What it is
PTSD can develop after experiencing or witnessing a traumatic event (violence, assault, disaster, serious accident, combat, medical trauma). It involves ongoing re-experiencing, avoidance, negative mood/cognition changes, and hyperarousal that last longer than a month and interfere with life. PTSD is treatable.
Note: Strong stress reactions in the first month are common; “Acute Stress Disorder” describes earlier symptoms.
Common signs and symptoms
- Re-experiencing: unwanted memories, nightmares, flashbacks, strong distress with reminders
- Avoidance: steering clear of places, people, or thoughts linked to the trauma
- Mood/cognition: negative beliefs (“I’m not safe,” “It was my fault”), guilt, shame, hopelessness, loss of interest, feeling detached
- Arousal/reactivity: hypervigilance, startle easily, irritability/anger, sleep problems, trouble concentrating, risky or numbing behaviors
- Physical cues: body jolts, tension, pain flares when triggered
Co-occurring depression, anxiety, substance use, pain, or TBI are common and should be addressed together.
Why it happens
- The brain’s alarm system stays on high alert; traumatic memories remain “stuck” and easily triggered
- Avoidance and numbing prevent memories from being processed and integrated
- Stress hormones and sleep disruption maintain symptoms
What helps right now
- Grounding skills:
- 5-4-3-2-1 sensory grounding; press feet into the floor, name your surroundings
- Breathing: long, slow exhales (e.g., inhale 4, exhale 6–8)
- Routine and safety:
- Regular meals, movement, and consistent sleep
- Reduce alcohol/substances that worsen sleep and reactivity
- Support:
- Talk to trusted people or peer groups; set boundaries around triggers when needed
Evidence-based treatments
- Trauma-focused therapies (first-line):
- Prolonged Exposure (PE): gradually and safely facing avoided memories/situations to reduce fear
- Cognitive Processing Therapy (CPT): identify and shift stuck beliefs (guilt, blame, danger)
- EMDR (Eye Movement Desensitization and Reprocessing): reprocessing traumatic memories using bilateral stimulation
- Medications:
- SSRIs/SNRIs can reduce overall symptoms
- Prazosin may help with trauma-related nightmares for some people
- Integrated care:
- Treat co-occurring conditions (substance use, pain, insomnia) in parallel
- Sleep interventions (CBT-I) often improve daytime symptoms
Healing is possible—even for long-standing PTSD.
When to seek help now
- Symptoms persist beyond a month or interfere with work, relationships, or safety
- Severe nightmares, flashbacks, or avoidance that restrict life
- Thoughts of self-harm or suicide (seek urgent help)
How to talk to a clinician
- “Since [event], I’ve had nightmares, avoidance, and hypervigilance for months. I’d like trauma-focused therapy such as CPT, PE, or EMDR, and to discuss medication options.”
Outlook
Many people experience significant relief with trauma-focused therapy—often within weeks to months. Skills and support rebuild a sense of safety and control.
Resources for readers in the USA
- Immediate help: 988 Suicide & Crisis Lifeline (call/text 988); Crisis Text Line (text HOME to 741741); Veterans: 988 then 1; The Trevor Project: 1-866-488-7386 or text START to 678678
- Find care: FindTreatment.gov; Psychology Today directory; NAMI HelpLine (nami.org/help)
- PTSD-specific: VA PTSD resources (even for some non-VA users): ptsd.va.gov; International Society for Traumatic Stress Studies: istss.org
- Low-cost/community: Open Path Collective; Community Health Centers (findahealthcenter.hrsa.gov); 211
- Insurance tips: Verify in-network mental health benefits, telehealth, deductible, copay/coinsurance, prior authorization, out-of-network reimbursement, out-of-pocket max; note rep name/date/reference number
- Work/school supports: FMLA, ADA accommodations (e.g., flexible scheduling), EAP; campus counseling
- Urgent options besides ER: Mobile Crisis via 988 (where available), behavioral urgent care
Disclaimer: Educational information, not a diagnosis. If in crisis, use the resources above.