What Is Post-Traumatic Stress Disorder (PTSD)?

Signs and symptoms of PTSD

For people with PTSD, symptoms can be triggered by anything that makes the person feel threatened, whether it’s real or perceived danger. Triggers may include noises, smells, songs, etc.

There are four main symptom groups associated with PTSD. You must experience all of these symptoms for at least a month to receive a diagnosis.

1. Relive the event

Intrusive memories are memories of a trauma that occur in response to a triggering stimulus (such as a taste or smell) and can return at any time, making the person feel as if they are reliving the trauma. Physical symptoms include sweating and a racing heart.

In severe cases, people may relive the event through flashbacks, making them feel as if they were momentarily transported back to when the event occurred.

People with PTSD may also experience dreams and nightmares about the trauma. “These things cause a lot of distress to people, and when something like this happens, people often try to find ways to manage their emotions,” says Dr. Michelle Paul, director of the West Chester University School of Community Mental Health Services in West Chester, Pennsylvania.

2. Avoidance

People with PTSD actively try to avoid thoughts, feelings, people, places, and situations that remind them of the trauma. They may also avoid talking to others about their trauma.

For example, if you are involved in a serious car accident, you may drive several miles away to avoid the intersection where the traumatic event occurred.

Avoidance can lead to unhealthy behaviors. People may start drinking or using drugs, or use one or the other more frequently, Paul said. “It’s a way for someone to not feel the emotions that come up after experiencing trauma (and) self-medicate,” she says.

3. Arousal and reactivity

When people with PTSD go into fight-or-flight mode and their nervous system is on constant alert, they experience feelings of hyperarousal and agitation. “People search their surroundings for danger because they fear that danger is everywhere,” Dr. Paul says.

PTSD patients who experience symptoms of hyperarousal may have an increased startle response, difficulty concentrating, and experience sleep disturbances. They may also engage in destructive behavior or have aggressive outbursts.

4. Mood and cognitive changes

People with PTSD may experience changes in the way they view the world, themselves, and others. They may have more negative thoughts and feelings and feel less able to trust others or themselves. “They may decide that the world is not a safe place,” Paul said.

It is also common for people with PTSD to feel shame. Trying to make sense of what happened, they blame themselves. They may mistakenly believe that it was their fault or that they can prevent it from happening again, and this is especially true for women who are victims of sexual assault.

People may feel shame because they believe they were not strong enough to stop the trauma. “It’s a way for them to feel like they have some control over what happens to them, but that shame keeps them stuck,” Paul says.

Other mood and cognitive symptoms of PTSD include difficulty remembering specific parts of the trauma, feelings of isolation or isolation, decreased interest in activities you once enjoyed, and difficulty experiencing positive emotions. These symptoms can be particularly difficult to manage because they are not easy to diagnose.