Post-Traumatic Stress Disorder (PTSD)

Overview

What is post-traumatic stress disorder?

Post-traumatic stress disorder (PTSD) is a mental health issue that can develop after a distressing event. The event may be dangerous, life-threatening, shocking or very scary. Examples include:

  • Accident.
  • Fire.
  • Military combat.
  • Natural disaster, such as a tornado.
  • Physical abuse.
  • Sexual assault or rape.
  • Sudden death of a loved one.
  • Terrorist attack.

The traumatic event may have happened to you, or you may have seen it happen to someone else.

It’s normal to feel upset after something like that happening. You may have trouble sleeping, eating or doing things you enjoy for a little while. But with PTSD, symptoms last longer than a few months and interfere with your life.

How common is PTSD?

At least half the people in the United States have experienced a traumatic event. Among this group, 10% of men and 20% of women develop PTSD. Women experience neglect or abuse during childhood more often than men. They also experience sexual assault and domestic violence more often. Women tend to experience trauma differently than men, too.

Are some people more likely to develop PTSD than others?

There’s no way to predict who will develop PTSD from a traumatic event. However, PTSD is more common in people who have experienced:

  • Certain types of trauma, particularly military combat or sexual assault.
  • Injury during the event.
  • Lack of support from loved ones after a traumatic event.
  • Long-lasting or repeated trauma.
  • Personal history of anxiety or depression, even before the traumatic event.
  • Strong initial reaction to the event (for example, shaking or throwing up).
  • Very intense trauma.

Symptoms and Causes

What causes PTSD?

A traumatic event causes PTSD. But, scientists aren’t sure why some people get PTSD and others don’t.

What are the symptoms of PTSD?

PTSD symptoms vary from person to person. Still, everyone with PTSD experiences one or more of the following:

  • Avoiding things: You may avoid people or situations that remind you of the event. Examples include friends you met in the military service, the part of town where you experienced the trauma, or crowds in general. Some people with PTSD try to stay so busy that they don’t think about the event.
  • Being on edge: The disorder can make it hard for you to relax or enjoy the things you used to. You may feel jittery or anxious. Maybe you’re easily startled or always expect something bad to happen. You also may have trouble sleeping or concentrating.
  • Having negative thoughts and feelings: PTSD can make you feel negative, angry, sad, distrustful, guilty, or numb.
  • Reliving or re-experiencing the traumatic event: This can take the form of flashbacks or dreams. Perhaps a noise like a car backfiring or seeing something similar (for example, a fire) will trigger sudden, unwelcome memories.

How does PTSD affect your life?

PTSD can lead to other issues with your health and life, such as:

Children with PTSD may:

  • Act out the traumatic event when playing.
  • Cling to a parent or other adult.
  • Forget how to talk, or at least seem to.
  • Wet the bed even if they know how to use the toilet.

Diagnosis and Tests

How is PTSD diagnosed?

There’s no scan or blood test for PTSD. If you’ve experienced a traumatic event and are having symptoms of PTSD, talk to a healthcare provider.

The healthcare provider can make the diagnosis based on a conversation about your symptoms. To be considered PTSD, symptoms must last more than a month and interfere with your life.

Management and Treatment

The most effective treatment for PTSD combines medication and trauma-focused therapy.

Some medications can help your body produce more substances that manage stress and emotions. They fall into two broad categories:

  • Selective serotonin reuptake inhibitors (also called SSRIs).
  • Serotonin-norepinephrine reuptake inhibitors (also called SNRIs).

Trauma-focused therapy examines the event and its meaning. It can be done a few different ways:

  • Cognitive processing therapy: This method identifies negative thoughts and beliefs about the traumatic event and tries to change them.
  • Eye movement desensitization and reprocessing (EMDR): You focus on specific sounds or movements introduced by the therapist while you think about the event. It aims to make the event less upsetting over time.
  • Prolonged exposure therapy: This method encourages you to face thoughts, feelings and situations you’ve been avoiding. You may talk about your trauma over and over. You may also work toward doing things you’ve been staying away from.

Prevention

Can I prevent PTSD after a traumatic event?

You can’t necessarily prevent a traumatic event. But, some studies show that certain steps may help you prevent PTSD afterward:

  • Ask for help and support.
  • Believe that you can manage your emotions.
  • Find positive meaning from the trauma.
  • Focus on positive emotions and laughter.
  • Help other people.
  • Practice positive thinking.
  • Stay in constant contact with important people in your life.
  • Talk to loved ones about the event.
  • Think of yourself as a survivor instead of a victim.

Outlook / Prognosis

What is the outlook for people with PTSD?

Without treatment, PTSD can get worse over time. But treatment can help, even if the traumatic event was many years ago. For some people, treatment can cure PTSD. For others, it can make symptoms less intense.

Living With

What else can I do to cope?

Your healthcare provider can help you find support groups for people with PTSD caused by a similar event. You can connect with others who understand what you’re going through.

When should I seek immediate care?

If you think about hurting yourself or someone else, tell somebody right away. You can tell a healthcare provider, a friend or a family member.

You can also contact the Suicide and Crisis Lifeline at 988. You’re not alone. There’s always somebody who wants to help.

A note from Cleveland Clinic

PTSD is a mental health issue that lasts long after a traumatic event. It can make you feel negative and anxious. It can also cause you to re-experience the event or avoid certain things. If you have symptoms of PTSD, talk to a healthcare provider. Medication and specific kinds of counseling can help. If you feel like you might hurt yourself or someone else, seek help immediately.

Last reviewed by a Cleveland Clinic medical professional on 01/20/2021.

References

  • American Psychiatric Association. What Is Posttraumatic Stress Disorder? (https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd) Accessed 1/16/2021.
  • Anxiety and Depression Society of America. Post-Traumatic Stress Disorder PTSD. (https://adaa.org/sites/default/files/ADAA_PTSD.pdf) Accessed 1/16/2021.
  • Anxiety and Depression Society of America. How to Prevent Trauma from Becoming PTSD. (https://adaa.org/learn-from-us/from-the-experts/blog-posts/consumer/how-prevent-trauma-becoming-ptsd) Accessed 1/16/2021.
  • National Center for PTSD, U.S. Department of Veterans Affairs. Understanding PTSD and PTSD Treatment. (https://www.ptsd.va.gov/publications/print/understandingptsd_booklet.pdf) Accessed 1/16/2021.
  • National Institute of Mental Health. Post-Traumatic Stress Disorder. (https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml) Accessed 1/16/2021.

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