Following a traumatic incident, virtually anyone is shaken up. Typically, people go through a slow settling process. Some feel frightened and it only escalates more and more. Recognizing the symptoms of PTSD (post-traumatic stress disorder) can help you determine if it’s a normal stress reaction or a stress reaction that requires treatment.
When looking up the 17 symptoms of PTSD, it is crucial to realize that this is a reference to old diagnostic criteria for PTSD. Under the current definition of PTSD (in the DSM-5), 20 different symptoms are categorized into four broad groups: intrusion symptoms, avoidance symptoms, negative changes in thoughts and feelings, and arousal and reactivity symptoms.
Knowing these symptoms can help you identify when trauma related reactions may require professional help.
What Is PTSD?
PTSD is a mental health disorder that can occur following exposure to or witnessing death, serious injury and/or sexual violence. It may also occur when there are repeated exposures to upsetting details of these events, and this is often the case for first responders.
The U.S. Department of Veterans Affairs’ National Center for PTSD estimates that about 1 in 13 people (or 6 in 100) will suffer from PTSD at some point in their lives. Women, combat veterans and those who have been victims of assault are more likely to experience this.
The 17 symptoms of PTSD
The symptoms are divided into four clusters of symptoms. These are explained in layman’s terms.
Intrusion (Reliving the Event) – Cluster 1
These symptoms are a way to re-experience the trauma in the present moment.
1. Unwanted, intrusive memories
Memories cannot be suppressed. You are not the one who selected to think about it; and you cannot simply turn it off.
2. Nightmares
The event occurs again in the dreams or the same fears and themes. Often people have a racing heart and are sweating when they wake up in the morning.
3. Flashbacks
Flashbacks can be anything from feeling very deeply connected to “back there” to a fleeting foggy confusion of “where am I?”
4. Emotional distress at reminders that is strong.
Have extreme fear, anger, and sadness when triggered by sound, smell, date or place.
5. Reactions to reminders – physical
Before you even have time to think, your body is already responding with pounding heart, sweating, shaking, nausea or quick breathing.
Cluster 2: Avoidance
Avoidance is protective but can also help maintain the trauma.
6. Thinking, feeling or talking about the avoidance of thoughts, feelings or conversations
You avoid thinking of things, change the subject or keep yourself too busy so you don’t feel.
7. Avoiding people, places or activities.
There are certain streets, events or individuals that you avoid because they remind you of the past. Your world may become smaller with the passage of time.
Cluster 3: Negative changes in thinking and mood
The symptoms may not be noticed for the reason that they mimic the symptoms of personality change.
8. Difficulty to recall important parts of the event
Common gaps are in memory of trauma. No lying or “faking” it. Traumatic memories can be stored in the brain in bits and pieces.
9. Extreme opinions and skewed accusations
You might have the feeling: “I am broken”, “No one is trustworthy” or “It is very dangerous in the world”. You can also blame yourself and/or others that are not actually responsible for what happened. These two are considered two separate symptoms in DSM-5-TR.
10. Ongoing fears, guilt, shame or anger
These feelings don’t go away with the years. They are a part of our lives but out of the way.
11. Loss of interest in doing things that they used to enjoy.
Weaning the enjoyment is derailed from hobbies, sports and social plans.
12. Feeling disconnected and/or numb emotionally
You might feel isolated from family and friends or unable to experience joy, love or satisfaction. (Detachment and inability to feel positive emotions are separated in DSM-5-TR.)
Cluster 4: Feeling on Edge – Arousal and Reactivity
Your alarm system is always on.
13. Irritability, angry outbursts
Nothing can take the place of little things that set you off. Many of them claim to feel that they have “a short fuse” and do not recognize themselves.
14. Destructive or reckless behavior
This may mean engaging in risky driving behavior, heavy drinking, substance abuse or other risky behaviors.
15. Hypervigilance
You are in constant fear of danger, stand by the door or cannot relax in public.
16. Exaggerated startle response
Avoids areas of loud noise, or jumps and reacts very differently to any loud noises around them.
17. Difficulty paying attention, sleeping
Your mind wanders and sleep is light, short or interrupted. These two are considered two separate symptoms in DSM-5-TR.
What is it like to have post-traumatic stress disorder (PTSD)?
PTSD may be unique to each individual. A person can be feeling threatened or on edge when there’s no actual threat. Others might primarily experience intrusive memories, nightmares, avoidance, emotional numbness, and/or changes in relationships.
Symptoms may change from day to day. PTSD symptoms can fluctuate throughout many years, the U.S. Department of Veterans Affairs reports, and some people will improve after several months while for others, it will last for a year or more, reports the National Institute of Mental Health.
This does not mean if someone has one or more trauma related symptoms, then they have PTSD.
What are the Early Signs of PTSD?
Reactions to trauma initially can be thoughts of anxiety, sadness, anger, trouble sleeping, and trouble focusing, or rethinking the trauma. After a traumatic event there can be some short-term reactions that a person may have and over time, they make a recovery.
If symptoms are becoming more persistent they may occur in any of the following ways:
- Frequent nightmares, intrusive memories
- Strategies to avoid reminders of the event
- Always on the defensive with a heightened sense of awareness of potential threats
- Ongoing fear, guilt, shame, and/or anger
- Difficulty sleeping
- Problems concentrating
- Going through withdrawal from activities
- Embarrassment or shame about their weight
- Problems on the job, in relationships, or in daily life that are related to the symptoms of the disorder. Work, relationship and activities of daily living problems related to the disorder.
It is important to be assessed by a professional, because there are a number of mental health issues that can have symptoms similar to PTSD.
What is the impact of PTSD on their everyday life?
PTSD symptoms may impact the emotional well-being but also go beyond that. They can disrupt sleep patterns, focus and attention, interpersonal relationship, work, school and daily functioning.
One case in point is that if after a serious accident a person stops driving, they may have a hard time getting to work. A person who suffers from many nightmares might get tired during the day. The person who is constantly alert may not be able to relax or focus.
The effect will be quite different on different individuals. In order for PTSD to be diagnosed, symptoms have to last longer than 1 month and be clinically significant and cause a degree of distress or functional impairment in important areas of life.
PTSD Vs Complex PTSD
PTSD and cPTSD are not interchangeable terms, but do share some common characteristics.
According to the ICD-11 framework, complex PTSD (C-PTSD) comprises the core symptoms of PTSD and other issues with emotional regulation, self-concept and relationships.
There are also variations among different diagnostic systems in the terminology used. C-PTSD is listed as a diagnosis in the ICD-11, but not in the DSM-5.
Treatment: PTSD Is Treatable
There is effective treatment available and many people will recover greatly. There are mainly two choices:
Cognitive processing therapy (CPT) and prolonged exposure (PE), and EMDR have all been shown to have strong research support when used for trauma focused psychotherapy.
Antidepressants:
The U.S. FDA has approved two antidepressants: Sertraline and Paroxetine. Your doctor might recommend other doctors if you need them.
Support and self-care:
Using peer groups, regular sleep, exercise and restricting alcohol can help in addition to professional support.
It’s up to you which one is best, consult a qualified provider to make the right choice.
When to Seek Help
If you have any concerns or questions, contact the professional:
- Symptoms last more than a month
- You’re unable to go to work, school, or hold relationships.
- You use alcohol and/or drugs to deal with stress
- Says things like, “I can’t do this anymore” or “I don’t want to live like this. Expresses feelings of hopelessness or thoughts of hurting oneself.
If you are in an emergency or are considering suicide, dial your local emergency telephone number immediately. The Suicide & Crisis Lifeline is available in the U.S. via phone and text message to the number 988.
Conclusion
Identifying the signs of PTSD can be a critical first step in understanding changes in thoughts, emotions, behaviors and physical reactions to trauma.
While people still frequently look up the list of 17 symptoms of PTSD, the official list of the Department of Health and Human Services (HHS) has 20 symptoms, organized into four symptom clusters. Just because someone experiences a number of symptoms does NOT mean they have PTSD. All of these have an impact: duration, symptom pattern, severity, functional impact and clinical assessment.
If you see yourself or someone you know exhibiting some of these symptoms, professional support can help to clarify and determine if there is a need for treatment or resources.
Frequently Asked Questions
How many symptoms of PTSD are there?
There are 17 symptoms of PTSD that are included in the older DSM-IV. Many sources continue to list the 17 symptoms of PTSD. However, DSM-5-TR has its 20 symptoms, divided into four clusters.
What are the signs of PTSD?
Commonly reported are flashbacks, nightmares, avoidance of reminders, hypervigilance, irritability, and sleep problems.
Can anxiety be synonymous with PTSD?
No. There are some similarities, but PTSD is related to a particular traumatic incident and involves symptoms such as flashbacks, avoidance of the trauma. Anxiety disorders do not relate to an event in this fashion. They may be simultaneous also.
What is CPTD?
CPTSD (Complex PTSD) is known under the umbrella of ICD-11, the World Health Organizations’ classification system. It may be chronic or repetitive, like an extended period of abuse, and causes problems with emotional control, body image and relationships. It is not included in the list of separate diagnoses in DSM-5-TR.
Does PTSD go away?
Treatment is effective for many who recover, or experience significant improvement. Some may have symptoms that wax and wane. The sooner the support is provided, the better the results.
