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Post-Traumatic Stress Disorder (PTSD)

Symptoms, Treatment, and Self-Help for PTSD

Post-Traumatic Stress Disorder (PTSD) In This Article

After a traumatic experience, it's normal to feel frightened, sad, anxious, and disconnected. But if the upset doesn't fade and you feel stuck with a constant sense of danger and painful memories, you may be suffering from post-traumatic stress disorder (PTSD). It can seem like you'll never get over what happened or feel normal again. But by seeking treatment, reaching out for support, and developing new coping skills, you can overcome PTSD and move on with your life.

What is post-traumatic stress disorder (PTSD)?

Post-traumatic stress disorder (PTSD) can develop following a traumatic event that threatens your safety or makes you feel helpless.

Most people associate PTSD with battle-scarred soldiers—and military combat is the most common cause in men—but any seemingly life-threatening event—or series of events—that overwhelms you with feelings of hopelessness and helplessness can trigger PTSD, especially if the event feels unpredictable and uncontrollable.

PTSD can affect those who personally experience the catastrophe, those who witness it, and those who pick up the pieces afterwards, including emergency workers and law enforcement officers. It can even occur in the friends or family members of those who went through the actual trauma.

Veterans with PTSD

If you’re a veteran suffering from PTSD or combat stress, there are steps you can take to begin the recovery process and deal with your symptoms. See PTSD in Military Veterans.

Traumatic events that can lead to PTSD include:

  • War
  • Natural disasters
  • Car or plane crashes
  • Terrorist attacks
  • Sudden death of a loved one
  • Rape
  • Kidnapping
  • Assault
  • Sexual or physical abuse
  • Childhood neglect

Or any shattering, disabling event that leaves you feeling helpless and hopeless

The difference between PTSD and a normal response to trauma

When your sense of safety and trust are shattered by a traumatic event, it’s normal for the mind and body to be in shock. It’s common to have bad dreams, feel fearful, and find it difficult to stop thinking about what happened. For most people, these symptoms gradually lift over time. But this normal response to trauma becomes PTSD when the symptoms don’t ease up and your nervous system gets “stuck” and fails to recover its equilibrium. 

The latest research shows that the brain has three ways of regulating the nervous system and responding to stressful events:

  • Social engagement is the most evolved strategy for keeping yourself feeling calm and safe. Socially interacting with another person—making eye contact, listening in an attentive way, talking—can quickly calm you down and put the brakes on defensive responses like “fight-or-flight.”
  • Mobilization, or the fight-or-flight response, occurs when social engagement isn’t appropriate and you need to either defend yourself or escape the danger at hand—such as in a natural disaster. Your heart pounds faster, muscles tighten, blood pressure rises, breath quickens, and your senses become sharper. These physical changes increase your strength and stamina and speed your reaction time. Once the danger has passed, your nervous system then calms the body, slowing heart rate, lowering blood pressure, and winding back down to its normal balance.
  • Immobilization occurs when you’ve experienced an overwhelming amount of stress in a situation and, while the immediate danger has passed, you find yourself “stuck.” Your nervous system is unable to return to its pre-stress state of balance and you’re unable to move on from the event. This is PTSD.

Signs and symptoms of post-traumatic stress disorder (PTSD)

PTSD develops differently from person to person. While the symptoms of PTSD most commonly develop in the hours or days following the traumatic event, it can sometimes take weeks, months, or even years before they appear. There are three main types of symptoms and they can arise suddenly, gradually, or come and go over time:

  1. Re-experiencing the traumatic event
  2. Avoiding reminders of the trauma
  3. Increased anxiety and emotional arousal

Symptoms of PTSD: Re-experiencing the traumatic event

  • Intrusive, upsetting memories of the event
  • Flashbacks (acting or feeling like the event is happening again)
  • Nightmares (either of the event or other frightening things)
  • Feelings of intense distress when reminded of the trauma
  • Intense physical reactions to reminders of the event (e.g. pounding heart, rapid breathing, nausea, muscle tension, sweating)

Symptoms of PTSD: Avoidance and numbing

  • Avoiding activities, places, thoughts, or feelings that remind you of the trauma
  • Inability to remember important aspects of the trauma
  • Loss of interest in activities and life in general
  • Feeling detached from others and emotionally numb
  • Sense of a limited future (you don’t expect to live a normal life span, get married, have a career)

Symptoms of PTSD: Increased anxiety and emotional arousal

  • Difficulty falling or staying asleep
  • Irritability or outbursts of anger
  • Difficulty concentrating
  • Hypervigilance (on constant “red alert”)
  • Feeling jumpy and easily startled

Other common symptoms of post-traumatic stress disorder (PTSD)

  • Guilt, shame, or self-blame
  • Substance abuse
  • Feelings of mistrust and betrayal
  • Depression and hopelessness
  • Suicidal thoughts and feelings
  • Physical aches and pains

Symptoms of PTSD in children and adolescents

In children—especially those who are very young—the symptoms of PTSD can be different than those in adults. Symptoms in children include:

  • Fear of being separated from parent
  • Losing previously-acquired skills (such as toilet training)
  • Sleep problems and nightmares without recognizable content
  • Somber, compulsive play in which themes or aspects of the trauma are repeated
  • New phobias and anxieties that seem unrelated to the trauma (such as a fear of monsters)
  • Acting out the trauma through play, stories, or drawings
  • Aches and pains with no apparent cause
  • Irritability and aggression

Post-traumatic stress disorder (PTSD) causes and risk factors

Traumatic events are more likely to cause PTSD when they involve a severe threat to your life or personal safety: the more extreme and prolonged the threat, the greater the risk of developing PTSD. Intentional, human-inflicted harm—such as rape, assault, and torture—also tends to be more traumatic than “acts of God” or more impersonal accidents and disasters. The extent to which the traumatic event was unexpected, uncontrollable, and inescapable also plays a role.

Other risk factors for PTSD include:

  • Previous traumatic experiences, especially in early life
  • Family history of PTSD or depression
  • History of physical or sexual abuse
  • History of substance abuse
  • History of depression, anxiety, or another mental illness
  • High level of stress in everyday life
  • Lack of support after the trauma
  • Lack of coping skills

Getting help for post-traumatic stress disorder (PTSD)

Recovering from PTSD involves helping your nervous system return to its pre-trauma state of balance. As discussed above, the best way to regulate your nervous system is through social engagement—interacting with another human being—be it a loved one, a friend, or a professional therapist. However, as someone with PTSD, you need to first become “unstuck” and move out of the immobilization stress response.

While this process is easier with the guidance and support of an experienced therapist or doctor, you don’t need to wait for a medical appointment to start feeling better. There are plenty of things you can do now to help yourself cope with symptoms, reduce anxiety and fear, and take back control of your life.

PTSD self-help tip 1: Get moving

We’ve long known that exercise can make you feel better, both mentally and physically. However, new research suggests that by really focusing on your body and how it feels as you exercise, you can actually help your nervous system become “unstuck” and move out of the immobilization stress response.

Any exercise that engages both your arms and legs—such as walking, running, swimming, or dancing—will work well if, instead of continuing to focus on your thoughts, you focus on how your body feels as you exercise. Try to notice the sensation of your feet hitting the ground, for example, or the rhythm of your breathing, or the feeling of the wind on your skin. Many people find rock climbing, boxing, or martial arts especially effective as these activities make it easier to maintain the focus on body movements—after all, if you don’t, you could get hurt.

Spending time in nature

Pursuing outdoor activities like hiking, camping, mountain biking, rock climbing, whitewater rafting, and skiing have been shown to help veterans cope with PTSD symptoms and transition back into civilian life.

But it’s not just veterans who can benefit from spending time outdoors. Anyone with PTSD can benefit from the relaxation, seclusion, and peace that come with being out in nature. Focusing on strenuous outdoor activities can also challenge your sense of helplessness and help your nervous system become “unstuck.” Seek out local organizations that offer outdoor recreation or teambuilding opportunities. 

PTSD self-help tip 2: Connect with others

Support from other people is vital to your recovery from PTSD. Social interaction with someone who cares about you is the most effective way to calm your nervous system, so it’s important to find someone you can connect with face to face—someone you can talk to for an uninterrupted period of time, someone who will listen to you without judging, criticizing, or continually being distracted by the phone or other people. That person may be your significant other, a family member, or a friend.

How PTSD can get in the way of connecting with others

Many people find that PTSD can leave them feeling disconnected, withdrawn and, while their nervous system is still stuck, make it difficult to connect with other people. No matter how close they are to the person, or how helpful that person tries to be, they just don’t feel any better after talking with them. If that describes you, there are some things you can do to help the process along.

  • Before you’re due to sit down to chat with a friend or loved one, take some time to exercise. As well as calming you when you’re feeling anxious or on edge, physical activity can also open your nervous system’s pathway to social engagement. Think of it as shaking loose all the blockages to connecting with people.
  • If exercising isn’t practical, find a quiet place and take a few minutes before you meet your friend to move around, jump up and down, swing your arms and legs—in other words, flail around like you did as a three year old. A few minutes of that and you’ll be breathing heavily, your head will feel clearer, and you’ll be in a better place to connect.
  • It may sound weird, but vocal toning is also a great way to open up your nervous system to social engagement—even if you can’t sing or consider yourself tone-deaf. Again, find a quiet place before hooking up with a friend and, with a straight back, your lips together and teeth slightly apart, simply make “mmmm” sounds. Change the pitch and volume until you experience a pleasant vibration in your face. Practice for a few minutes and notice if the vibration spreads to your heart and stomach as well.

A powerful program for reconnecting

It’s difficult to connect to others if you’re unable to connect to yourself and what you’re feeling. Helpguide offers a free online program that teaches you how to reconnect to your physical and emotional feelings—even those uncomfortable or disturbing emotions you’ve been trying to avoid—without becoming overwhelmed. It can make a huge difference in your ability to relate to others, manage stress, balance your moods, and take back control of your life.

PTSD self-help tip 3: Challenge your sense of helplessness

Trauma can leave you feeling powerless and vulnerable. It’s important to remind yourself that you have strengths and coping skills that can get you through tough times.

One of the best ways to reclaim your sense of power is by helping others: volunteer your time, give blood, reach out to a friend in need, or donate to your favorite charity. Taking positive action directly challenges the sense of helplessness.

Also consider joining a support group for survivors of the same type of trauma you experienced. Support groups for PTSD can help you feel less isolated and alone and also provide invaluable information on how to cope with symptoms and work towards recovery. If you can’t find a support group in your area, look for an online group.

PTSD self-help tip 4: Take care of yourself

The symptoms of PTSD can be hard on your body so it’s important to take care of yourself and develop some healthy lifestyle habits.

  • Take time to relax. Relaxation techniques such as meditation, deep breathing, massage, or yoga can activate the body’s relaxation response and ease symptoms of PTSD.
  • Avoid alcohol and drugs. When you’re struggling with difficult emotions and traumatic memories, you may be tempted to self-medicate with alcohol or drugs. But substance use worsens many symptoms of PTSD, including emotional numbing, social isolation, anger, and depression. It also interferes with treatment and can add to problems at home and in your relationships.
  • Eat a healthy diet. Start your day right with breakfast, and keep your energy up and your mind clear with balanced, nutritious meals throughout the day. Limit processed food, fried food, refined starches, and sugars, which can exacerbate mood swings and energy fluctuations.
  • Get enough sleep. Sleep deprivation exacerbates anger, irritability, and moodiness. Aim for somewhere between 7 to 9 hours of sleep each night. Develop a relaxing bedtime ritual (listen to calming music, watch a funny show, or read something light) and make your bedroom as quiet, dark, and soothing as possible.

Professional treatment for post-traumatic stress disorder (PTSD)

Treatment for PTSD relieves symptoms by helping you deal with the trauma you’ve experienced. Rather than avoiding the trauma and any reminder of it, a doctor or therapist will encourage you to recall and process the emotions you felt during the original event in order to reduce the powerful hold the memory has on your life.

You’ll also:

  • Explore your thoughts and feelings about the trauma
  • Work through feelings of guilt, self-blame, and mistrust
  • Learn how to cope with and control intrusive memories
  • Address problems PTSD has caused in your life and relationships

Types of treatment for post-traumatic stress disorder (PTSD)

  • Trauma-focused cognitive-behavioral therapy involves carefully and gradually “exposing” yourself to thoughts, feelings, and situations that remind you of the trauma. Therapy also involves identifying upsetting thoughts about the traumatic event–particularly thoughts that are distorted and irrational—and replacing them with more balanced picture.
  • Family therapy can help your loved ones understand what you’re going through. It can also help everyone in the family communicate better and work through relationship problems caused by PTSD symptoms.
  • Medication is sometimes prescribed to people with PTSD to relieve secondary symptoms of depression or anxiety. While antidepressants may help you feel less sad, worried, or on edge, they do not treat the causes of PTSD.
  • EMDR (Eye Movement Desensitization and Reprocessing) incorporates elements of cognitive-behavioral therapy with eye movements or other forms of rhythmic, left-right stimulation, such as hand taps or sounds. These work by “unfreezing” the brain’s information processing system, which is interrupted in times of extreme stress.

Finding a therapist for post-traumatic stress disorder (PTSD)

When looking for a therapist, seek out mental health professionals who specialize in the treatment of trauma and PTSD. You can ask your doctor or other trauma survivors for a referral, or call a local mental health clinic, psychiatric hospital, or counseling center.

Beyond credentials and experience, it’s important to find a PTSD therapist who makes you feel comfortable and safe, so there is no additional anxiety about the treatment itself. Trust your gut; if a therapist doesn’t feel right, look for someone else. For therapy to work, you need to feel understood. To find a trauma therapist, see the Resources and References section below.

Helping someone with post-traumatic stress disorder (PTSD)

If a loved one has post-traumatic stress disorder, it can take a heavy toll on your relationship and family life. It can be hard to understand why your loved one won’t open up to you—why he or she is less affectionate and more volatile. The symptoms of PTSD can also result in job loss, substance abuse, and other stressful problems.

Letting your family member’s PTSD dominate your life while ignoring your own needs is a surefire recipe for burnout. In order to take care of your loved one, you first need to take care of yourself. It’s also helpful to learn all you can about PTSD. The more you know about the symptoms and treatment options, the better equipped you'll be to help your loved one and keep things in perspective.

Tips for helping a loved one with PTSD

  • Be patient and understanding. Getting better takes time so be patient with the pace of recovery and offer a sympathetic ear. A person with PTSD may need to talk about the traumatic event over and over again. This is part of the healing process, so avoid the temptation to tell your loved one to stop rehashing the past and move on.
  • Try to anticipate and prepare for PTSD triggers. Common triggers include anniversary dates; people or places associated with the trauma; and certain sights, sounds, or smells. If you are aware of what triggers may cause an upsetting reaction, you’ll be in a better position to offer your support and help your loved one calm down.
  • Don’t take the symptoms of PTSD personally. Common symptoms of post-traumatic stress disorder include emotional numbness, anger, and withdrawal. If your loved one seems distant, irritable, or closed off, remember that this may not have anything to do with you or your relationship.
  • Don’t pressure your loved one into talking. It is often very difficult for people with PTSD to talk about their traumatic experiences. For some, it can even make things worse. Never try to force your loved one to open up. Let the person know, however, that you’re there when and if he or she wants to talk.

More help for PTSD

PTSD and Trauma Help Center: With the right help and coping skills, you can overcome the effects of trauma and move on with your life.

Resources and references

General information about post-traumatic stress disorder (PTSD)

Post-Traumatic Stress Disorder News & Research – Overview of the latest research on PTSD, including its causes, risk factors, and promising new treatments. (National Institute of Mental Health)

Myths and Facts About PTSD – Learn the truth behind common misconceptions about PTSD. (Post-traumatic Stress Disorder Alliance)

Signs and symptoms of post-traumatic stress disorder (PTSD)

Post-Traumatic Stress Disorder Self-Test – Online self-test for PTSD to help you evaluate your symptoms. (Anxiety Disorders Association of America)

The Symptoms of Post-Traumatic Stress Disorder: Chronic and/or Delayed – Description of PTSD’s many symptoms, including withdrawal, avoidance, isolation, and flashbacks. (PTSD Support Services)

Common Reactions – Find information on some common reactions to trauma, including anger, nightmares, sleep problems, avoidance, and depression. (National Center for PTSD)

Treatment and self-help for post-traumatic stress disorder (PTSD)

Treatment of PTSD – Guide to the treatments for PTSD, including cognitive therapy, exposure therapy, and EMDR. (National Center for PTSD)

Self-Help and Coping – Series of articles on how to cope with PTSD in healthy ways that promote healing and recovery. (National Center for PTSD)

Helping a loved one with post-traumatic stress disorder (PTSD)

Returning from the War Zone: A Guide – Advice for service members and their families on what to expect and how to adapt after returning home from war. (National Center for PTSD)

Partners with PTSD – Article for the friends and family members of people with PTSD. Includes an explanation of symptoms and what you can do to help. (Gift from Within)

Finding help and support for post-traumatic stress disorder (PTSD)

Finding a Therapist – Advice on how to find a therapist for PTSD treatment. Includes questions to ask a potential therapist. (National Center for PTSD)

How to Choose a Therapist for Post-Traumatic Stress and Dissociative Conditions – Tips on choosing a therapist and treatments for PTSD. Includes a phone number for referrals. (The Sidran Institute)

Help for U.S. veterans suffering from post-traumatic stress disorder (PTSD)

Vet Centers offer free counseling to combat veterans and their families. To find out more about the resources and benefits available to you, you can also call the VA Health Benefits Service Center at 1-877-222-VETS.

Click here for a nationwide directory of facilities for veterans, including VA hospitals and Vet Centers, provided by the U.S. Department of Veterans Affairs.

VVA’s Guide on PTSD – Advice for combat veterans on how to get help and claim military benefits. (Vietnam Veterans of America)

VA Aid & Attendance Pension – Often overlooked benefits for veterans and surviving spouses who require the regular attendance of another person to assist in eating, bathing, dressing and undressing or taking care of the needs of nature.

Help for other nations’ veterans suffering from post-traumatic stress disorder (PTSD)

Canadian veterans: visit Operational Stress Injury Social Support (OSISS) or call 1-800-883-6094 to talk to a peer who has been through similar experiences.

UK veterans: visit Combat Stress or call the 24-hour helpline 0800 138 1619.

Australian veterans: visit Veterans and Veterans Families Counselling Service (VVCS) or call 1800 011 046.

Trauma therapist referral

For help locating a trauma therapist in the U.S., treatment center, or support group in your area, contact the Sidran Traumatic Stress Institute at (410) 825-8888.

What other readers are saying

“All the web surfing I have ever done on any topic has not had such a jolting effect as when I read your page on PTSD. Twenty months back I went through an experience that still haunts me daily. I clearly suffer from all three the symptoms mentioned in your article. Your page . . . felt to me as if, for the very first time, someone had sat and listened to my story and actually cared. Maybe if I begin to understand, I can begin to heal. Thank you for the candle light in the midst of this very dark cave in which I find myself.” ~ South Africa

Authors: Melinda Smith, M.A., Lawrence Robinson, and Jeanne Segal, Ph.D. Last updated: August 2015.