In most cases, the symptoms develop during the first month after a traumatic event. However, in a minority of cases, there may be a delay of months or even years before symptoms start to appear.
Some people with PTSD experience long periods when their symptoms are less noticeable, followed by periods where they get worse. Other people have constant, severe symptoms.
The specific symptoms of PTSD can vary widely between individuals, but generally fall into the categories described below.
Re-experiencing is the most typical symptom of PTSD. This is when a person involuntarily and vividly re-lives the traumatic event in the form of:
repetitive and distressing images or sensations
physical sensations – such as pain, sweating, nausea or trembling
Some people have constant negative thoughts about their experience, repeatedly asking themselves questions that prevent them from coming to terms with the event.
For example, they may wonder why the event happened to them and if they could have done anything to stop it, which can lead to feelings of guilt or shame.
Avoidance and emotional numbing
Trying to avoid being reminded of the traumatic event is another key symptom of PTSD. This usually means avoiding certain people or places that remind you of the trauma, or avoiding talking to anyone about your experience.
Many people with PTSD try to push memories of the event out of their mind, often distracting themselves with work or hobbies.
Some people attempt to deal with their feelings by trying not to feel anything at all. This is known as emotional numbing. This can lead to the person becoming isolated and withdrawn, and they may also give up pursuing activities they used to enjoy.
Hyperarousal (feeling ‘on edge’)
Someone with PTSD may be very anxious and find it difficult to relax. They may be constantly aware of threats and easily startled. This state of mind is known as hyperarousal.
Hyperarousal often leads to:
sleeping problems (insomnia)
Many people with PTSD also have a number of other problems, including:
other mental health problems – such as depression, anxiety or phobias
self-harming or destructive behaviour – such as drug misuse or alcohol misuse
other physical symptoms – such as headaches, dizziness, chest pains and stomach aches.
PTSD sometimes leads to work-related problems and the breakdown of relationships.
Psychological treatment for PTSD includes Trauma Focused CBT and Eye Movement Desensitisation and Reprocessing (EMDR).