What is PTSD?
Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after experiencing or witnessing a terrifying or life-threatening event, such as war/combat, mass violence, a natural disaster, a serious accident, or sexual assault.
Not everyone who experiences trauma develops PTSD. It is normal to have anxiety, flashbacks, nightmares, and feelings of numbness or detachment after being exposed to a traumatic event. These symptoms cause major distress and problems with resuming daily activities. It may be difficult for a person to go back to work or school, spend time with family and friends, or do things they used to enjoy.
After a period of several weeks and with some self-care, most people start to feel better. A strong support system can make it less likely for someone to develop PTSD, or to require psychiatric treatment.
In the case of someone who develops PTSD, symptoms continue to last months after the event, cause significant distress, and interfere with their daily functioning. PTSD is treatable, and the chances of recovery are greater if the person gets help early.
What Are the Causes of PTSD?
PTSD has long been associated with war and combat. It was referred to as “shell shock” during World War I and “combat fatigue” after World War II. However, people of any age, gender, and background can develop PTSD after going through (or hearing about) an event involving actual or threatened death, serious injury, or sexual violence.
PTSD is more common after certain types of trauma, such as combat exposure and sexual assault. Other events, such as mass violence or natural disasters, can also lead to PTSD.
There are certain factors that can increase the likelihood of an individual developing PTSD, such as:
- Experiencing an intense or long-lasting traumatic event
- Sustaining an injury during the event
- A strong initial reaction to the event, such as shaking or vomiting
- Having previously experienced trauma, such as childhood abuse
- Military personnel and first responders have an increased chance of being exposed to a traumatic event
- Having co-occurring disorders, such as anxiety or depression; or having family members with mental health problems
- A history of alcohol or substance abuse
- Lack of a support system
Whether or not symptoms of acute stress become manageable can depend on factors that occur after the event. For example, high levels of stress can make it more likely to develop PTSD, while having strong social support can make it less likely.
What Are the Symptoms of PTSD?
An individual with PTSD experiences one or more of the symptoms mentioned below, which fall into four categories:
Intrusive memories can present in the following ways:
- Reliving or re-experiencing the traumatic event as if it were happening in the current moment (flashbacks)
- Recurrent, involuntary memories of the event
- Distressing dreams or nightmares
- Severe emotional distress or physical reactions to reminders of the event can lead to avoidance of people or situations that trigger these reactions
- Trying to avoid thinking or talking about the event
- Some people try to stay extra busy in order to prevent themselves from thinking about the event
Alterations in condition and mood
- Inability to remember important aspects of the event
- Negative thoughts about oneself, other people or the world in general that lead to distorted beliefs (such as “I deserve this” or “I cannot trust anyone”)
- An overwhelming sense of guilt or shame
- Lack of interest in activities that used to be enjoyable
- Feeling detached from loved ones
- Being unable to experience positive emotions
Alterations in arousal and reactivity
This category refers to changes in a person’s physical and emotional reactions, including:
- Being irritable and having angry outbursts
- Being easily startled or frightened
- Being on edge and hyper aware of potential danger, or always expecting something bad to happen
- Self-destructive behavior such as abusing substances or alcohol
- Trouble sleeping or concentrating
How is PTSD Diagnosed?
A healthcare provider, such as a psychiatrist or other mental healthcare professionals, base a diagnosis on criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which is published by the American Psychiatric Organization.
In order to be diagnosed with PTSD, an individual must have been exposed to a traumatic event in one of the following ways:
- Directly experiencing a traumatic event
- Witnessing a traumatic event occur to others
- Learning that a loved one experienced a traumatic event, or their life was threatened during an event
- Being repeatedly exposed to graphic details of traumatic events (for example, if you are a first responder to scenes where traumatic events occurred or a police officer reading details of trauma such as child abuse)
If you have one of these types of exposure to trauma, and the symptoms of acute stress have lasted longer than a month, it is a good idea to talk to your healthcare provider.
At a Glance
Dr. Paul Poulakos
- Attending Psychiatrist at Mount Sinai Beth Israel Medical Center
- Assistant Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai
- Past Clinical Assistant Professor of NYU Langone Medical Center
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