What is PTSD?
Post-traumatic stress disorder (PTSD) can develop following any event that makes you fear for your safety. 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. This may happen 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. PTSD can also result from surgery performed on children too young to fully understand what’s happening to them.
This is something new for me. As a teenager I was diagnosed with Depression. I was never officially diagnosed with PTSD, probably because I never saw a doctor after the 11 months I was sent away to boarding school. After that incident, I didn’t realize all the damage that was done until later on. Where it affected my behavior, relationships, and way of thinking. Unfortunately I relate to the Complex PTSD the most. For me it’s not always an on going thing. Like many trauma survivors out there, so many random things can trigger us. A past memory, feeling unsafe, or just a Christmas Hymn you heard during dinner. – Nicole
PTSD vs. a normal response to traumatic events
Following a traumatic event, 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. You don’t feel a little better each day. In fact, you may start to feel worse.
A normal response to trauma becomes PTSD when you get stuck
After a traumatic experience, the mind and the body are in shock. But as you make sense of what happened and process your emotions, you start to come out of it. With PTSD, however, you remain in psychological shock. Your memory of what happened and your feelings about it are disconnected. In order to move on, it’s important to face and feel your memories and emotions.
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.
- Re-experiencing the traumatic event through intrusive memories, flashbacks, nightmares, or intense mental or physical reactions when reminded of the trauma.
- Avoidance and numbing, such as avoiding anything that reminds you of the trauma, being unable to remember aspects of the ordeal, a loss of interest in activities and life in general, feeling emotionally numb and detached from others and a sense of a limited future.
- Hyper-arousal, including sleep problems, irritability, hyper-vigilance (on constant “red alert”), feeling jumpy or easily startled, angry outbursts, and aggressive, self-destructive, or reckless behavior.
Negative thought and mood changes like feeling alienated and alone, difficulty concentrating or remembering, depression and hopelessness, feeling mistrust and betrayal, and feeling guilt, shame, or self-blame.
PTSD causes and types of trauma
Trauma or PTSD symptoms can result from many different types of distressing experiences, including military combat, childhood neglect or abuse, an accident, natural disaster, personal tragedy, or violence. But whatever your personal experiences or symptoms, the following can offer strategies to help you heal and move on:
PTSD in military veterans
For all too many veterans, returning from military service means coping with symptoms of PTSD. You may have a hard time readjusting to life out of the military. Or you may constantly feel on edge, emotionally numb and disconnected, or close to panicking or exploding. But it’s important to know that you’re not alone and there are plenty of ways you can deal with nightmares and flashbacks, cope with feelings of depression, anxiety or guilt, and regain your sense of control.
Emotional and psychological trauma
If you’ve experienced an extremely stressful event—or series of events—that’s left you feeling helpless and emotionally out of control, you may have been traumatized. Psychological trauma often has its roots in childhood, but any event that shatters your sense of safety can leave you feeling traumatized, whether it’s an accident, injury, the sudden death of a loved one, bullying, domestic abuse, or a deeply humiliating experience. Whether the trauma happened years ago or yesterday, you can get over the pain, feel safe again, and move on with your life.
Rape or sexual trauma
The trauma of being raped or sexually assaulted can be shattering, leaving you feeling scared, ashamed, and alone, or plagued by nightmares, flashbacks, and other unpleasant memories. But no matter how bad you feel right now, it’s important to remember that you weren’t to blame for what happened, and you can regain your sense of safety, trust, and self-worth.
Types of PTSD
Normal Stress Response
The normal stress response occurs when healthy adults who have been exposed to a single discrete traumatic event in adulthood experience intense bad memories, emotional numbing, feelings of unreality, being cut off from relationships or bodily tension and distress. Such individuals usually achieve complete recovery within a few weeks. Often a group debriefing experience is helpful. Debriefings begin by describing the traumatic event. They then progress to exploration of survivors’ emotional responses to the event. Next, there is an open discussion of symptoms that have been precipitated by the trauma. Finally, there is education in which survivors’ responses are explained and positive ways of coping are identified.
Acute Stress disorder
Acute stress disorder is characterized by panic reactions, mental confusion, dissociation, severe insomnia, suspiciousness, and being unable to manage even basic self care, work, and relationship activities. Relatively few survivors of single traumas have this more severe reaction, except when the trauma is a lasting catastrophe that exposes them to death, destruction, or loss of home and community. Treatment includes immediate support, removal from the scene of the trauma, use of medication for immediate relief of grief, anxiety, and insomnia, and brief supportive psychotherapy provided in the context of crisis intervention.
Uncomplicated PTSD
Uncomplicated PTSD involves persistent reexperiencing of the traumatic event, avoidance of stimuli associated with the trauma, emotional numbing, and symptoms of increased arousal. It may respond to group, psychodynamic, cognitive-behavioral, pharmacological, or combination approaches.
Comorbid PTSD
PTSD comorbid with other psychiatric disorders is actually much more common than uncomplicated PTSD. PTSD is usually associated with at least one other major psychiatric disorder such as depression, alcohol or substance abuse, panic disorder, and other anxiety disorders. The best results are achieved when both PTSD and the other disorder(s) are treated together rather than one after the other. This is especially true for PTSD and alcohol or substance abuse. The same treatments used for uncomplicated PTSD should be used for these patients, with the addition of carefully managed treatment for the other psychiatric or addiction problems.
Complex PTSD
Complex PTSD (sometimes called “Disorder of Extreme Stress”) is found among individuals who have been exposed to prolonged traumatic circumstances, especially during childhood, such as childhood sexual abuse. These individuals often are diagnosed with borderline or antisocial personality disorder or dissociative disorders. They exhibit behavioral difficulties (such as impulsivity, aggression, sexual acting out, eating disorders, alcohol or drug abuse, and self-destructive actions), extreme emotional difficulties (such as intense rage, depression, or panic) and mental difficulties (such as fragmented thoughts, dissociation, and amnesia). The treatment of such patients often takes much longer, may progress at a much slower rate, and requires a sensitive and highly structured treatment program delivered by a team of trauma specialists.
PTSD treatment and therapy
Treatment for PTSD can relieve symptoms by helping you deal with the trauma you’ve experienced. A doctor or therapist will encourage you to recall and process the emotions you felt during the original event in order to reduce the powerful hold the memory has on your life.
During treatment you’ll also explore your thoughts and feelings about the trauma, work through feelings of guilt and mistrust, learn how to cope with intrusive memories, and address the problems PTSD has caused in your life and relationships.
The types of treatment available for PTSD include:
Trauma-focused cognitive-behavioral therapy involves gradually “exposing” yourself to feelings and situations that remind you of the trauma, and replacing distorted and irrational thoughts about the experience with a more balanced picture.
Family therapy can help your loved ones understand what you’re going through and help you work through relationship problems together as a family.
Medication is sometimes prescribed to people with PTSD to relieve secondary symptoms of depression or anxiety, although they do not treat the causes of PTSD.
EMDR (Eye Movement Desensitization and Reprocessing) incorporates elements of cognitive-behavioral therapy with eye movements or other forms of rhythmic, left-right stimulation, such as hand taps or sounds. These techniques work by “unfreezing” the brain’s information processing system, which is interrupted in times of extreme stress.
Finding a therapist for PTSD
When looking for a therapist, seek out mental health professionals who specialize in the treatment of trauma and PTSD. You can ask your doctor or other trauma survivors for a referral, call a local mental health clinic, psychiatric hospital, or counseling center. Beyond credentials and experience, it’s important to find a PTSD therapist who makes you feel comfortable and safe. Trust your gut; if a therapist doesn’t feel right, look for someone else. For therapy to work, you need to feel comfortable and understood.
Where to turn for help
Find treatment and support for PTSD
In the U.S.: Call the NAMI helpline at 1-800-950-NAMI to find a support group near you or search for Trauma Treatment Programs (PDF).
In the UK: PTSD UK offers treatment and support options.
In Australia: Phoenix Australia offers PTSD helplines and resources.
In Canada: Find Your Local CMHA division for support and treatment options.
If you’re a veteran with PTSD:
In the U.S.: Call the Veterans Crisis Line at 1-800-273-8255 (Press 1); call the Veteran Center Call Center hotline to talk with another combat veteran at 1-877-927-8387; or use the PTSD Program Locator to find specialized VA PTSD treatment.
In the UK: Visit Combat Stress or call the 24-hour helpline 0800 138 1619.
In Canada: Visit Operational Stress Injury Social Support (OSISS) for a local number to talk to a peer who has been through similar experiences.
In Australia: Visit Veterans and Veterans Families Counselling Service (VVCS) or call 1800 011 046.
APA Reference
PTSD, N. (2018). Types of PTSD. Psych Central. Retrieved on June 7, 2019, from https://psychcentral.com/lib/types-of-ptsd/
Authors: Melinda Smith, M.A., Lawrence Robinson, Robert Segal, M.A., and Jeanne Segal, Ph.D. Last updated: May 2019