PTSD Symptoms After a Traumatic Event
PTSD symptoms fall into four groups: re-experiencing the event, avoiding reminders, feeling on edge, and negative changes in thoughts and mood. They usually begin within three months of a traumatic event, though sometimes later. Most people start to feel better after a few weeks. Symptoms that last longer than a month and disrupt daily life can be signs of PTSD.
Key points
It is natural to feel afraid during and after a traumatic event, and most people recover with time.
PTSD symptoms come in four groups: re-experiencing, avoidance, arousal and reactivity, and cognition and mood.
Symptoms usually start within 3 months of the event but can appear later.
A diagnosis requires symptoms for at least 1 month that interfere with daily life, and only a mental health provider can make it.
Talk therapy, medication or both are the main treatments.
Is it normal to have symptoms after a traumatic event?
Yes. The National Institute of Mental Health (NIMH) says it is natural to feel afraid during and after a traumatic situation, and that most people recover from their initial symptoms over time.
Post-traumatic stress disorder (PTSD) is considered when symptoms continue and get in the way of daily life. The VA National Center for PTSD describes PTSD as a mental health problem that can develop after you go through or see a life-threatening event.
Having some of the reactions below soon after an event does not mean you have PTSD. It means your mind and body are responding to something serious.
What are the four types of PTSD symptoms?
NIMH groups the symptoms this way. The VA uses the same four groups with slightly different names.
Re-experiencing. Flashbacks, meaning reliving the event, sometimes with physical symptoms such as a racing heart or sweating. Recurring memories or dreams about the event, and distressing thoughts.
Avoidance. Staying away from places, events or objects that are reminders of the experience, and avoiding thoughts or feelings related to it.
Arousal and reactivity. Being easily startled, feeling tense or on guard, difficulty concentrating, trouble falling or staying asleep, irritability or angry outbursts, and risky or reckless behavior.
Cognition and mood. Trouble remembering key parts of the event, negative thoughts about yourself or the world, exaggerated blame of yourself or others, ongoing fear, anger, guilt or shame, loss of interest in activities, feeling isolated, and difficulty feeling positive emotions.
When do PTSD symptoms start, and how long do they last?
According to NIMH, symptoms usually begin within 3 months of the traumatic event, but they sometimes emerge later. The VA adds that symptoms may not appear until months or years afterward, and that they may come and go over many years.
Duration is part of what separates PTSD from an expected stress reaction. NIMH states that to be diagnosed with PTSD, an adult must have all of the following for at least 1 month:
At least one re-experiencing symptom
At least one avoidance symptom
At least two arousal and reactivity symptoms
At least two cognition and mood symptoms
What else has to be true for a PTSD diagnosis?
Counting symptoms is not enough. NIMH notes that the symptoms must be severe enough to interfere with parts of daily life, such as relationships or work, and must not be related to medication, substance use or another illness.
This is why a checklist cannot tell you whether you have PTSD. The VA is direct about it: only a mental health provider can diagnose PTSD. A list like this one is for recognizing patterns worth bringing to a professional.
Many of these symptoms are felt physically. We look at sleep, startle and stomach complaints in how trauma shows up in the body.
How do PTSD symptoms look in children and teens?
Children can react differently from adults. NIMH says that in children younger than 6, symptoms can include wetting the bed after having learned to use the toilet, forgetting how to talk or being unable to talk, acting out the scary event during play, and being unusually clingy with a parent or other adult.
Older children and teens usually show symptoms more like those seen in adults. NIMH notes they may also develop disruptive, disrespectful or destructive behavior, feel guilt over not preventing injury or death, or have thoughts of revenge.
If you are seeing changes like these in your child after a frightening event, child and pediatric counseling may be a helpful next step.
When should you seek help for PTSD symptoms?
The VA recommends talking to a doctor or mental health care provider if symptoms last longer than 4 weeks, cause you great distress, or interfere with your work or home life. Our list of signs you may benefit from trauma therapy covers the everyday signals people tend to miss.
You do not have to wait a month to ask for support. And if you or someone you know is struggling or having thoughts of suicide, call or text 988. In a life-threatening situation, call 911. Our office does not provide emergency services.
Treatment is available. NIMH lists the main treatments as psychotherapy, medications, or a combination of the two. Medication decisions belong with a prescriber. The VA names three trauma-focused talk therapies with the most research support: Cognitive Processing Therapy, Prolonged Exposure, and EMDR. You can read about one of them in what is EMDR therapy.
How Balanced Life can help
Balanced Life Counseling Services provides trauma therapy for children, teens and adults at our Salisbury and Bethesda offices and by telehealth. Some of our clinicians are trained or certified in EMDR, and several use cognitive behavioral therapy.
A first appointment is a conversation about what has been going on and what you would like to change. To schedule or ask a question, contact us.
Frequently asked questions
How long do symptoms have to last before it is considered PTSD?
NIMH states that an adult must have the required symptoms for at least 1 month to be diagnosed with PTSD, and the symptoms must be severe enough to interfere with daily life. The VA similarly suggests seeing a provider if symptoms last longer than 4 weeks. Only a mental health provider can make the diagnosis.
Can PTSD symptoms start years after the event?
They can. NIMH says symptoms usually begin within 3 months of the traumatic event but sometimes emerge later. The VA National Center for PTSD notes that symptoms may not appear until months or years later and may come and go over many years. A delayed start does not make the symptoms less real or less treatable.
Does everyone who goes through trauma develop PTSD?
No. NIMH says it is natural to feel afraid during and after a traumatic situation and that most people recover from initial symptoms over time. Certain factors can raise the risk, such as earlier traumatic experiences, particularly in childhood, and having little or no social support after the event.
Can PTSD be treated?
Yes. NIMH lists psychotherapy, medications, or a combination as the main treatments. The VA National Center for PTSD describes trauma-focused talk therapies as having the most research support. Treatment works differently for each person, and a mental health provider can help you choose an approach that fits your needs and preferences.
Sources
If you are in crisis or thinking about suicide, call or text 988 (Suicide and Crisis Lifeline). In an emergency, call 911.