Post-traumatic stress disorder (ptsd)

What is post-traumatic stress disorder (PTSD)?

Post-traumatic stress disorder (PTSD) is a condition that can follow experiencing or witnessing any disturbing event that makes you fear for your safety. While it’s normal to feel frightened, sad, anxious, and disconnected after a traumatic experience, if the upset doesn’t fade, you may be suffering from PTSD.

Most people associate PTSD with rape or battle-scarred soldiers—and military combat is the most common cause in men. But any event, or series of events, that overwhelms you with feelings of hopelessness and helplessness and leaves you emotionally shattered, can trigger PTSD—especially if the event feels unpredictable and uncontrollable.

PTSD can affect people who personally experience the traumatic event, those who witness the event, or those who pick up the pieces afterwards, such as emergency workers and law enforcement officers. It can even occur in the friends or family members of those who went through the actual trauma. Whatever the cause for your PTSD, by seeking treatment, reaching out for support, and developing new coping skills, you can learn to manage your symptoms, reduce painful memories, and move on with your life.

Traumatic events that can lead to PTSD include:

War

Natural disasters

Car or plane crashes

Terrorist attacks

Sudden death of a loved one

Rape

Kidnapping

Assault

Sexual or physical abuse

Childhood neglect

Or any shattering event that leaves you stuck and feeling helpless and hopeless.

Causes

When you experience a stressful event, your nervous system reacts with the fight-or-flight response. Your heart pounds faster, your blood pressure rises, and your muscles tighten, increasing your strength and reaction speed. Once the danger has passed, your nervous system calms your body, lowers your heart rate and blood pressure, and winds back down to its normal state.

PTSD occurs when you experience too much stress in a situation. Even though the danger has passed, your nervous system is “stuck,” unable to return to its normal state of balance and you’re unable to move on from the event. Recovering from PTSD involves helping your nervous system become “unstuck” so you can heal and move on from the trauma.

PTSD vs. a normal response to traumatic events

Following a traumatic event such as a natural disaster, traffic accident, terrorist attack, or assault, almost everyone experiences at least some of the symptoms of PTSD. When your sense of safety and trust are shattered, it’s normal to feel unbalanced, disconnected, or numb. It’s very common to have bad dreams, feel fearful, and find it difficult to stop thinking about what happened. These are normal reactions to abnormal events.

For most people, however, these symptoms are short-lived. They may last for several days or even weeks, but they gradually lift. But if you have post-traumatic stress disorder, the symptoms don’t decrease and you don’t feel a little better each day. In fact, you may start to feel worse.

Signs and symptoms of PTSD

PTSD develops differently from person to person because everyone's nervous system and tolerance for stress is a little different. While you're most likely to develop symptoms of PTSD in the hours or days following a traumatic event, it can sometimes take weeks, months, or even years before they appear. Sometimes symptoms appear seemingly out of the blue. At other times, they are triggered by something that reminds you of the original traumatic event, such as a noise, an image, certain words, or a smell.

While everyone experiences PTSD differently, there are four main types of symptoms:

1. Re-experiencing the traumatic event

This can involve:

Intrusive, upsetting memories of the event.

Flashbacks (acting or feeling like the event is happening again).

Nightmares (either of the event or other frightening things).

Feelings of intense distress when reminded of the trauma.

Intense physical reactions to reminders of the event (e.g. pounding heart, rapid breathing, nausea, muscle tension, sweating).

2. Avoidance and numbing

Such as:

Avoiding activities, places, thoughts, or feelings that remind you of the trauma.

Inability to remember important aspects of the event.

Loss of interest in activities and life in general.

Feeling detached from others and emotionally numb.

Sense of a limited future (you don’t expect to live a normal life span, get married, have a career).

3. Increased anxiety and emotional arousal (hyperarousal)

These symptoms include:

Difficulty falling or staying asleep.

Irritability or outbursts of anger.

Difficulty concentrating.

Hypervigilance (on constant “red alert”).

Feeling jumpy or easily startled.

Self-destructive or reckless behavior.

4. Negative thought and mood changes

Such as:

Feeling alienated and alone.

Depression and hopelessness.

Feelings of mistrust and betrayal.

Guilt, shame, or self-blame.

Substance abuse.

Physical aches and pains.

Suicidal thoughts.

How can I help myself?

Living with PTSD can feel overwhelming. This page offers some practical suggestions for looking after yourself.

Tips on coping with flashbacks

Flashbacks can be very distressing, but there are things you can do that might help. You could:

Focus on your breathing. When you are frightened, you might stop breathing normally. This increases feelings of fear and panic, so it can help to concentrate on breathing slowly in and out while counting to five.

Carry an object that reminds you of the present. Some people find it helpful to touch or look at a particular object during a flashback. This might be something you decide to carry in your pocket or bag, or something that you have with you anyway, such as a keyring or a piece of jewellery.

Tell yourself that you are safe. It may help to tell yourself that the trauma is over and you are safe now. It can be hard to think in this way during a flashback, so it could help to write down or record some useful phrases at a time when you're feeling better.

Comfort yourself. For example, you could curl up in a blanket, cuddle a pet, listen to soothing music or watch a favourite film.

Keep a diary. Making a note of what happens when you have a flashback could help you spot patterns in what triggers these experiences for you. You might also learn to notice early signs that they are beginning to happen.

Try grounding techniques. Grounding techniques can keep you connected to the present and help you cope with flashbacks or intrusive thoughts. For example, you could describe your surroundings out loud or count objects of a particular type or colour. See our page on self-care for dissociative disorders for more information on grounding techniques.

You can't stop the waves but you can learn to surf; through my PTSD recovery journey I've learnt that emotions come and go in waves. It's best not to fight against them but ride with them.

Get to know your triggers add

Confide in someone add

Give yourself time add

Try peer support add

Find specialist support add

Look after your physical health add

Exercise