Post-Traumatic Stress Disorder

Symptoms of PTSD usually begin within 3 months of the traumatic event, but they sometimes emerge later. To meet the criteria for PTSD, a person must have symptoms for longer than 1 month, and the symptoms must be severe enough to interfere with aspects of daily life, such as relationships or work. The symptoms also must be unrelated to medication, substance use, or other illness.

The course of the disorder varies. Some people recover within 6 months, while others have symptoms that last for 1 year or longer. People with PTSD often have co-occurring conditions, such as depression, substance use, or one or more anxiety disorders.

After a dangerous event, it is natural to have some symptoms. For example, some people may feel detached from the experience, as though they are observing things rather than experiencing them. A mental health professional who has experience helping people with PTSD, such as a psychiatrist, psychologist, or clinical social worker, can determine whether symptoms meet the criteria for PTSD.

To be diagnosed with PTSD, an adult must have all of the following for at least 1 month:

• At least one re-experiencing symptom
• At least one avoidance symptom
• At least two arousal and reactivity symptoms
• At least two cognition and mood symptoms

Re-experiencing symptoms include:

• Experiencing flashbacks—reliving the traumatic event, including physical symptoms such as a racing heart or sweating
• Having recurring memories or dreams related to the event
• Having distressing thoughts
• Experiencing physical signs of stress

Thoughts and feelings can trigger these symptoms, as can words, objects, or situations that are reminders of the event.

Avoidance symptoms include:

• Staying away from places, events, or objects that are reminders of the traumatic experience
• Avoiding thoughts or feelings related to the traumatic event

Avoidance symptoms may cause people to change their routines. For example, some people may avoid driving or riding in a car after a serious car accident.

Arousal and reactivity symptoms include:

• Being easily startled
• Feeling tense, on guard, or on edge
• Having difficulty concentrating
• Having difficulty falling asleep or staying asleep
• Feeling irritable and having angry or aggressive outbursts
• Engaging in risky, reckless, or destructive behavior

Arousal symptoms are often constant. They can lead to feelings of stress and anger and may interfere with parts of daily life, such as sleeping, eating, or concentrating.

Cognition and mood symptoms include:

• Having trouble remembering key features of the traumatic event
• Having negative thoughts about oneself or the world
• Having exaggerated feelings of blame directed toward oneself or others
• Having ongoing negative emotions, such as fear, anger, guilt, or shame
• Losing interest in enjoyable activities
• Having feelings of social isolation
• Having difficulty feeling positive emotions, such as happiness or satisfaction

Cognition and mood symptoms can begin or worsen after the traumatic event. They can lead a person to feel detached from friends or family members.

If you or someone you know is struggling or having thoughts of suicide, call or text the 988 Suicide and Crisis Lifeline at 988 or chat at 988lifeline.org. In life-threatening situations, call 911.

How do children and teens react to trauma?

Children and teens can have extreme reactions to trauma, but some of their symptoms may not be the same as those seen in adults. In children younger than age 6, these symptoms can include:

• Wetting the bed after having learned to use the toilet
• Forgetting how to talk or being unable to talk
• Acting out the scary event during playtime
• Being unusually clingy with a parent or other adult

Older children and teens usually show symptoms more like those seen in adults. They also may develop disruptive, disrespectful, or destructive behaviors. Older children and teens may feel guilty for not preventing injury or deaths. They may also have thoughts of revenge.

Learn more about how to help children and adolescents cope with disasters and other traumatic events.