Post-traumatic stress disorder (PTSD) may affect each person differently. However, there are some common symptoms many people experience, such as intrusive thoughts, nightmares, memory loss, and more.
PTSD is a mental health condition that occurs in some people following a traumatic event, series of events, or the witnessing of an event. PTSD may affect a person in various ways, including their mental, physical, social, and spiritual well-being.
PTSD symptoms typically begin within
Treatment of PTSD generally involves psychotherapy, such as cognitive behavioral therapy (CBT) and exposure therapy. Medications, such as antidepressants, may also help people manage some symptoms of PTSD.
This article explains 17 symptoms of PTSD that people may experience.
Intrusive thoughts are part of the reexperiencing category of PTSD symptoms. They are unwanted and, sometimes, unexpected thoughts a person may experience about the traumatic event.
The Anxiety and Depression Association of America (ADAA) explains that intrusive thoughts are “stuck” thoughts that can cause distress. The ADAA also states that these thoughts do not necessarily reflect a person’s desires. Most people do not act on their intrusive thoughts.
These recurrent and intrusive memories of an event are a
For many people, nightmares are a hallmark symptom of PTSD. According to a 2018 review, around
According to the U.S. Department of Veterans Affairs (VA), people with PTSD who experience nightmares have a higher risk of suicidal thoughts or attempts. The VA also states that this is one of the main reasons research is being done to find an effective treatment for nightmares associated with PTSD.
Prolonged and intense sensations of anxiety and fear may occur when waking from these nightmares. This can lead to difficulty in returning to sleep.
Nightmares can also lead to avoidance behavior before bedtime, including staying up late or leaving the lights on. This can cause insomnia and daytime dysfunction.
While there is not yet a specific treatment to manage PTSD nightmares, there are ways that may help a person sleep better. These include:
- keeping an evening routine
- exercising regularly
- avoiding heavy amounts of caffeine and alcohol
- avoiding smoking
- trying progressive muscle relaxation techniques
- talking about the nightmares or keeping a journal
Avoidance is one of the main categories of symptoms of PTSD. Many people with PTSD may avoid certain factors they believe may trigger their symptoms. This may include:
They may also avoid thinking about or remembering the event. Many people may resist talking about it or how they feel as well.
One way some people with PTSD attempt to push out thoughts and memories from their minds is by distracting themselves with hobbies or work.
Memory loss is common among people with PTSD. It often relates to details of the traumatic event.
Research suggests that people with PTSD show more episodic memory deficits than those in control groups. Episodic memory is a person’s ability to recall specific episodes from one’s past.
Some evidence shows that memory loss from PTSD may be related to a smaller hippocampus. The hippocampus is the part of the brain responsible for emotions and memory.
People with PTSD appear to have a smaller size area than those without the condition. This may have an association with anxiety, fear, and flashbacks, as well as memory loss.
A person with PTSD may find they have more negative thoughts about themselves and others than before the traumatic event.
While these thoughts are common among people who have experienced trauma, they can also worsen or trigger other symptoms. According to a
Negative thoughts may include feeling guilt or shame over the event or believing the world is dangerous and people cannot be trusted.
Social isolation is another possible symptom of PTSD. Avoiding possible triggers and thoughts, and avoiding talking about the traumatic event, can cause a person with PTSD to distance themselves from others.
They may also feel as though they are detached or estranged from other people due to the trauma.
The heightened level of arousal associated with PTSD can also lead to feelings of anger or irritability. This may include angry outbursts.
The study also notes that people with PTSD had a higher frequency of hostile or irritable feelings than those without the condition. People with PTSD may also be more likely to have feelings of irritation at any given time than those without the condition.
People with PTSD may find they lose interest in activities they once found pleasure in. They may have little or no desire to take part in these activities.
People with PTSD may feel distant from others. This can lead to a loss of interest in sexual activities as well. PTSD can have lasting effects on relationships.
Sharing feelings openly and honestly with a partner can help maintain a healthy relationship.
People with PTSD may feel on edge, anxious, and find it difficult to relax. This is known as hyperarousal or hypervigilance.
A person experiencing hyperarousal may feel:
- as though they are always alert
- as if they have to be on the lookout for danger
Some behaviors associated with hyperarousal include:
- over-awareness of what people think
- lack of objectivity
- frequently scanning surroundings for potential threats
- reluctance to try new things or meet new people
- inability to hold conversations due to being distracted and unable to focus
- overanalyzing situations
Other symptoms of PTSD, such as hyperarousal and sleep issues, can also lead to difficulty concentrating. A person with PTSD may have issues paying attention during conversations, activities, or at work.
Difficulties in concentrating are one of the changes in arousal and reactivity criteria for the diagnosis of PTSD.
According to the VA, 90–100% of people with PTSD experience sleep disturbances, such as insomnia. Insomnia is when a person has difficulty falling asleep or staying asleep at least three times a week.
There are various ways PTSD can disrupt sleep. These include:
- avoiding sleep
- losing sleep time
- increasing arm and leg movements
- talking during sleep
- feeling on alert or on edge
- being unable to relax
- having difficulty with silence
Reexperiencing is a
Flashbacks are when a person relives the traumatic event. This can include physical symptoms, such as sweating and an increased heart rate. Flashbacks can be vivid enough the person feels they are seeing the event before their eyes.
Factors that cause flashbacks can differ from person to person. Common triggers include:
People with PTSD may experience difficult beliefs or feelings. These may include:
- feeling unable to trust others
- feeling as though nowhere is safe
- blaming themselves for the event
- feeling as though no one understands
- having persistent and overwhelming feelings of anger, shame, or guilt
PTSD may cause people to cast blame on themselves or others for the event and the consequences that follow it. This blame may often be both persistent and distorted.
Unjustly blaming oneself or others for a traumatic event falls into the PTSD symptom category of alterations to mood and cognition.
A person with PTSD may find it difficult to experience positive emotions. This is also known as having a void of happiness or satisfaction.
As part of their avoidance, some people with PTSD may also experience emotion numbing. This is when a person attempts to cope with their feelings by not feeling anything at all. This can lead to social withdrawal and isolation.
Since people with PTSD often feel on edge and experience hyperarousal, they may also be easily startled or have an exaggerated response to being startled.
This may be partly due to the body’s inability to relax and the person’s need to be constantly aware of their surroundings.
Hyperarousal, sleep issues, and avoidance can lead a person with PTSD to engage in behaviors that may be harmful or self-destructive.
These behaviors may include:
- drug or alcohol misuse
- driving recklessly
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.
People may experience the symptoms of PTSD in various ways. Common symptoms include sleep issues, hyperarousal, and avoidance.
For some people, PTSD symptoms may resolve within a few months of the traumatic event. However, for others, symptoms can last for a year or more.
Treatment for PTSD is available. Options typically include psychotherapy, such as CBT, and medications to address anxiety, sleep issues, and other symptoms.
If a person is experiencing symptoms of PTSD, they can speak with a healthcare or mental health professional for support and next steps.