While you might think post-traumatic stress disorder (PTSD) is reserved for military veterans, this mental health condition can develop in anyone who has experienced or witnessed a traumatic event.
For a veteran or first responder, signs of PTSD may appear after experiences on the job. For everyone who isn’t a veteran or first responder, a wide range of experiences may lead to PTSD.
Whether you’ve personally experienced a traumatic event or were a bystander witnessing the event, PTSD doesn’t discriminate. And because PTSD doesn’t discriminate, it’s important to be able to recognize the symptoms, either in yourself or a loved one.
If you or something you love is experiencing thoughts of suicide, please call the National Suicide Prevention Hotline by dialing 988.
For more information on organizations that can help you manage PTSD, please refer to our resources below.
Intro to PTSD Symptoms
Symptoms may crop up immediately following a traumatic event or even years later. Either way, they can get in the way of daily life and affect your well-being. These symptoms look different from person to person based on the kind of trauma you’ve experienced, your natural levels of resilience, and how much social support you have.
For those with other conditions in addition to PTSD, such as dementia in older veterans, symptoms are more difficult to identify without specialized care.[1] But across the board, PTSD symptoms often include intrusive memories of the traumatic event, avoidance behaviors, negative changes in thinking and mood, and changes in physical and emotional reactions.[2]
While it’s important for those experiencing PTSD to be able to identify symptoms, it’s important for their support network to be able to as well. Families, friends, caregivers, and healthcare providers can use their knowledge of PTSD symptoms to intervene early, which can make the difference between a manageable condition and a debilitating one. Even less-severe cases of PTSD have progressed into instances of significantly impaired mental and physical health.[3]
Here’s a list of symptoms people may experience with PTSD:
- Fear and anxiety
- Mood disturbances
- Anger and irritability
- Intrusive memories
- Negative thoughts and beliefs
- Detachment and estrangement
- Avoidance behaviors
- Changes in physical and emotional reactions
- Self-destructive behavior
- Fatigue
- Accelerated heart rate and breathing
- Muscle tension and pain
- Gastrointestinal problems
- Headaches and migraines
- Dizziness and fainting
In the rest of this article, we’ll go into more detail about the symptoms of PTSD and what they look like in everyday life. Once you know how this condition manifests in how you think, act, and feel, you and your community can take steps toward managing it.
1. Emotional Symptoms of PTSD
Fear and Anxiety
Fear and anxiety go hand in hand with PTSD because you’re always on the lookout for a threat, even if there’s no actual threat present. This may be due to repeated thoughts of the traumatic event against your will.
Persistent Fear Even When Not in Danger
Persistent fear is more than just feeling nervous. When you experience persistent fear, you have a constant sense of dread or panic that doesn’t seem to go away, even in safe and familiar settings. This feeling has nothing to do with the actual level of threat in your environment.
On top of making sure you never quite feel at ease, persistent fear is linked to specific changes in your brain functions. Specifically, the medial prefrontal cortex and the amygdala control fear responses. When these regions of the brain are activated for a long period of time, such as when you’re in a constant state of fear, they start to have trouble regulating fear after the threat has gone away.
Overwhelming Anxiety in Daily Life
Like persistent fear, overwhelming anxiety goes beyond normal worry or stress. This kind of anxiety is all-consuming and gets in the way of your day-to-day activities. For example, as you go about your daily routine, you may be overcome by a wave of anxiety or even a panic attack seemingly out of the blue.[4]
This type of anxiety may also spread over a longer period of time, presenting as a persistent nervousness that doesn’t seem to go away. These feelings may be so intense that they affect your sleep, appetite, and concentration. Research shows that poor sleep quality and an inability to regulate emotions are linked to the overwhelming anxiety veterans experience in PTSD, though the trend isn’t exclusive to veterans.[5]
Mood Disturbances
If you’re feeling particularly down, you’re not alone. Mood disturbances are another key symptom of PTSD and are closely linked with mental health problems. Common disturbances include feelings of sadness, hopelessness, and emotional numbness. You may experience dramatic mood swings and shifts in your overall sense of well-being.[6]
These profoundly sad moods also commonly include self-blame, guilt, worthlessness, and recurrent thoughts of death, which can make it especially hard to function and enjoy life.
Persistent Sadness or Hopelessness
PTSD is often paired with constant feelings of sadness and hopelessness that make it difficult to find pleasure in activities you once enjoyed. You might sink into despair or pessimism for prolonged periods of time. It’s hard to get rid of these feelings when they refuse to go away.
With PTSD, those feelings may persist for months or even years after the traumatic event.[7] And because it’s so difficult to enjoy the things you used to be passionate about, you might find it difficult to identify any positive aspects in life.
Feelings of Guilt or Shame
Feelings of guilt or shame may stem from action or inaction during a traumatic event, which leads to a sense of breaking your personal moral code.[8]
Regardless of whether the traumatic event was your fault, you may feel unwarranted guilt or shame. For instance, you might feel guilty for surviving when others didn’t, or you could feel ashamed about whatever reaction you had during the event.
Persistent feelings of guilt and shame may also lead to sadness and hopelessness if you blame yourself for what happened or are unable to overcome these feelings.
Anger and Irritability
Out of the main PTSD symptoms we’ve discussed thus far, anger and irritability are the most likely to get you in trouble with others. Following a traumatic event, you may exhibit more antisocial behavior, substance abuse, verbal hostility, and even assault. These behaviors can negatively impact relationships in both your personal and work life, even leading to legal problems in extreme cases.[9]
Frequent Anger Outbursts
Frequent anger outbursts are just what they sound like — spontaneous outbursts triggered by seemingly minor irritations. Thanks to your constant state of arousal and hypervigilance, you may lose your temper and shout or act aggressively in situations that don’t call for such a reaction.[10]
Irritability in Normal Situations
Even if you aren’t having extremely angry reactions to minor events, you might have persistent feelings of irritability on a daily basis. While you might not consciously label these feelings as irritable, you might find yourself being tense or short-tempered for little to no reason, or being hypersensitive.
Such behaviors and feelings may leave you feeling like you don’t have control over your own life.[11]
As a result, you might find it difficult to adapt to new surroundings or any changes in your routine. When you’re constantly on edge and stressed out due to your PTSD, it’s difficult to shift away from what your brain registers as “safe.”
2. Psychological Symptoms of PTSD
Intrusive Memories
One of the better-known symptoms of PTSD, intrusive memories are uniquely stressful because they may occur at any time. You might be triggered by something found in your everyday environment, whether it’s at work, at home, in public, or in private. That trigger might lead to thoughts and vivid images about the traumatic event to the point that you’re emotionally and physically distressed.[12]
Such intense reactions — along with the potential for these memories to intrude at any given moment — can make it difficult for you to go about your day, never knowing when you’ll stumble across the next trigger.[13] As a result, you might go out of your way to avoid potential triggers.
Flashbacks: Reliving the Trauma
Though reminders of the trauma can trigger them, flashbacks may also occur randomly. These experiences are more than just memories — you completely relive the traumatic event. That includes reexperiencing what you saw, heard, and felt during the event. As a result, you might completely lose touch with reality and become immersed in the same fear, anxiety, or distress you felt originally.[14]
Flashbacks can also vary in how intense they are and how long they last. Some might be a few seconds while others last for a few minutes. During the flashback, you might find yourself completely detached from the present, and reexperiencing the trauma makes it difficult to remind yourself that you’re actually safe. You might find yourself dissociating to avoid being drawn back into those painful experiences.[17]
Recurring Unwanted Memories
While intrusive memory is an umbrella term for flashbacks and recurring unwanted memories, the latter don’t involve you completely reliving the trauma. But you do remember enough of the traumatic event that it disrupts your current activity.
These disruptions might be vivid mental images, physical sensations, or intense emotional reactions related to the trauma you experienced. Unwanted memories can intrude on your daily life for more than a month after the event, which takes a toll on your psychological well-being.[15]
Negative Thoughts and Beliefs
With negative thoughts and beliefs, you are vulnerable to having a pessimistic or distorted view of yourself and the world around you. Feeling like you can’t control your negative thoughts is common among those with PTSD, so you aren’t alone in the struggle against your own mind.[16]
Negative Beliefs About Yourself or Others
The world is a difficult place to navigate when you’re constantly battling negative beliefs about yourself and others. These beliefs might manifest as feelings of unworthiness, guilt, or blame, which you may feel toward yourself when you think about the traumatic event or its aftermath.
That negative self-perception often extends beyond your self-image, causing you to view the world and people around you negatively. For example, peritraumatic dissociation is a reaction that involves depersonalization and emotional numbness during trauma, among other reactions. This reaction can intensify negative self-beliefs along with other PTSD symptoms.[17]
Distorted Feelings Like Blame or Betrayal
Following a traumatic experience, you may blame yourself for what happened, even if it was entirely outside your control. These feelings of self-blame are often accompanied by guilt and shame, which wreak havoc on your self-esteem and self-worth.
Distortions around the trauma may affect your perception of those around you, leading to feelings of betrayal. Those feelings are especially strong if the trauma involves other people, causing you to develop a deep mistrust of others. That mistrust may get in the way of your ability to form healthy connections.[18]
Detachment and Estrangement
Detachment and estrangement following a traumatic event often present as a diminished interest in activities, feeling disconnected or emotionally numb, and feeling isolated from others.[19]
That sense of detachment makes it difficult for you to interact with people and form the healthy relationships you need to feel fulfilled, even causing angry outbursts that push others further away.[20]
Feeling Detached From Others
Detachment becomes obvious when you’re in social activities. You might be surrounded by friends and family but not feel close to them. In children, neutral facial expressions make it clear that PTSD leads to emotional numbing and detachment even during social activities.[21]
Like every other symptom of PTSD, feeling detached isn’t limited to one demographic. Both children with PTSD and Holocaust survivors with PTSD display signs of detachment, showing that traumatic events have lingering effects on your ability to form healthy social relationships.[22]
Emotional Numbness
Along with feeling detached from others, you may also experience an overall inability to feel your own emotions. This emotional numbness is especially common among healthcare workers who’ve experienced intense periods of stress, such as the COVID-19 outbreak.[23]
In everyday life, emotional numbness may manifest in a lack of interest in activities you used to enjoy. You could feel indifferent to the same situations that used to excite or inspire you, living life within a limited range of emotions.[24]
3. Behavioral Symptoms of PTSD
Avoidance Behaviors
If you’re leaning into avoidance behaviors, you’re more than likely avoiding places, activities, or people that trigger memories of the traumatic event.
This is a way to protect yourself from experiencing unpleasant thoughts and feelings associated with the trauma. Though you’re avoiding distress and anxiety in the short term, avoidance is often related to overall poorer emotional well-being.[25]
Avoiding Places, Activities, or People
To avoid those heavy, disturbing feelings that your mind and body link to your trauma, you might avoid places, activities, or people associated with the traumatic event. That can look like steering clear of anything and everything that might remind you of the trauma, whether it was directly involved in your original experience or not.
For example, if you were in a car accident with your friend, you may avoid driving with that friend — or driving altogether. Avoiding these potential triggers also makes you avoid potential opportunities for connection and growth, worsening your social skills and quality of life.[26]
Avoiding Thoughts or Conversations About the Trauma
Even if you aren’t outwardly avoiding reminders of the trauma, you might be unwilling to talk or think about the traumatic event. You may actively suppress memories associated with the trauma to be able to function as you go about your day at home or in the world.
Avoiding these internal triggers allows you to reduce any unpleasant feelings brought upon by reminders of the trauma, but over time that avoidance may lead to other unpleasant effects.
For example, survivors of traumatic events during World War II often avoided thoughts or conversations surrounding their trauma, which led to recurrent distressing dreams and difficulty managing emotions.[27]
Changes in Arousal and Reactivity
When you’re trying to navigate daily life after a traumatic event, you may find yourself constantly reacting to minor noises and sounds around you. These hyperreactive behaviors may extend into the night, when you probably find yourself having trouble falling and staying asleep.[28]
Being Easily Startled or Frightened
While your body’s in a constant state of hyperarousal, you’re far more susceptible to startle responses than those without PTSD. You might jolt or experience intense fear when faced with noises and movements that aren’t typically considered threatening.
This symptom reflects your constant state of “fight or flight,” which makes you more sensitive to your surroundings.[29]
Difficulty Sleeping or Concentrating
Difficulty sleeping or concentrating is a byproduct of other symptoms of PTSD, like intrusive thoughts or nightmares related to the trauma. When you’re experiencing either of those on a regular basis, you might also have difficulty falling asleep or wake up frequently throughout the night.
Besides the lack of sleep, PTSD directly affects your ability to focus on tasks at hand. Usually, this is due to the constant distraction of traumatic memories, but it can also be attributed to the general state of anxiety you’re in following the traumatic event.[30]
Self-Destructive Behavior
Self-destructive behavior includes any actions that are harmful or potentially harmful to yourself. Such behaviors can manifest as early as your teen years and persist into adulthood.[31]
Engaging in Risky or Self-Destructive Activities
Risky or self-destructive activities typically involve substance abuse, reckless driving, unhealthy diet habits, and engaging in unprotected sexual activities. You might be inclined to engage in these behaviors after a traumatic event because your ability to regulate your emotions has been severely impacted.[32]
In research on veterans, other common behaviors include driving while intoxicated, substance abuse (see the next section), and aggression.[33]
These behaviors are your brain’s way of coping with the overwhelming emotions you experience following a traumatic event. Those same behaviors put you at further risk of physical and psychological harm, perpetuating PTSD symptoms.
Increased Use of Alcohol or Drugs
With the emotional pain, anxiety, and other distressing symptoms that accompany PTSD, you may turn to alcohol or drugs to cope. Consistently using these to numb yourself can lead to substance abuse, which then exacerbates the symptoms you’re already experiencing.
This ongoing loop of behavior spirals into greater and greater drug and alcohol abuse, which actually increases your exposure to traumatic events and frequency of other PTSD-related symptoms.[34]
Along with compounding PTSD symptoms, substance abuse has severe long-term health effects. Using and abusing substances for long periods of time increases your risk of cancer and heart disease. For example, substances like tobacco and alcohol are linked to lung and liver cancer. Abuse of these substances also affects your blood pressure and heart rate, leading to other cardiovascular complications and illnesses.[35]
4. Physical Symptoms of PTSD
Fatigue
As a result of a sustained period of stress, you may feel tired all the time. When your body is always ready to react to danger even when there’s no actual danger around, fatigue becomes the norm.[36]
Constant Feelings of Tiredness
Usually, people feel tired after they’ve had a long day or didn’t sleep well the night before. With PTSD, you feel tired all the time, even after resting and going about your regular day.
This is because your body uses all of its energy to be on high alert at all times, leaving you exhausted when there doesn’t seem to be any extra stress or danger in your life.[37]
Lack of Energy and Motivation
When your mind and body are using all their energy just to get through the day, it can be difficult to muster up enough to do anything other than the basics. On top of being on constant alert, the areas of your brain that control energy and motivation levels are also affected by PTSD.[38]
Lack of motivation and energy can make it hard to do things you’d otherwise enjoy, like spending time with loved ones or having hobbies.
Accelerated Heart Rate and Breathing
With other symptoms of PTSD, including intrusive memory and constant feelings of anxiety, you might often notice that your heart beats faster and your breathing speeds up. That’s because something has triggered your “fight or flight” response, which is your natural reaction to perceived danger. So, with PTSD, your heart and lungs are always working double time.[39]
Increased Heart Rate in Response to Stress
Increased heart rate is your body’s natural response to stress. But with PTSD, your body is under stress even without any real danger present.
As part of that “fight or flight” stress response, your heart pumps more blood to the muscles. This prepares the body to either fight or run away from a threat, but when there’s no “threat” in sight, increased heart rate can take you by surprise and scare you.[40]
Rapid Breathing or Hyperventilation During Anxiety
During moments of high anxiety, which are common in PTSD, you might start breathing really fast. This is called hyperventilation.
Your body hyperventilates when it’s trying to get more oxygen during stressful situations. Even though it’s a natural reaction, it may be uncomfortable or even scary, especially since you most likely experience it during reminders of the traumatic event.[41]
Muscle Tension and Pain
Thanks to your constant state of stress, PTSD involves constant tension that leads to aches and pains all over your body. And when your body’s under chronic stress, you release chemicals like cortisol, which makes your muscles tense up even more.[42]
Chronic Muscle Tension Leading to Body Aches
As we mentioned, constant stress means constant muscle tension. Even when there isn’t a real threat, your muscles are always “on guard,” which makes you feel sore and achy.[43]
When your muscles can’t catch a break, you suffer the consequences through aches and pains.
Persistent Neck, Shoulder, or Back Pain
Aside from general body aches, you probably get pain specifically in your neck, shoulders, and back. These parts of the body are especially prone to tension and pain.
Your body is constantly on alert, causing these muscles to get so tight for so long that you probably feel uncomfortable doing everyday activities.[44] Your muscles don’t get a break, so you don’t get a break.
Gastrointestinal Problems
When you’re constantly under stress, your body releases certain chemicals that lead to stomach pain and discomfort. Along with affecting the acid in your stomach, these chemicals influence how you digest your food too.[45]
Stress-Induced Stomachaches or Nausea
As a result of those stress chemicals, your stomach produces more acid. That acid makes your stomach ache, and you might frequently feel nauseous.[46]
This issue is so common for people with PTSD because of your high levels of stress and anxiety. More stress leads to more stomach issues, and the cycle continues.
Changes in Appetite or Digestive Issues
You might feel hungry all the time or not at all. That’s because people with PTSD react differently to stress and anxiety.
Stress and anxiety either completely shut down your appetite or make you crave more food, especially comfort foods. Whichever way your gut reacts, it’s further evidence that PTSD affects more than your mind.[47]
Headaches and Migraines
While constant tension leads to general body aches, tension in the muscles in your head and neck specifically leads to headaches.
Along with causing tension, stress also makes your brain more sensitive to pain. After experiencing a traumatic event, you’ve probably found yourself experiencing more frequent headaches and migraines.[48]
Frequent Tension Headaches
Thanks to underlying stress following a traumatic event, you may experience muscle tension in your neck, shoulders, and scalp. This tension creates a tight band-like pain around the head, leading to headaches.
Because PTSD involves a constant state of stress, you may find yourself experiencing headaches frequently from all that tension.[49]
Stress-Related Migraines
Unlike ordinary headaches, migraines are extremely intense and usually involve nausea, vomiting, and sensitivity to light and sound.
Migraines are also caused by stress. With chronic or intense bouts of stress, the brain reacts with these severe, debilitating headaches.[50]
Dizziness and Fainting
PTSD affects how your brain and body work together, especially when you’re stressed or scared. Between sudden drops in blood pressure and not enough oxygen getting to your brain, you may experience dizziness and fainting spells.[51]
Episodes of Dizziness or Lightheadedness
On top of being unpleasant to deal with, intense anxiety and stress can affect the balance of the inner ear and blood flow to the brain. In especially stressful moments, you might have a panic attack and hyperventilate.
That rapid breathing can decrease how much carbon dioxide is in your blood, leading to dizziness or lightheadedness. Similar to how you feel when you’re spinning and suddenly stop, these episodes of dizziness are reactions to stress.[52]
Fainting Spells Related to Stress Responses
Your body also reacts to stress by decreasing your heart rate and dilating blood vessels. While your body is trying its best to help you, these reactions can also lead to a drop in blood pressure, causing you to faint.
You might be prone to fainting during especially stressful experiences or when your brain perceives a threat, leading to a temporary loss of consciousness.[53]
Professional Diagnosis and Treatment Are Important
Professional diagnosis and treatment are crucial for managing your PTSD symptoms. A licensed mental health professional can give you an assessment to make sure the diagnosis is accurate and then make an individualized treatment plan for you.
Treatment plans may include talk therapy, medication, or a combination of both, depending on your needs. Talk to a professional to learn more about cognitive-behavioral therapy (CBT), eye movement desensitization and reprocessing (EMDR), and medications like antidepressants. Again, please consult mental health professionals on your healing journey for PTSD and other mental health problems.
While PTSD is a complex and challenging condition, you can manage your symptoms and improve your quality of life by seeking the right resources. No matter how alone you may feel, know that there are therapists, support groups, and community resources waiting to help.
A list of available resources is provided below.
Seeking help is a sign of strength, not weakness. In the case of PTSD, your recovery begins with recognizing the symptoms and then asking for help.
Summary of PTSD Symptoms
To sum things up, PTSD is a mental health condition that develops after experiencing or witnessing a traumatic event. The symptoms of PTSD can be grouped into four main categories:
- Intrusive memories: You have recurrent, unwanted memories of the traumatic event, as well as flashbacks and nightmares.
- Avoidance: You may avoid thinking or talking about the traumatic event and avoid places, activities, or people that remind you of the trauma.
- Negative changes in thinking and mood: You may have negative thoughts about yourself or others, feelings of hopelessness, memory problems, and difficulty maintaining close relationships.
- Changes in physical and emotional reactions: You may be easily startled or frightened, always being on guard, have trouble sleeping or concentrating, or engage in self-destructive behavior.
Remember, while these are the main manifestations of PTSD, everyone experiences this condition differently.
Recognizing the symptoms of PTSD and understanding the importance of seeking help and receiving professional diagnosis and treatment are crucial steps in the journey towards healing and recovery.
Resources
If you’re looking for resources for PTSD, see the information below:
- National Center for PTSD: This organization offers comprehensive resources for PTSD, including information on understanding the disorder, treatment options, and tools for managing symptoms.
- Website: National Center for PTSD
- Phone: 1-800-273-8255 (Press 1 for Veterans)
- PTSD Alliance: An alliance of professional and advocacy organizations that provide educational resources to individuals suffering from PTSD.
- Website: PTSD Alliance
- Anxiety and Depression Association of America (ADAA): ADAA offers resources specifically for anxiety and depression, which are often comorbid with PTSD.
- Website: ADAA
- Phone: 240-485-1001
- Substance Abuse and Mental Health Services Administration (SAMHSA): SAMHSA provides general mental health resources and a treatment locator for finding mental health services in your area.
- Website: SAMHSA
- Phone: 1-800-662-HELP (4357)
- Crisis Text Line: For immediate crisis support, the Crisis Text Line offers free, 24/7 support.
- Text “HELLO” to 741741
- National Suicide Prevention Lifeline: If you or someone you know is in immediate danger, contact the National Suicide Prevention Lifeline.
- Phone: 1-800-273-TALK (8255)
These resources provide valuable information and support for individuals with PTSD and their loved ones. It is important to reach out for help and know that you are not alone.
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