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Post-traumatic stress disorder (PTSD)

Post-traumatic stress disorder (PTSD) is a mental health condition that's triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.

Many people who go through traumatic events have difficulty adjusting and coping for a while, but they don't have PTSD — with time and good self-care, they usually get better. But if the symptoms get worse or last for months or even years and interfere with your functioning, you may have PTSD.

Getting effective treatment after PTSD symptoms develop can be critical to reduce symptoms and improve function.

Symptoms Causes Risk factors Complications Prevention

Post-traumatic stress disorder symptoms may start within three months of a traumatic event, but sometimes symptoms may not appear until years after the event. These symptoms cause significant problems in social or work situations and in relationships.

PTSD symptoms are generally grouped into four types: intrusive memories, avoidance, negative changes in thinking and mood, or changes in emotional reactions.

Intrusive memories

Symptoms of intrusive memories may include:

  • Recurrent, unwanted distressing memories of the traumatic event
  • Reliving the traumatic event as if it were happening again (flashbacks)
  • Upsetting dreams about the traumatic event
  • Severe emotional distress or physical reactions to something that reminds you of the event

Avoidance

Symptoms of avoidance may include:

  • Trying to avoid thinking or talking about the traumatic event
  • Avoiding places, activities or people that remind you of the traumatic event

Negative changes in thinking and mood

Symptoms of negative changes in thinking and mood may include:

  • Negative feelings about yourself or other people
  • Inability to experience positive emotions
  • Feeling emotionally numb
  • Lack of interest in activities you once enjoyed
  • Hopelessness about the future
  • Memory problems, including not remembering important aspects of the traumatic event
  • Difficulty maintaining close relationships

Changes in emotional reactions

Symptoms of changes in emotional reactions (also called arousal symptoms) may include:

  • Irritability, angry outbursts or aggressive behavior
  • Always being on guard for danger
  • Overwhelming guilt or shame
  • Self-destructive behavior, such as drinking too much or driving too fast
  • Trouble concentrating
  • Trouble sleeping
  • Being easily startled or frightened

Intensity of symptoms

PTSD symptoms can vary in intensity over time. You may have more PTSD symptoms when you're stressed in general, or when you run into reminders of what you went through. For example, you may hear a car backfire and relive combat experiences. Or you may see a report on the news about a sexual assault and feel overcome by memories of your own assault.

When to see a doctor

If you have disturbing thoughts and feelings about a traumatic event for more than a month, if they're severe, or if you feel you're having trouble getting your life back under control, talk to your health care professional. Get treatment as soon as possible to help prevent PTSD symptoms from getting worse.

If you have suicidal thoughts

If you or someone you know is having suicidal thoughts, get help right away through one or more of these resources:

  • Reach out to a close friend or loved one.
  • Contact a minister, a spiritual leader or someone in your faith community.
  • Call a suicide hotline number — in the United States, call the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255) to reach a trained counselor. Use that same number and press 1 to reach the Veterans Crisis Line.
  • Make an appointment with your doctor, mental health provider or other health care professional.

When to get emergency help

If you think you may hurt yourself or attempt suicide, call 911 or your local emergency number immediately.

If you know someone who's in danger of committing suicide or has made a suicide attempt, make sure someone stays with that person. Call 911 or your local emergency number immediately. Or, if you can do so safely, take the person to the nearest hospital emergency room.

You can develop post-traumatic stress disorder when you go through, see or learn about an event involving actual or threatened death, serious injury or sexual violation.

Doctors aren't sure why some people get PTSD. As with most mental health problems, PTSD is probably caused by a complex mix of:

  • Inherited mental health risks, such as an increased risk of anxiety and depression
  • Life experiences, including the amount and severity of trauma you've gone through since early childhood
  • Inherited aspects of your personality — often called your temperament
  • The way your brain regulates the chemicals and hormones your body releases in response to stress

People of all ages can have post-traumatic stress disorder. However, some factors may make you more likely to develop PTSD after a traumatic event, such as:

  • Experiencing intense or long-lasting trauma
  • Having experienced other trauma earlier in life, including childhood abuse or neglect
  • Having a job that increases your risk of being exposed to traumatic events, such as military personnel and first responders
  • Having other mental health problems, such as anxiety or depression
  • Lacking a good support system of family and friends
  • Having biological (blood) relatives with mental health problems, including PTSD or depression 

Kinds of traumatic events

The most common events leading to the development of PTSD include:

  • Combat exposure
  • Childhood neglect and physical abuse
  • Sexual assault
  • Physical attack
  • Being threatened with a weapon

Many other traumatic events also can lead to PTSD, such as fire, natural disaster, mugging, robbery, car accident, plane crash, torture, kidnapping, life-threatening medical diagnosis, terrorist attack, and other extreme or life-threatening events.

Post-traumatic stress disorder can disrupt your whole life: your job, your relationships, your health and your enjoyment of everyday activities.

Having PTSD also may increase your risk of other mental health problems, such as:

  • Depression and anxiety
  • Issues with drugs or alcohol use
  • Eating disorders
  • Suicidal thoughts and actions

After surviving a traumatic event, many people have PTSD-like symptoms at first, such as being unable to stop thinking about what's happened. Fear, anxiety, anger, depression, guilt — all are common reactions to trauma. However, the majority of people exposed to trauma do not develop long-term post-traumatic stress disorder.

Getting support can help you recover. This may mean turning to family and friends who will listen and offer comfort. It may mean seeking out a mental health provider for a brief course of therapy. Some people may also find it helpful to turn to their faith community.

Getting timely help and support may prevent normal stress reactions from getting worse and developing into PTSD. Support from others may also help prevent you from turning to unhealthy coping methods, such as misuse of alcohol or drugs.

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