Post-traumatic stress disorder (PTSD) is a mental health problem you may develop after experiencing traumatic events. The condition was first recognised in war veterans. It has had different names in the past, such as ‘shell shock’, but it’s not only diagnosed in soldiers. A wide range of traumatic experiences can be causes of PTSD.
“When something traumatic happens in your life it rocks you to the core. The world is no longer a safe place. It becomes somewhere that bad things can and do happen.”
When is it diagnosed?
When you go through something you find traumatic it’s understandable to experience some symptoms of PTSD afterwards, such as feeling numb or having trouble sleeping. This is sometimes described as an ‘acute stress reaction’.
Many people find that these symptoms disappear within a few weeks, but if your symptoms last for longer than a month, you might be given a diagnosis of PTSD. Your GP might refer you to a specialist before this if your symptoms are particularly severe.
“I started experiencing symptoms of PTSD after my boyfriend died. I suffered extremely vivid flashbacks that could happen at any time, anywhere, and were deeply distressing… I threw myself into another relationship very quickly to try and avoid how I was feeling, but then also would not express much affection to my new partner.”
Are there different types of PTSD?
If you are given a diagnosis of PTSD, you might be told that you have mild, moderate or severe PTSD. This explains what sort of impact your symptoms are having on you currently – it’s not a description of how frightening or upsetting your experiences might have been.
PTSD may be described differently in some situations:
- Delayed-onset PTSD. If your symptoms emerge more than six months after experiencing trauma, this might be described as ‘delayed PTSD’ or ‘delayed-onset PTSD’.
- Complex PTSD. If you experienced trauma at an early age or it lasted for a long time, you might be given a diagnosis of ‘complex PTSD’. See our page on complex PTSD for more information.
- Birth trauma. PTSD that develops after a traumatic experience of childbirth is also known as ‘birth trauma’. See our page on PTSD and birth trauma for more information.
If you experience some PTSD symptoms while supporting someone close to you who’s experienced trauma, this is sometimes known as secondary trauma.
See our pages on trauma for more information on how traumatic experiences can affect your mental health.
“I couldn’t understand why I felt like my brain wasn’t functioning – I couldn’t remember things, I couldn’t process things. It was like my brain had just slowed down and ground to a halt.”
Experiences of facing stigma
There are lots of misconceptions about PTSD. For example, people may wrongly assume it means you are ‘dwelling’ on past events. They might even suggest that you should ‘get over it’ or ‘move on’. But having PTSD isn’t a choice or a sign of weakness, and it’s important to remember that you are not alone.
See our page on stigma and misconceptions for lots of ideas on how to deal with stigma.
What are the symptoms?
This page covers:
Each person’s experience of PTSD is unique to them. You might have experienced a similar type of trauma to someone else, yet be affected in different ways.
These are some common signs and symptoms that you might recognise. Everyone’s experience is different, so you may experience some, none or all of these things.
Reliving aspects of what happened
This can include:
- vivid flashbacks (feeling like the trauma is happening right now)
- intrusive thoughts or images
- intense distress at real or symbolic reminders of the trauma
- physical sensations such as pain, sweating, nausea or trembling.
Alertness or feeling on edge
This can include:
- panicking when reminded of the trauma
- being easily upset or angry
- extreme alertness, also sometimes called ‘hypervigilance’
- disturbed sleep or a lack of sleep
- irritability or aggressive behaviour
- finding it hard to concentrate – including on simple or everyday tasks
- being jumpy or easily startled
- other symptoms of anxiety.
“My heart was constantly racing and I felt permanently dizzy. I couldn’t leave the house and became afraid of going to sleep as I was convinced I was going to die.”
Avoiding feelings or memories
This can include:
- feeling like you have to keep busy
- avoiding anything that reminds you of the trauma
- being unable to remember details of what happened
- feeling emotionally numb or cut off from your feelings
- feeling physically numb or detached from your body
- being unable to express affection
- doing things that could be self-destructive or reckless
- using alcohol or drugs to avoid memories.
Difficult beliefs or feelings
This can include:
- feeling like you can’t trust anyone
- feeling like nowhere is safe
- feeling like nobody understands
- blaming yourself for what happened
- overwhelming feelings of anger, sadness, guilt or shame.
“The lack of sleep and the sense of never being at peace are exhausting.”
This could be because when we feel stressed emotionally, our bodies release hormones called cortisol and adrenaline. This is the body’s automatic way of preparing to respond to a threat, sometimes called the ‘fight, flight or freeze’ response.
Studies have shown that someone with PTSD will continue producing these hormones when they’re no longer in danger, which is thought to explain some symptoms such as extreme alertness and being easily startled.
Some people also experience physical symptoms similar to symptoms of anxiety, such as headaches, dizziness, chest pains and stomach aches.
“I thought I was coping quite well to start with. Then a few weeks after the event, I began experiencing unpleasant physical symptoms, similar to those of a heart attack: chest pain, tightness and dizzy spells so severe that I thought I would pass out.”
A flashback is a vivid experience in which you relive some aspects of a traumatic event or feel as if it is happening right now. This can sometimes be like watching a video of what happened, but flashbacks do not necessarily involve seeing images, or reliving events from start to finish. You might experience any of the following:
- seeing full or partial images of what happened
- noticing sounds, smells or tastes connected to the trauma
- feeling physical sensations, such as pain or pressure
- experiencing emotions that you felt during the trauma.
You might notice that particular places, people or situations can trigger a flashback for you, which could be due to them reminding you of the trauma in some way. Or you might find that flashbacks seem to happen at random. Flashbacks can last for just a few seconds, or continue for several hours or even days.
“I feel like I’m straddling a timeline where the past is pulling me in one direction and the present another. I see flashes of images and noises burst through, fear comes out of nowhere. My heart races, my breathing is loud and I no longer know where I am.”
If you are experiencing symptoms of PTSD, you might also find that you have difficulty with some everyday aspects of your life, such as:
- looking after yourself
- holding down a job
- maintaining friendships or relationships
- remembering things and making decisions
- your sex drive
- coping with change
- simply enjoying your leisure time.
If you drive you may have to tell the DVLA that you have PTSD. For more information on your right to drive, including when and how to contact the DVLA, see our legal pages on fitness to drive.
“My behaviour changed and became erratic. I would alternate from wanting to shut myself away and not see or talk to anyone to going out to parties in the middle of the week and staying out late.”
It’s common to experience other mental health problems alongside PTSD, which could include:
“I was also deeply depressed and experiencing huge amounts of anxiety, refusing to go anywhere alone or go near any men that I didn’t know… I would lock my bedroom windows and barricade my bedroom door at night.”