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Symptoms
By Mayo Clinic staffPost-traumatic stress disorder symptoms typically start within three months of a traumatic event. In a small number of cases, though, PTSD symptoms may not appear until years after the event.
Post-traumatic stress disorder symptoms are generally grouped into three types: intrusive memories, avoidance and numbing, and increased anxiety or emotional arousal (hyperarousal).
Symptoms of intrusive memories may include:
- Flashbacks, or reliving the traumatic event for minutes or even days at a time
- Upsetting dreams about the traumatic event
Symptoms of avoidance and emotional numbing may include:
- Trying to avoid thinking or talking about the traumatic event
- Feeling emotionally numb
- Avoiding activities you once enjoyed
- Hopelessness about the future
- Memory problems
- Trouble concentrating
- Difficulty maintaining close relationships
Symptoms of anxiety and increased emotional arousal may include:
- Irritability or anger
- Overwhelming guilt or shame
- Self-destructive behavior, such as drinking too much
- Trouble sleeping
- Being easily startled or frightened
- Hearing or seeing things that aren't there
Post-traumatic stress disorder symptoms can come and go. You may have more post-traumatic stress disorder symptoms when things are stressful in general, or when you run into reminders of what you went through. You may hear a car backfire and relive combat experiences, for instance. Or you may see a report on the news about a rape and feel overcome by memories of your own assault.
When to see a doctor
It's normal to have a wide range of feelings and emotions after a traumatic event. You might experience fear and anxiety, a lack of focus, sadness, changes in how well you sleep or how much you eat, or crying spells that catch you off guard. You may have nightmares or be unable to stop thinking about the event. This doesn't mean you have post-traumatic stress disorder.
But if you have these disturbing thoughts and feelings for more than a month, if they're severe, or if you feel you're having trouble getting your life back under control, talk to your health care professional. Getting treatment as soon as possible can help prevent PTSD symptoms from getting worse.
In some cases, post-traumatic stress disorder symptoms may be so severe that you need emergency help, especially if you're thinking about harming yourself or someone else. If this happens, call 911 or other emergency medical service, or ask a supportive family member or friend for help.
- Posttraumatic stress disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed Jan. 5, 2011.
- Posttraumatic stress disorder. In: Hales RE, et al. The American Psychiatric Publishing Textbook of Psychiatry. 5th ed. ArlingtonWashington, D.C.: American Psychiatric Publishing; 2008. http://www.psychiatryonline.com. Accessed Jan. 5, 2011.
- Shalev AY. Posttraumatic stress disorder and stress-related disorders. Psychiatric Clinics of North America. 2009;32:687.
- Practice parameter for the assessment and treatment of children and adolescents with posttraumatic stress disorder. Journal of the American Academy of Child & Adolescent Psychiatry. 2010;4:414.
- May AC, et al. Posttraumatic stress disorder In: Ferri FF. Ferri's Clinical Advisor 2011: Instant Diagnosis and Treatment. Philadelphia, Pa.: Mosby Elsevier; 2011. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-323-05610-6..00025-1--sc30645&isbn=978-0-323-05610-6&type=bookPage§ionEid=4-u1.0-B978-0-323-05610-6..00025-1--sc30645&uniqId=230982534-3. Accessed Jan. 5, 2011.
- Holzer SR. Mediational significance of PTSD in the relationship of sexual trauma and eating disorders. Child Abuse & Neglect: The International Journal. 2008;32:561. http://www.mdconsult.com/das/citation/body/230982534-5/jorg=journal&source=MI&sp=20885418&sid=1101209736/N/20885418/1.html?issn=0145-2134. Accessed Jan. 5, 2011.
- Understanding PTSD. National Center for PTSD. http://www.ptsd.va.gov/public/understanding_ptsd/booklet.pdf. Accessed Jan. 5, 2011.
- Nakell L. Adult post-traumatic stress disorder: Screening and treating in primary care. Primary Care: Clinics in Office Practice. 2007;34:593.
- Acupuncture may help symptoms of posttraumatic stress disorder. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/research/results/spotlight/092107.htm. Accessed Jan. 5, 2011.
- Coping with traumatic stress reactions. National Center for PTSD. http://www.ptsd.va.gov/public/pages/coping-traumatic-stress.asp. Accessed Jan. 12, 2011.
- Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 11, 2011.
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