Post-Traumatic Stress Disorder (PTSD) Symptoms, Causes & Treatment Options

PTSD is a syndrome that may include extreme self-protectiveness, mood problems, nightmares, flashbacks, and avoidant behavior that sometimes develops after exposure to scary or life-threatening events.

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Contents

  1. Overview
  2. Symptoms
  3. Potential Causes
  4. Treatment, Prevention and Relief
  5. When to Seek Further Consultation
  6. References

What Is Post-Traumatic Stress Disorder (PTSD)?

Summary

PTSD is a disorder that sometimes develops after people are experience or witness a shocking, scary, or life-threatening event. Trauma may affect combat veterans as well as people who have experienced physical or sexual assault, abuse, natural disasters, accidents, or other serious events. PTSD can also occur indirectly, such as after hearing about the violent death of a close friend or family member or being repeatedly exposed to details of trauma, such as in law enforcement or social service occupations [1].

PTSD occurs when symptoms persist for more than one month following a traumatic exposure. Symptoms may include nightmares or flashbacks of the event, negative thoughts and feelings, avoidance of reminders of the event, feeling constantly on alert, and difficulty sleeping, among other symptoms. These symptoms often interfere with daily activities and strain relationships. PTSD is associated with increased risk of depression, anxiety, suicide, and substance use.

Although some people recover from PTSD with time and social support, a number of treatments have been found to reduce symptoms and facilitate recovery from PTSD. These include medications, such as SSRIs, psychotherapy, and alternative therapies.

Recommended care

Post-Traumatic Stress Disorder (PTSD) Symptoms

Main symptoms

The human body naturally reacts to threats with a “fight or flight” response to make you feel alert and promote safety. It is normal to feel unsettled following a scary event, and for most people, symptoms improve within days or weeks. In PTSD, symptoms persist for more than one month, interfering with daily tasks and relationships, and one may feel stressed or frightened even when danger is not immediately present [2]. Symptoms can vary from person-to-person and fluctuate over time. They generally fall into the following four domains [3]:

  • Intrusion symptoms: recurrent unwanted thoughts about the event, nightmares about the event, flashbacks in which one feels as if one is re-experiencing the event, intense emotional or physical distress at cues that resemble an aspect of the event
  • Avoidance: efforts to avoid thoughts or feelings related to the event or external reminders (e.g., people, places, activities, objects, or situations) that elicit distressing thoughts, feelings, or memories of the event
  • Negative changes in mood and thoughts: exaggerated negative beliefs about oneself or the world (e.g., “I am broken,” “the world is completely dangerous”), blaming oneself for the event, persistent negative emotional state (e.g., fear, anger, guilt, shame), feeling detached from others, inability to experience positive feelings (e.g., happiness, love), inability to remember important aspects of the event
  • Hyperarousal: feeling constantly “on edge,” angry outbursts, startling easily, having difficulty focusing, difficulty sleeping

Other symptoms

A subset of people with PTSD additionally may experience depersonalization (i.e., feeling detached from one’s own mind or body) or derealization (e.g., feeling the world is unreal or dreamlike).

PTSD can also be associated with physical symptoms, such as:

  • Dizziness
  • Fatigue
  • Teeth grinding
  • Headaches
  • Nausea
  • Rapid heart rate
  • Sweating
  • Twitching
  • Weakness [4]

Symptoms in children

Children and adolescents may react differently to trauma than adults. In children, symptoms of PTSD may include [2]:

  • Bed wetting
  • Difficulty speaking
  • Increased clinginess to parents or other adults
  • Repetitive play that re-enacts traumatic event
  • Disruptive behavior
  • Feeling guilty

Complications

PTSD has been associated with increased risk of other medical conditions, including [4]:

  • Substance use disorders
  • Depression
  • Anxiety
  • Suicide
  • Chronic pain

Post-Traumatic Stress Disorder (PTSD) Causes

PTSD develops in an estimated 8% of men and 20% of women who are exposed to traumatic events [4] and affects an estimated 1 in 11 US adults during life [1]. The exact cause is not well understood, but it’s believed to be a complex interplay of genetic, environmental, and other factors. In addition to exposure to trauma, risk of PTSD may be increased by poor social support, prior trauma, feelings of helplessness, and other mental health problems [2,4].

Post-Traumatic Stress Disorder (PTSD) Symptom Checker

Take a quiz to find out if your symptoms point to post-traumatic stress disorder (PTSD)

Treatment Options, Relief, and Prevention for Post-Traumatic Stress Disorder (PTSD)

Psychotherapy

A variety of therapies can help relieve symptoms of PTSD. Therapy may include learning about trauma and its effects; practicing self-relaxation and anger reduction skills; improving daily routines (e.g., sleep, diet, and exercise); addressing feelings of guilt, shame, or anger related to the event; and changing reactions to reminders of trauma [2]. Specific therapies for trauma include:

  • Exposure therapy: uses progressive and repeated exposure to symptom triggers in a safe and controlled environment to help the individual gain control and learn to cope with distress
  • Cognitive processing therapy: focuses on altering negative emotions (e.g., guilt, anger) and thoughts (“the world is dangerous”)
  • Group therapy with survivors of similar events [1]
  • Eye movement desensitization and reprocessing (EMDR): a form of exposure therapy in which people are asked to follow a moving object (e.g., the therapist’s finger) while imagining exposure to the trauma [5]
  • Family therapy: PTSD can have significant impacts on one’s partner and children. In these situations, family or marital therapy can be helpful.

Medications

Medications have been found to help relieve symptoms of PTSD and in some cases enable people to more effectively participate in psychotherapy.

  • Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) such as sertraline (Zoloft) are the first-line treatment for PTSD. Use of these medications has been associated with a reduction in flashbacks, intrusive thoughts, irritability, concentration difficulties, hyperarousal, anxiety, and depressed mood; however, these effects may not be apparent for up to two months after starting treatment [4].
  • Prazosin (Minipress), a medication that blocks the adrenaline receptor, can be effective in reducing nightmares and insomnia in PTSD.
  • Depending on an individual’s particular symptoms, other medications may be recommended.

Other treatments

A variety of other treatments, including complementary and alternative medicine, have also been found to help people recover from PTSD. These approaches may include acupuncture, animal-assisted therapy, yoga, or dance and movement therapy.

Factors that promote recovery after trauma

Not everyone who experiences a traumatic event develops PTSD. The following may reduce the risk of developing symptoms after trauma [2]:

  • Seeking support from friends, family, or other caring individuals
  • Participating in support groups after traumatic events
  • Using positive coping strategies, learning from the bad event
  • Avoiding alcohol and drugs

When to Seek Further Consultation for Post-Traumatic Stress Disorder (PTSD)

If you are having symptoms of PTSD that are difficult to control and interfering with your daily life

Some difficulties following a traumatic event are normal. However, if you feel like you are experiencing symptoms that are out of control and getting in the way of work, family, school, and other responsibilities, report these concerns to your physician.

If you are having thoughts of ending your life

If for any reason you are feeling that life is no longer worth living, report these thoughts to your physician, call 911 or the National Suicide Prevention Lifeline (1-800-273-TALK), or seek help at the nearest emergency room.

If you are having problems controlling the use of substances

If the use of alcohol, tobacco, or other substances is getting in the way of your life, talk to a physician about other ways to control your symptoms and regain control of your life.