What is PTSD? Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after you go through or see a traumatic event, such as an assault, a serious accident, a disaster or war. Most people feel shaken for a while and then slowly recover. With PTSD, the fear does not fade. Upsetting memories and a constant sense of danger last longer than a month and get in the way of work, home and relationships.
This guide explains who develops PTSD, how it shows up, how it is diagnosed and which treatments have the strongest support. It draws on three trusted sources: NIMH (National Institute of Mental Health), the U.S. Department of Veterans Affairs (VA) and Mayo Clinic.
What is PTSD, and what does it do to people?
After a traumatic event such as a natural disaster, an act of violence or a serious accident, it is normal to feel anxious, sad or angry and to keep thinking about what happened. NIMH says most people recover from these reactions over time.
PTSD is what happens when they do not ease. In the words of NIMH, "People may be diagnosed with post-traumatic stress disorder (PTSD) if their symptoms last for an extended period after a traumatic event and begin to interfere with aspects of daily life, such as relationships or work."
Put simply, the body's alarm system stays switched on. Your nervous system keeps reacting as if the danger is still here. NIMH notes that people with PTSD "may continue to feel stressed or frightened, even though they are not in danger."
You may also see the name written as posttraumatic stress disorder, without the hyphen, which is how the VA spells it. Both names mean the same condition.
Who develops PTSD?
"Anyone can develop PTSD at any age," says the VA's PTSD Basics page. PTSD is often linked with military service, and the VA notes that combat-related trauma makes it more common for veterans. But it is far from only a military problem.
According to NIMH, people can develop PTSD after they experience or witness:
an act of violence, such as a physical or sexual assault
abuse
a serious accident
a natural disaster or a terror attack
other serious events
Mayo Clinic explains that PTSD can follow an event involving actual or threatened death, serious injury or sexual assault, and it adds fire, mugging, robbery and a life-threatening medical diagnosis to the list. NIMH also points out that "learning that a relative or close friend experienced trauma can cause PTSD."
PTSD is fairly common. NIMH reports that "About 6 of every 100 people will experience PTSD at some point in their lifetime, according to the National Center for PTSD," and that "Women are more likely than men to develop PTSD."
Some things raise the risk. The VA lists very intense or long-lasting trauma, a physical injury during the traumatic event and earlier traumatic exposure, and adds that "Stress can make PTSD more likely, while social support can make it less likely." Even so, NIMH notes that most people who live through a dangerous event "do not develop PTSD."
What are the symptoms of PTSD?
PTSD symptoms usually start soon after the traumatic event. But the VA says they "may not appear until months or years later," and they can come and go over many years. You might have PTSD if the symptoms last longer than 4 weeks, "cause you great distress, or interfere with your work or home life," the VA adds.
There are four groups of symptoms, and a diagnosis needs some of each.
Reliving the event (intrusion). Intrusive memories of the traumatic event come back without warning. You may have nightmares or flashbacks, where it feels like the event is happening again, with physical signs of stress such as a racing heart or sweating. Reminders such as a smell, a loud noise or a news report can trigger these reactions.
Avoidance. You may avoid people, places or situations that bring the trauma to mind. You may also avoid talking or even thinking about it, or keep very busy so the memories stay away.
Negative changes in thinking and mood. You may have negative thoughts about yourself or the world, or feel that no one can be trusted. Guilt, shame and emotional numbness are common, and you may lose interest in activities you once enjoyed. Some people cannot recall parts of the traumatic event.
Arousal and reactivity. You may feel tense and on edge, and be easily startled. Trouble concentrating, trouble sleeping, angry outbursts and feeling irritable are common. Some people take risks, like driving too fast or drinking too much. Mayo Clinic calls this group changes in physical and emotional reactions.
For adults, NIMH sets the bar for a diagnosis: at least one reliving symptom, one avoidance symptom, two arousal and reactivity symptoms, and two thinking and mood symptoms, all lasting at least 1 month.
PTSD can also change in severity over time. Mayo Clinic says symptoms may increase when you are generally stressed or when you come across reminders, such as the time of year the traumatic event took place.
PTSD rarely travels alone. NIMH notes that "People with PTSD often have co-occurring conditions, such as depression, substance use, or one or more anxiety disorders," and that panic disorder can occur too. If panic attacks are part of what you feel, mention them when you get help.
What are the 5 signs of PTSD?
There is no official list of five signs. Clinicians look at the four symptom groups above, plus how long they last and how much they disrupt your life. In everyday terms, here are five signs worth taking seriously:
Upsetting memories, dreams or flashbacks of the traumatic event that you cannot switch off.
Steering clear of people, places or talk that remind you of it.
Feeling numb, guilty or cut off from the people you care about.
Feeling jumpy, tense or angry, or struggling to rest and focus.
These changes have lasted more than a month and cause you real distress.
Having some of these signs does not mean you have PTSD, but it is worth talking to a professional.
What are the symptoms of PTSD in children?
Children can experience PTSD too, but it may look different. The VA gives these examples:
Children under 6 may get upset when a parent is not close by, have trouble sleeping, or act out the trauma in play.
Children ages 7 to 11 may act out the trauma through play, drawings or stories. Some have nightmares or become more irritable or aggressive.
Teens ages 12 to 18 tend to look more like adults, with "depression, anxiety, withdrawal, or reckless behavior like substance use or running away."
NIMH adds that young children may wet the bed after learning to use the toilet or be unusually clingy with a parent. If you are worried about a child, start with their pediatrician.
How does someone know if they have PTSD?
The VA is clear: "Only a mental health provider can diagnose PTSD." That could be a psychiatrist, psychologist, counselor or social worker. They will ask about your traumatic experiences, what you are noticing, how long it has gone on and what it does to your daily life. NIMH adds that the problems must not be caused by medication, substance use or another illness.
The VA's PTSD Basics page also links to a short self-screen of five questions. It is a helpful first step, but it is not a diagnosis.
What is living with PTSD like?
The VA puts it this way: "When you have PTSD, the world feels unsafe." Many people feel on guard all day. Small things can set off a strong emotional reaction, and loved ones may not understand why.
Mayo Clinic notes that PTSD can disrupt your whole life, including your job, your relationships, your physical health and your enjoyment of everyday activities. Some people try coping on their own by keeping busy, pulling away from others or drinking more. NIMH says support from family and friends can be an essential part of recovery.
Does PTSD ever go away?
For many people, PTSD gets much better. NIMH reports that "Although some people recover within 6 months, others have symptoms that last for 1 year or longer." Without treatment, symptoms can persist for years.
The VA is hopeful about care: "For many people, treatment can get rid of symptoms altogether. Others find they have fewer symptoms or feel that their symptoms are less intense." The VA suggests talking to a doctor or mental health provider if your symptoms last longer than a month, are very upsetting, or disrupt your daily life.
How is PTSD treated?
The main treatments are psychotherapy, medications, or both, says NIMH. According to the VA, "A few trauma-focused psychotherapies are the most highly recommended treatments for PTSD." Trauma-focused means the work centers on the memory of the traumatic event or what it means to you. The VA names three as the most effective:
Cognitive Processing Therapy (CPT): you learn skills to understand how the trauma changed your thoughts and feelings. Changing how you think about it can change how you feel.
Prolonged Exposure (PE): you gradually approach the memories, feelings and situations you have been avoiding.
EMDR: in full, Eye Movement Desensitization and Reprocessing. While you hold the memory in mind, you pay attention to a back-and-forth movement or sound.
These differ from general talk sessions: they are structured methods that focus on the trauma itself. For people still in an abusive relationship, NIMH says treatment is usually most effective when it addresses both the traumatic situation and the PTSD symptoms.
Medication can help too. NIMH says the FDA has approved two SSRIs, a type of antidepressant, for treating PTSD. The VA lists sertraline, paroxetine and venlafaxine as recommended options. Whether to take medication, and which one, is a decision to make with your doctor.
Some clinicians also use Brainspotting, a newer method with limited research behind it. It is not among the treatments the VA recommends most highly. NIMH also suggests exercise, mindfulness and steady daily routines, which support recovery alongside treatment, not in place of it.
Where can I learn more about PTSD?
These free U.S. sources are clear and reliable:
NIMH has a PTSD topic page and a free brochure on signs, symptoms and treatment.
The VA runs ptsd.va.gov, with plain-language guides, the self-screen and the PTSD Coach app.
Mayo Clinic has an overview of symptoms, causes and risk factors.
Getting help near Nashville
Dave Saunders, LPC-MHSP, NCC, sees adults 18 and up from Nashville and nearby at Dave Saunders Counseling. He has Level II training in both EMDR and Brainspotting, is also trained in Trauma-Focused CBT, and has worked with special forces, combat Marines and support personnel from the military. EMDR and Brainspotting sessions are held in person, in Suite 204 at 103 Continental Place in Brentwood. Learn more about PTSD care in Brentwood or check fees on the FAQ page. Your first step can be a free 10-minute consultation, which you can request through the contact page.
If you are in crisis or having thoughts of hurting yourself, call or text 988 now.