What is PTSD?

Authors: Melinda Smith, M.A., Lawrence Robinson, and Jeanne Segal, Ph.D. Last updated: May 2016.

Post-traumatic stress disorder (PTSD) can develop following a traumatic event that threatens your safety or makes you feel helpless. Most people associate PTSD with rape and 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 can trigger PTSD, especially if the event feels unpredictable and uncontrollable. PTSD can affect:

  • People who personally experience the traumatic event
    Those who witness the event
    Those who pick up the pieces afterwards, such as emergency workers
    Friends or family members of those who experienced the trauma

Traumatic events that can cause PTSD include:

War
Natural disasters
Car or plane crashes
Terrorist attacks
Sudden death of a loved one
Rape
Kidnapping
Assault
Sexual or physical abuse
Childhood neglect

PTSD symptoms: Everyone is different

PTSD develops differently from person to person. While the symptoms of PTSD most commonly develop in the hours or days following the traumatic event, it can sometimes take weeks, months, or even years before they appear. There are three main types of symptoms:

Re-experiencing the traumatic event. This may include upsetting memories, flashbacks, and nightmares, as well as feelings of distress or intense physical reactions when reminded of the event (sweating, pounding heart, nausea, for example).

Avoiding reminders of the trauma. You may try to avoid activities, places or thoughts that remind you of the trauma or be unable to remember important aspects of the event. You may feel detached from others and emotionally numb, or lose interest in activities and life in general, sensing only a limited future for yourself.

Increased anxiety and emotional arousal. These symptoms include trouble sleeping, irritability or outbursts of anger, difficulty concentrating, feeling jumpy and easily startled, and hypervigilance (on constant “red alert”).

Other common symptoms of post-traumatic stress disorder (PTSD)
Guilt, shame, or self-blame
Substance abuse
Feelings of mistrust and betrayal
Depression and hopelessness
Suicidal thoughts and feelings
Physical aches and pains
Symptoms of PTSD in children

In children—especially very young children—the symptoms of PTSD can be different from adults and may include:

Fear of being separated from parent
Losing previously-acquired skills (such as toilet training)
Sleep problems and nightmares
Somber, compulsive play in which themes or aspects of the trauma are repeated
New phobias and anxieties that seem unrelated to the trauma (such as a fear of monsters)
Acting out the trauma through play, stories, or drawings
Aches and pains with no apparent cause
Irritability and aggression

PTSD symptoms: How PTSD affects your nervous system

When your sense of safety is shattered by a traumatic event, it’s normal to have bad dreams, feel fearful, and find it difficult to stop thinking about what happened. For most people, these symptoms gradually lift over time. But this normal response to trauma becomes PTSD when the symptoms don’t ease up and your nervous system gets “stuck.”

Your nervous system has three ways of responding to stressful events:

Social engagement with another person—making eye contact, listening in an attentive way, talking—can quickly calm you down and put the brakes on defensive responses like “fight-or-flight.”

Mobilization, or fight-or-flight, occurs when social engagement isn’t appropriate and you need to defend yourself or escape the danger of a traumatic event. The heart pounds faster, blood pressure rises, and muscles tighten, increasing your strength and reaction speed. Once the danger has passed, the nervous system calms your body, lowering heart rate and blood pressure, and winding back down to its normal balance.

Immobilization occurs when you’ve experienced an overwhelming amount of stress in a situation and, while the immediate danger has passed, you find yourself “stuck.” Your nervous system is unable to return to its normal state of balance and you’re unable to move on from the event. This is PTSD.

PTSD self-help tip 1: Get moving

As well as releasing endorphins and making you feel better, by really focusing on your body and how it feels as you move, exercise can help your nervous system become “unstuck”.

Any rhythmic exercise that engages both your arms and legs—such as walking, running, swimming, or dancing—works well if instead of focusing on your thoughts, you focus on how your body feels.
Notice the sensation of your feet hitting the ground, for example, or the rhythm of your breathing, or the feeling of the wind on your skin.

Rock climbing, boxing, weight training, or martial arts can make it easier to focus on your body movements—after all, if you don’t, you could get hurt.

Aim to exercise for 30 minutes or more each day—or if it’s easier, three 10-minute spurts of exercise.

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