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Post-traumatic stress disorder (PTSD): A straight-talking, informative guide

It is entirely natural to experience a range of emotions after a traumatic event. Most people recover from these initial reactions and feelings within a few weeks. However, if you have ongoing problems, there could be something else going on, like PTSD. PTSD isn’t talked about enough. Not many people really understand what PTSD is or how to deal with it. Fewer people understand the significant impact that it can have on your life. 

At Thriveworks, we are here to give you practical, no-nonsense advice. It’s not always easy to talk, hear, or read about PTSD, hence this practical guide. It will help you understand what PTSD is, how it impacts lives, and what to do about it. You can sit down and read the complete guide, jump to the bits you want to know about, or take it in a little at a time. PTSD can happen to anyone, and this guide is for everyone. 

What Is Post-traumatic Stress Disorder (PTSD)?

PTSD is a condition that some people develop after experiencing or witnessing a traumatic event. It is an ongoing and intense physical and emotional response. It’s normal to have upsetting memories, trouble sleeping, or feel a range of emotions after this type of event. However, if the feelings and symptoms last more than a few months, it may be PTSD. Although often connected to war veterans and survivors, it can happen to anyone who has experienced trauma. 

What Qualifies As a Traumatic Event?

There is no one exhaustive list of traumatic events. They are described as situations that cause fear, helplessness, serious injury, or a threat of injury or death. It could be one event or a series of events. It could be something you are involved in or witness. 

Examples of traumatic events that may lead to PTSD include:

  • Violent physical or sexual assaults
  • Military combat 
  • Living through, witnessing, or experiencing war
  • Being involved in a terrorist attack
  • Being held hostage
  • Natural disasters such as earthquakes or tsunamis
  • Accidents (like road traffic accidents)
  • Ongoing physical, sexual, or psychological abuse or harassment
  • Traumatic childbirth
  • Frequently witnessing distressing events (for example, when working in the military or emergency services)
  • Seeing another person being abused, hurt, or killed
  • Experiencing a situation where you are fearful for your life

What Are the Symptoms of PTSD?

Symptoms of PTSD usually appear soon after a traumatic event; however, in some cases, they might not appear until weeks, months, or even years later. Not everyone has the same symptoms, and people experience symptoms in their own way. PTSD symptoms are categorized into four different types. 

  1. Re-experiencing symptoms (re-living the event). There are symptoms like nightmares, flashbacks, frightening thoughts, and emotional/physical reactions to bad memories. A noise, sight, or smell may also cause you to re-live the event (these are called triggers).
  2. Avoidance symptoms (avoiding things that remind you of the event). Choosing to stay away from people, activities, or places that remind you of the trauma are all avoidance symptoms. They may also include avoiding talking about the event, suppressing feelings, or feeling detached.
  3. Arousal and reactivity symptoms (feeling on edge, sometimes known as hyperarousal). Some people may feel like they are constantly alert and looking out for danger. Difficulty sleeping, feeling edgy, irritability, or being easily startled are other reactivity symptoms. Outbursts of anger, driving aggressively, and abuse of drugs/alcohol might also occur. 
  4. Cognition and mood symptoms (new harmful feelings since the event). These are negative and depressive feelings. Distorted feelings of guilt or blame. You may find you have lost interest in activities you used to enjoy, and feel estranged, isolated, or suicidal. Feeling you cannot trust anyone is often experienced, and you may forget the specifics of the traumatic event or not be able to talk about it.

What Are the Diagnostic Criteria for PTSD?

According to the National Institute of Mental Health, adults must have all of the following symptoms for at least one month to be diagnosed with PTSD:

  • At least one re-experiencing symptom
  • At least one avoidance symptom
  • At least two arousal and reactivity symptoms
  • At least two cognition and mood symptoms 

Being diagnosed with PTSD can involve several steps. The diagnosis will be made by a mental health professional, and they will have to carry out a few assessments before being able to make a diagnosis. You will have to answer a lot of questions, including questions about the traumatic event you experienced. There are a variety of screening questionnaires that a professional may use to help make the diagnosis. A few examples include:

  • Clinician-Administered PTSD Scale (CAPS)
  • Structured Clinical Interview for DSM (SCID)
  • PTSD-Interview
  • Structured Interview for PTSD (SI-PTSD)
  • PTSD Symptom Scale Interview (PSS-I)

How Common Is PTSD?

You may think experiencing trauma isn’t that common. However, it is quite the opposite. In fact, 60% of men and 50% of women are estimated to experience trauma at some point in their life. Furthermore, the National Center for PTSD states that approximately 6 out of every 100 people will experience PTSD at some point in their lives. And over the last year, PTSD affected 3.6% of adults in the United States (US). This is equivalent to around 8 million adults experiencing PTSD symptoms every year. 

PTSD is more common in women than men. This is due to sexual assault being the most frequent type of traumatic experience reported by women with PTSD. Approximately 8 in every 100 women develop PTSD sometime during their lifetime compared with 4 in every 100 men.

What Are the Causes of PTSD?

PTSD occurs as the result of being involved in or witnessing a traumatic experience. It’s important to remember that PTSD isn’t always caused by a traumatic event that physically happens to you. Some people develop PTSD after witnessing a friend or loved one experiencing harm or being put in a dangerous situation. The unexpected death of someone close to you can also lead to PTSD.

Who Is at Risk of Developing PTSD?

Not everyone who lives through a traumatic event develops PTSD. It is entirely normal to cycle through a range of emotions after a traumatic event. However, most people will fully recover and not develop PTSD. 

That said, there are risk factors that make some people more likely to develop PTSD than others. PTSD is seen to be more common after certain types of trauma, such as combat and sexual assault. Risk factors that make experiencing PTSD more likely include:

  • Living through a prolonged traumatic event (such as war or being held hostage)
  • Childhood trauma or abuse
  • A previous history of mental illness or substance abuse
  • Getting severely injured
  • Repeatedly witnessing traumatic events (such as when working in the military or emergency services)
  • Seeing another person get hurt, abused, or seeing a dead body
  • Having little or no social support 
  • Added stress after a traumatic event (such as grieving the loss of a loved one, ongoing pain, or loss of a job)

What Are the 5 Stages of PTSD?

PTSD affects everyone differently. There are five different stages of PTSD, and as you pass through the stages, symptoms can come and go. The stages of PTSD aren’t fixed. You may find you go from one to another, back and forth, throughout your recovery journey. Everyone has their own journey. The five stages of PTSD are:

  1. The impact stage (emergence stage): directly follows the traumatic event. This is the immediate stage where a person struggles to deal with what has just happened. It can include experiencing things such as shock, hypervigilance, fear, anxiety, or guilt. 
  2. The denial stage (numbing stage): is a stage that not everyone experiences. It’s where someone tries to protect themselves by denying that the traumatic event ever happened. It’s a way of avoiding feeling the emotions connected to the event. But, it does have to be dealt with to move forwards in recovery. 
  3. The rescue stage: is the beginning of coming to terms with what has happened. This stage is about acknowledging the traumatic event. It might even include returning to the location of the trauma. However, it involves dealing with a significant amount of ongoing emotions and physical effects. It can be the most challenging and sometimes the most destructive stage. 
  4. The immediate recovery stage (short-term recovery):  is the beginning of healing. People start to return to a more ‘normal’ life in this stage, rather than just surviving. There are two sub-stages of this phase. In one case, a person might be humbled by the outpouring of love and support that they have experienced. However, on the other hand, people may be disappointed in the lack of care or concern shown to them by others. Physical and emotional symptoms still continue throughout this phase. 
  5. The long-term reconstruction stage (long-term recovery): is all about implementing a recovery program. It is about rebuilding life again. However, also continuing to deal with personal problems post the traumatic event. In this stage, people begin to implement coping mechanisms to address symptoms. Some people find they begin to look forward to their lives. But, some can become concerned about the future presenting feelings such as fear, resentment, and depression. This is often the longest stage and learning to implement coping strategies is a vital part of continuing to deal with life. 

How Does PTSD Impact a Person's Life?

PTSD impacts everyone’s life differently. There is a vast range of emotional and physical symptoms. Below are a few examples of how PTSD can affect life; however, no person’s story is the same as the next.

People with PTSD can have trouble in relationships with family or friends. They may experience feelings that make it difficult to trust, communicate, and solve problems or be close to people. Intimacy may be a problem. 

For caregivers, their symptoms might also directly impact their children. Children may not understand what is happening if their parent is having re-experiencing symptoms. Or, a parent with PTSD might not feel like joining in family events or doing fun activities. If you have PTSD, it can be hard to have “good” feelings. Some people simply feel like they can no longer enjoy life. 

PTSD symptoms make it hard for someone to function like they usually would. They may be afraid of going out of the house, experience panic attacks, avoid social situations, be easily startled, or have symptoms triggered by specific sounds or smells. 

Some people with PTSD turn to alcohol or drug abuse which can lead to losing their job, home, or destroy their close relationships. Others may not be able to work because of other physical or emotional symptoms. Symptoms can make it hard to do something seen as simple, like a grocery shop, meaning a person with PTSD might not care for themselves properly. 

Symptoms can interfere with work, home life, relationships, self-care, physical health, mental health, and social life. 

What Are the Physical Effects of PTSD?

Some people with PTSD experience physical symptoms similar to what people with anxiety experience. This is because, when we are under stress, our body releases the hormones cortisol and adrenaline. With PTSD, some people continue to produce these hormones when they are no longer in a dangerous or stressful situation. These physical symptoms include:

  • Feeling your heart is racing
  • Headaches
  • Lightheadedness/dizziness
  • Chest pains
  • Stomach aches or feeling sick
  • Pins and needles
  • Fast breathing
  • Sweating or hot flushes
  • Teeth grinding
  • Sleep problems
  • Panic attacks
  • Feeling restless
  • A change in sex drive
  • Needing the toilet more or less frequently

Can PTSD Be Cured?

PTSD can be treated but not cured. Treatment means you can learn to effectively manage symptoms, restore to normal functioning, and get back to living your life. For some people, symptoms might be alleviated completely. For those whose symptoms do not completely go away, they often see significant improvements with treatment and experience a much better quality of life.

How Is PTSD Treated?

There are several treatments for PTSD. Two of the most recommended and researched therapies are:

  • Trauma-focused cognitive behavioral therapy (TF-CBT).  Cognitive behavioral therapy (CBT) focuses on the relationship among thoughts, feelings, and behaviors; targets current problems and symptoms; and focuses on changing patterns of behaviors, thoughts, and feelings that lead to difficulties in functioning,” according to The American Psychology Association. TF-CBT is a type of CBT that has been specifically adapted for PTSD.
  • Eye movement desensitization and reprocessing (EMDR). The treatment involves making eye movements while thinking about the traumatic event. EMDR helps change the negative way you think about a traumatic experience. It creates a similar effect to the way your brain processes memories and experiences when you are asleep. It can help reduce symptoms such as being easily startled. 

Other therapies that might be recommended include: 

  • Cognitive processing therapy
  • Prolonged exposure therapy
  • Support groups

For some people, specific medication can help alongside other therapies. Medication can help people to manage their anxiety, depression, or other symptoms that can occur alongside their PTSD symptoms. 

Treatment is a different process for everyone. You may think that you don’t need treatment. However, when PTSD isn’t treated, it usually doesn’t go away and may even get worse. Most people find treatment helps them to live a better quality of life. 

How Do You Manage PTSD in Your Everyday Life?

PTSD can be overwhelming. It can be difficult to know where to start with dealing with PTSD. Here are a few things that might help:

  • Find people you can confide in. PTSD can make it hard to open up to people, but talking can help. If you don’t feel you can talk to a friend or family member, then you may feel comfortable talking to your family doctor, counselor, or a telephone support helpline. You don’t have to talk about the traumatic event, but you might want to talk about how you currently feel. 
  • Get professional support. PTSD can be treated with professional therapy support. Thriveworks has counselors, therapists, psychologists, and psychiatrists who can help you heal from your traumatic event and manage your PTSD symptoms. 
  • Understand your triggers. Triggers are different for everyone. They can be as simple as a specific anniversary or date. In that case, try to plan ahead and put coping strategies in place when you know a trigger date is coming up. If your triggers relate to smells, noises, or places, you might want to think about these before going to a specific event. That way, you can plan ahead in case you think you might experience your triggers at an event. 
  • Learn to cope with flashbacks. Flashbacks can be distressing. Things like focussing on your breathing, comforting yourself, telling yourself you are safe, and learning grounding techniques can help you get through a flashback. Keeping a diary might help you to spot a flashback pattern or triggers that are causing flashbacks. A professional can help you learn coping strategies to deal with flashbacks. 
  • Find peer support. Some people find talking to others who have had similar experiences helps. There may be a peer support group near you. But, if not, there are many online peer support groups too.
  • Look after your body and physical health. The physical and emotional symptoms of PTSD can be exhausting on the mind and body. Looking after your physical health can help by eating a healthy diet, exercising, and spending time outdoors. 
  • Avoid negative coping strategies. Try to avoid turning to alcohol or drugs to cope with your emotions. What feels like a quick fix can make the situation worse in the long run. 
  • Be kind to yourself. With PTSD, it can be easy to judge and put pressure on yourself. Try to be patient. It takes time and support to alleviate the symptoms of PTSD. Allow yourself time to recover. 
Helen Massy
Written by
Helen Massy
Published May 20, 2022, 1 min read.
Table of contents

What Is Post-traumatic Stress Disorder (PTSD)?

What Qualifies As a Traumatic Event?

What Are the Symptoms of PTSD?

What Are the Diagnostic Criteria for PTSD?

How Common Is PTSD?

What Are the Causes of PTSD?

Who Is at Risk of Developing PTSD?

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  • Author
Helen Massy

Written by Helen Massy

Helen is a medical and health writer who strives to make health literacy accessible. She has an extensive background as a health care professional and senior leader in the UK National Health Service (NHS).

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