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Medical Author:

Maria Pease, MD

Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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PTSD Symptoms

After a trauma in which you think you might die, see someone die, or become seriously injured, and you feel intense fear, helplessness, or horror, it is very common to become distressed and anxious. You may have trouble sleeping, have nightmares, think about the trauma a lot, try to avoid the site of the trauma, and/or try to avoid feelings at all and become more numb. This is called "acute stress disorder." For most people, this distressing period passes within about four weeks.

People who develop PTSD do not get over their trauma so quickly. This disorder must be diagnosed by a medical professional, but there are three main symptoms:

1. Re-experiencing the trauma, such as flashbacks, nightmares, intrusive thoughts, etc.

2. Avoidance: trying to avoid thoughts, feelings, situations, or people who might remind you of the trauma

3. Hyperarousal: always being on alert, trouble sleeping, irritability, difficulty concentrating, exaggerated startle response

There are other associated symptoms of PTSD:

• Panic attacks: a feeling of intense fear, which can be accompanied by shortness of breath, dizziness, sweating, nausea, and a racing heart.



• Physical symptoms: chronic pain, headaches, stomach pain, diarrhea, tightness or burning in the chest, muscle cramps, or low back pain



• Feelings of mistrust: losing trust in others and thinking the world is a dangerous place



• Problems in daily living: having problems functioning in your job, at school, or in social situations



• Substance abuse: using drugs or alcohol to cope with the emotional pain



• Relationship problems: having problems with intimacy or feeling detached from your family and friends



• Depression: persistent sad, anxious, or empty mood; loss of interest in once-enjoyed activities; feelings of guilt and shame; or hopelessness about the future. Other symptoms of depression may also develop.



• Suicidal thoughts: thoughts about taking one's own life

PTSD is often associated with other psychiatric and physical problems.

• Some 88% of men and 79% of women with PTSD also have another psychiatric disorder. Nearly half suffer from major depression, 16% from anxiety disorders, and 28% from social phobia. They also are more likely to engage in risky health behaviors such as alcohol abuse, which affects 52% of men with PTSD and 28% of women, while drug abuse is seen in 35% of men and 27% of women with PTSD.



• Veterans who have been diagnosed with psychiatric conditions have a significantly higher prevalence of all cardiovascular disease risk factors (tobacco use, hypertension, dyslipidemia, obesity and diabetes than those without mental-health diagnoses).

Children and adolescents also experience trauma, and PTSD.

Following the trauma, children may initially show agitated or confused behavior. They also may show intense fear, helplessness, anger, sadness, horror, or denial. Children who experience repeated trauma may develop a kind of emotional numbing to deaden or block the pain and trauma. This is called dissociation. Children with PTSD avoid situations or places that remind them of the trauma. They may also become less responsive emotionally, depressed, withdrawn, and more detached from their feelings.

A child with PTSD may also re-experience the traumatic event by

• having frequent memories of the event, or in young children, play in which some or all of the trauma is repeated over and over;



• having upsetting and frightening dreams;



• acting or feeling like the experience is happening again;



• or developing repeated physical or emotional symptoms when the child is reminded of the event.

Children with PTSD may also show the following symptoms:

• Worry about dying at an early age



• Losing interest in activities



• Having physical symptoms such as headaches and stomachaches



• Showing more sudden and extreme emotional reactions



• Having problems falling or staying asleep



• Showing irritability or angry outbursts



• Having problems concentrating



• Acting younger than their age (for example, clingy or whiny behavior, thumbsucking)



• Showing increased alertness to the environment



• Repeating behavior that reminds them of the trauma

Teenagers' symptoms might include

• recurrent, intrusive, and distressing memories of the event;



• recurrent, distressing dreams of the event;



• acting or feeling as if the traumatic event were recurring;



• intense psychological distress when exposed to reminders of the traumatic event and consequent avoidance of those stimuli;



• numbing of general responsiveness (detachment, estrangement from others, decreased interest in significant activities);



• or persistent symptoms of increased arousal (irritability, sleep disturbances, poor concentration, hyper-vigilance, anxiety).