PTSD Symptoms and Signs
Post-traumatic stress disorder (PTSD) is a condition following a traumatic event in which the memory keeps returning as though it were happening now, reminders are avoided, and the body stays on guard for more than a month.
Also called: Post-Traumatic Stress Disorder, Post traumatic stress disorder, Post-traumatic stress.
ICD-10 F43.1 · ICD-11 6B40
The danger ended. The alarm did not.
Most people go through something terrifying at some point in their life. In the weeks after, it is normal to have bad dreams, to jump at noises, and to replay what happened. For most people, this fades.
PTSD, post-traumatic stress disorder, is what happens when it does not fade. Months or years later, the memory still arrives on its own, as if it is happening now, and the body still reacts as if the danger is in the room.
This is not a sign of weakness. A memory and an alarm system learned one lesson far too well, and never unlearned it.
FROM INSIDE
What it is actually like
A flashback is not like remembering. It is closer to being back there. The same sounds, the same smells, and the same fear in the body. Nothing tells you it is over.
Life then shrinks around the reminders. People avoid roads, places, films and conversations. They avoid their own thoughts too. Avoiding helps for a moment. Over time it holds the fear in place.
The body stays on guard. Sleep is light. A slammed door feels like a threat. Sitting with your back to a room can feel impossible, and nobody around you can see why.
A smoke alarm that heard one real fire
It went off when there was a fire, which was right. Now it goes off for toast, for steam and for a candle. It is not broken. It is set far too sensitive, and it will not reset on its own.
WHAT IT DOES
Four groups of symptoms
A diagnosis needs symptoms from all four groups. Two people with PTSD can still look very different from each other.
Reliving
Memories push in without being invited. There are nightmares and flashbacks. The body reacts strongly to anything that acts as a reminder.
Avoiding
The person keeps away from places, people, conversations and thoughts linked to the event. From outside this often looks like being busy, or like not caring.
Thoughts and mood
Blame, guilt or shame sets in and will not shift. The person feels numb, or cut off from other people. Parts of what happened cannot be remembered at all.
On guard
The person jumps at small noises, sleeps badly, cannot concentrate, and gets irritable. They watch for danger all the time.
3.9% — LIFETIME
70% — EXPOSED
5.6% — DEVELOP IT
2x — WOMEN
When it tends to begin
Peak age of onset: 16.
Median age of onset: 30.
PTSD can start at any age, including in childhood. It usually begins within three months of the event. For some people it appears much later, sometimes years later. That often happens when a new stress or a strong reminder arrives. These ages tell you as much about when trauma tends to happen as they do about the brain.
How it is actually diagnosed
It starts with exposure to death, serious injury or sexual violence, either real or threatened. That exposure can happen in four ways. It can happen to you directly. You can witness it. You can learn it happened to someone close to you. Or you can face it over and over at work. All of the points below must then be true.
- At least one reliving symptom and at least one avoidance symptom
- At least two changes in thoughts and mood, and at least two signs of being on guard
- The symptoms have lasted more than one month
- They cause real distress, or get in the way of work, relationships or daily life
- They are not caused by alcohol, drugs, medication or another illness
During the first month, the same reaction has a different name. It is called acute stress disorder, and it often fades on its own. The international system, ICD-11, the eleventh International Classification of Diseases, also recognises complex PTSD. That adds lasting problems with emotions, self-worth and relationships. It usually follows trauma that went on for a long time.
If it is worse than that right now
PTSD often comes with depression, heavy drinking and thoughts of suicide. Those thoughts are common in PTSD, and they can be treated.
If you are thinking about harming yourself, contact emergency services or a crisis line now.