Post-traumatic stress disorder (PTSD) is a mental health condition 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.
Most people who go through traumatic events may have temporary difficulty adjusting and coping, but they usually get better with time and good self-care. If the symptoms worsen, last for months or even years, and interfere with your day-to-day functioning, you may have PTSD.
People with PTSD may relive their trauma, have intense anxiety, avoid things that remind them of their trauma, and experience overwhelming emotions. These emotions can affect the way they relate to others. This could potentially damage their relationships or add extra challenges.
What Causes PTSD?
You can develop post-traumatic stress disorder when you 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:
- Stressful experiences, including the amount and severity of trauma you’ve gone through in your life
- Inherited mental health risks, such as a family history of anxiety and depression
- Inherited features of your personality — often called your temperament
- The way your brain regulates the chemicals and hormones your body releases in response to stress
Symptoms of PTSD
PTSD symptoms are generally grouped into four types: intrusive memories, avoidance, negative changes in thinking and mood, and changes in physical and emotional reactions. Symptoms can vary over time or vary from person to person.
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 or nightmares about the traumatic event
- Severe emotional distress or physical reactions to something that reminds you of the traumatic event
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
Adverse changes in thinking and mood
Symptoms of adverse changes in thinking and mood may include:
- Negative thoughts about yourself, other people, or the world
- Hopelessness about the future
- Memory problems, including not remembering important aspects of the traumatic event
- Difficulty maintaining close relationships
- Feeling detached from family and friends
- Lack of interest in activities you once enjoyed
- Difficulty experiencing positive emotions
- Feeling emotionally numb
Changes in physical and emotional reactions
Symptoms of changes in physical and emotional reactions (also called arousal symptoms) may include:
- Being easily startled or frightened
- Always being on guard for danger
- Self-destructive behavior, such as drinking too much or driving too fast
- Trouble sleeping
- Trouble concentrating
- Irritability, angry outbursts, or aggressive behavior
- Overwhelming guilt or shame
For children six years old and younger, signs and symptoms may also include:
- Re-enacting the traumatic event or aspects of the traumatic event through play
- Frightening dreams that may or may not include aspects of the traumatic event
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 encounter 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 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 medical doctor or mental health professional. Getting some therapy as soon as possible can help prevent PTSD symptoms from worsening.
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, such as childhood abuse
- 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
- Having problems with substance misuse, such as excess drinking or drug use
- Lacking a sound support system of family and friends
- Having blood relatives with mental health problems, including anxiety or depression
Post-traumatic stress disorder treatment can help you regain a sense of control over your life. The primary treatment is psychotherapy, but it can also include medication. Combining these treatments can help improve your symptoms by:
- Teaching you skills to address your symptoms
- Helping you think better about yourself, others, and the world
- Learning ways to cope if any symptoms arise again
- Treating other problems often related to traumatic experiences, such as depression, anxiety, or misuse of alcohol or drugs
You don’t have to try to handle the burden of PTSD on your own.
Several types of psychotherapy, also called talk therapy, may treat children and adults with PTSD. Some types of psychotherapy used in PTSD treatment include:
- Cognitive therapy: This type of talk therapy helps you recognize the ways of thinking (cognitive patterns) that keep you stuck — for example, negative beliefs about yourself and the risk of traumatic things happening again. For PTSD, cognitive therapy often is used along with exposure therapy.
- Exposure therapy: This behavioral therapy helps you safely face both situations and memories that you find frightening so that you can learn to cope with them effectively. Exposure therapy can be beneficial for flashbacks and nightmares. One approach uses virtual reality programs that allow you to re-enter the setting in which you experienced trauma.
- Eye movement desensitization and reprocessing (EMDR): EMDR combines exposure therapy with a series of guided eye movements that help you process traumatic memories and change how you react to them.
Your therapist can help you develop stress management skills to help you better handle stressful situations and cope with stress in your life.
All these approaches can help you gain control of lasting fear after a traumatic event. You and your mental health professional can discuss what type of therapy or combination of treatments may best meet your needs.
You may try individual therapy, group therapy, or both. Group therapy can offer a way to connect with others going through similar experiences.
Several types of medications can help improve symptoms of PTSD:
- Antidepressants: These medications can help symptoms of depression and anxiety. They can also help improve sleep problems and concentration. The selective serotonin reuptake inhibitor (SSRI) medications sertraline (Zoloft) and paroxetine (Paxil) are approved by the Food and Drug Administration (FDA) for PTSD treatment.
- Anti-anxiety medications: These drugs can relieve severe anxiety and related problems. Some anti-anxiety medications have the potential for abuse, so they are generally used only for a short time.
- Prazosin: While several studies indicated that prazosin (Minipress) might reduce or suppress nightmares in some people with PTSD, a more recent study showed no benefit over placebo. But participants in the current study differed from others in ways that potentially could impact the results. Individuals considering prazosin should speak with a doctor to determine whether or not their particular situation might merit a trial of this drug.