSW-S

Reviewed On: October 17, 2019

Updated On: July 14, 2023


Panic attacks, nightmares, intrusive thoughts, depression, and insomnia are all common symptoms of post-traumatic stress disorder (PTSD). PTSD is a mental health condition that can develop in anyone who’s experienced a dangerous, shocking, or life-threatening traumatic experience. War, rape, sexual assault, childhood abuse, an abusive relationship, or even a serious accident can all be a cause of PTSD.

One of the most characteristic and debilitating PTSD symptoms involves “flashbacks,” or the feeling of re-experiencing a traumatic event. It’s really important to understand that PTSD can evolve, and symptoms can worsen over time. This is one reason why understanding the disorder and seeking treatment is so essential.

Read on to learn more about the signs and symptoms of PTSD and to learn when it’s time to get help.

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.”

Licensed Clinical Social Worker (LCSW), BCD, C-DBT Ashley Ertel

Main Symptoms of PTSD

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.”

Licensed Clinical Social Worker (LCSW), BCD, C-DBT Ashley Ertel

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.”

Licensed Clinical Social Worker (LCSW), BCD, C-DBT Ashley Ertel

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.

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.

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 PTSD test from Talkspace.

See References

Ashley Ertel, LCSW, BCD

Ashley Ertel, LCSW, is a Nationally Board Certified Licensed Clinical Social Worker. She has over a decade of experience specializing in trauma and depression, working primarily with first responders, military personnel, and veterans, and sexual assault survivors.

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