Overview

Post-traumatic stress disorder (PTSD) is a mental health condition that's caused by an extremely stressful or terrifying event — either being part of it or witnessing it. Symptoms may include flashbacks, nightmares, severe anxiety and uncontrollable thoughts about the event.

Most people who go through traumatic events may have a hard time adjusting and coping for a short time. But with time and by taking good care of themselves, they usually get better. If the symptoms get worse, last for months or years, and affect their ability to function daily, they may have PTSD.

Getting treatment after PTSD symptoms arise can be very important to ease symptoms and help people function better.

Symptoms

Post-traumatic stress disorder symptoms may start within the first three months after a traumatic event. But sometimes symptoms may not appear until years after the event. These symptoms last more than one month and cause major problems in social or work situations and how well you get along with others. They also can affect your ability to do your usual daily tasks.

Generally, PTSD symptoms are 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.

Intrusive memories

Symptoms of intrusive memories may include:

  • Unwanted, distressing memories of a traumatic event that come back over and over again.
  • Reliving a traumatic event as if it were happening again, also known as flashbacks.
  • Upsetting dreams or nightmares about a traumatic event.
  • Severe emotional distress or physical reactions to something that reminds you of a traumatic event.

Avoidance

Symptoms of avoidance may include:

  • Trying not to think or talk about a traumatic event.
  • Staying away from places, activities or people that remind you of a traumatic event.

Negative changes in thinking and mood

Symptoms of negative changes in thinking and mood may include:

  • Negative thoughts about yourself, other people or the world.
  • Ongoing negative emotions of fear, blame, guilt, anger or shame.
  • Memory problems, including not remembering important aspects of a traumatic event.
  • Feeling detached from family and friends.
  • Not being interested in activities you once enjoyed.
  • Having a hard time feeling 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.
  • Physical reactions, such as sweating, rapid breathing, fast heartbeat or shaking.

For children 6 years old and younger, symptoms also may include:

  • Reenacting a traumatic event or aspects of a traumatic event through play.
  • Frightening dreams that may or may not include aspects of a traumatic event.

Intensity of symptoms

Over time, PTSD symptoms can vary in how severe they are. You may have more PTSD symptoms when you're generally stressed or when you come across reminders of what you went through, including the same time of year when a past traumatic event happened. 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

Talk to your healthcare professional or a mental health professional if you have disturbing thoughts and feelings about a traumatic event for more than a month, especially if they're severe. Also, see a health professional if you're having trouble getting your life back under control. Getting treatment as soon as possible can help prevent PTSD symptoms from getting worse.

If you have suicidal thoughts

If you or someone you know has suicidal thoughts, get help right away:

  • Reach out to a close friend or loved one.
  • Contact a minister, spiritual leader or someone in your faith community.
  • Contact a suicide hotline.
    • In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. Services are free and confidential.
    • U.S. veterans or service members who are in crisis can call 988 and then press "1" for the Veterans Crisis Line. Or text 838255. Or chat online.
    • The Suicide & Crisis Lifeline in the U.S. has a Spanish language phone line at 1-888-628-9454 (toll-free).
  • Make an appointment with your healthcare professional or mental health professional.

When to get emergency help

If you think you may hurt yourself or attempt suicide, call 911 or your local emergency number right away.

If you know someone who's in danger of attempting suicide or has made a suicide attempt, make sure someone stays with that person for safety. Call 911 or your local emergency number right away. Or, if you can do so safely, take the person to the nearest hospital emergency department.

Causes

You can develop post-traumatic stress disorder when you go through, see or learn about an event involving actual or threatened death, serious injury or sexual assault.

Healthcare professionals aren't sure why some people get PTSD. As with most mental health problems, a mix of factors probably causes it, including:

  • Extremely stressful experiences, as well as 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.

Risk factors

People of all ages can have post-traumatic stress disorder. But you may be more likely to develop PTSD after a traumatic event if you:

  • Have severe or long-lasting traumatic experiences.
  • Were physically injured during the traumatic event.
  • Have been exposed to other trauma earlier in life, such as childhood abuse.
  • Have a job that exposes you to traumatic events, such as being in the military or being a first responder.
  • Have other mental health problems, such as anxiety or depression.
  • Drink too much or misuse drugs.
  • Do not have a good support system of family and friends.
  • Have blood relatives with mental health problems, including PTSD or depression.

Traumatic events that raise risk

The most common events that can lead to PTSD include:

  • Combat exposure.
  • Childhood physical abuse.
  • Sexual violence.
  • Physical assault.
  • Being threatened with a weapon.
  • An accident.

Many other traumatic events also can lead to PTSD, such as fire, natural disaster, mugging, robbery, plane crash, torture, kidnapping, a life-threatening medical diagnosis, a terrorist attack, and other extreme or life-threatening events.

Complications

Post-traumatic stress disorder can disrupt your whole life — your education, job, how well you get along with others, physical health and enjoyment of everyday activities. Having PTSD also may raise your risk of other mental health problems, such as:

  • Depression and anxiety disorders.
  • Issues with drugs or alcohol use.
  • Thinking about and attempting suicide.

Prevention

After surviving a traumatic event, many people have PTSD-like symptoms at first, such as not being able to stop thinking about what's happened. Fear, anxiety, anger, depression and guilt are all common reactions to trauma. But most people exposed to trauma don't go on to develop PTSD.

Getting timely help and support may prevent usual stress reactions from getting worse and leading to PTSD. This may mean turning to family and friends who will listen and offer comfort. It also may mean seeking out a mental health professional for a brief course of therapy. Some people also may find it helpful to turn to their faith communities.

Support from others also may prevent you from turning to unhealthy coping methods, such as misusing alcohol or drugs.

By Mayo Clinic Staff