Post-Traumatic Stress Disorder (PTSD) Basics

Post-traumatic stress disorder (PTSD) is a mental health problem. PTSD can only develop after you go through or see a life-threatening event. It's normal to have stress reactions to these types of events, and most people start to feel better after a few weeks or months. Learn about PTSD symptoms and treatments to help you get better.

It's normal to have upsetting memories, feel on edge, or have trouble sleeping after a traumatic event (also called trauma). At first, it may be hard to do daily activities you are used to doing, like going to work, going to school, or spending time with people you care about. However, most people start to feel better after a few weeks or months. For some people, PTSD symptoms may start later, or they may come and go over time. If it's been longer than a few months and thoughts and feelings from the trauma are upsetting you or causing problems in your life, you may have PTSD.

When you have PTSD, the world feels unsafe. You may have upsetting memories, feel on edge, or have trouble sleeping. You may also try to avoid things that remind you of your trauma—even things you used to enjoy.

Who develops PTSD?

Anyone can develop PTSD at any age. Some factors can increase the chance that someone will have PTSD, many of which are not under that person's control. For example, having a very intense or long-lasting traumatic event or getting injured during the event can make it more likely that a person will develop PTSD. PTSD is also more common after certain types of trauma, like combat and sexual assault.

Personal factors—like previous traumatic exposure, age, and gender—can affect whether or not a person will develop PTSD. What happens after the traumatic event is also important. Stress can make PTSD more likely, while social support can make it less likely.

What are the symptoms of PTSD?

PTSD symptoms usually start soon after the traumatic event, but they may not appear until months or years later. They also may come and go over many years. If the symptoms last longer than four weeks, cause you great distress, or interfere with your work or home life, you might have PTSD.

There are four types of PTSD symptoms, but they may not be exactly the same for everyone. Each person experiences symptoms in their own way.

Reliving the Event (Re-experiencing Symptoms)

Memories of the traumatic event can come back at any time. They can feel very real and scary. Here are examples:

• You may have nightmares.
• You may feel like you are going through the event again. This is called a flashback.
• You may see, hear, or smell something that causes you to relive the event. This is called a trigger. News reports, seeing an accident, or hearing fireworks are examples of triggers.

Avoiding Things That Remind You of the Event (Avoidance Symptoms)

You may try to avoid situations or people that remind you of the trauma event. You may even avoid talking or thinking about the event. Here are some examples:

• You may avoid crowds because they feel dangerous.
• You may avoid driving if you were in a car accident or if your military convoy was bombed.
• If you were in an earthquake, you may avoid watching movies about earthquakes.
• You may keep very busy or avoid getting help so you don't have to think or talk about the event.

Having More Negative Thoughts and Feelings Than Before the Event

The way you think about yourself and others may become more negative because of the trauma. Here are some examples:

• You may feel numb—unable to have positive or loving feelings toward other people—and lose interest in things you used to enjoy.
• You may forget about parts of the traumatic event or not be able to talk about them.
• You may think the world is completely dangerous, and no one can be trusted.
• You may feel guilt or shame about the event, wishing you had done more to keep it from happening.

Feeling on Edge or Keyed Up (Also Called Hyperarousal)

You may be jittery, or always alert and on the lookout for danger. You might suddenly become angry or irritable. Here are examples:

• You may have a hard time sleeping.
• You may find it hard to concentrate.
• You may be startled by a loud noise or surprise.
• You might act in unhealthy ways, like smoking, abusing drugs or alcohol, or driving aggressively.

What are the symptoms of PTSD in children?

Children may have symptoms like those above or other symptoms. As children get older, their symptoms are more like those of adults. Here are some examples of PTSD symptoms in children and teens:

• Children under six may get upset if their parents are not close by, have trouble sleeping, or act out the trauma in their play.
• Children ages 7 to 11 may also act out the trauma through play, drawings, or stories. Some have nightmares or become more irritable or aggressive. They may also want to avoid school or have trouble with schoolwork or friends.
• Children ages 12 to 18 have symptoms more similar to adults: depression, anxiety, withdrawal, or reckless behavior, like substance abuse or running away.

Do people with PTSD get better?

After a traumatic event, it's normal to think, act, and feel differently than usual—but most people start to feel better after a few weeks or months. Talk to a doctor or mental health care provider (like a psychiatrist, psychologist, or social worker) if your symptoms

• Last longer than a few months
• Are very upsetting
• Disrupt your daily life

"Getting better" means different things for different people. There are many different treatment options for PTSD. For many people, these treatments can get rid of symptoms altogether. Others find they have fewer symptoms or feel that their symptoms are less intense. Your symptoms don't have to interfere with your everyday activities, work, and relationships.

What treatments are available?

Both trauma-focused psychotherapy (sometimes called counseling or talk therapy) and medication are proven to treat PTSD. Sometimes people combine psychotherapy and medication.

Trauma-Focused Psychotherapy

Trauma-focused psychotherapy is the most highly recommended treatment for PTSD. Trauma-focused means that the treatment focuses on the memory of the traumatic event or its meaning. These are the three most effective types of trauma-focused psychotherapy:

• Cognitive processing therapy (CPT) is where you learn skills to understand how trauma changed your thoughts and feelings. Changing how you think about the trauma can change how you feel.
• Prolonged exposure (PE) is where you talk about your trauma repeatedly until memories are no longer upsetting. This will help you get more control over your thoughts and feelings about the trauma. You also go to places or do things that are safe, but that you have been staying away from because they remind you of the trauma.
• Eye movement desensitization and reprocessing (EMDR) involves focusing on sounds or hand movements while you talk about the trauma. This helps your brain work through the traumatic memories.

Medications for PTSD

Certain medications can be effective for treating PTSD symptoms. Some specific SSRIs (selective serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake inhibitors), which are used for depression, also work for PTSD. These include sertraline, paroxetine, fluoxetine, and venlafaxine.