Post-Traumatic Stress Disorder

Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after experiencing or witnessing a traumatic event, or after learning that such an event happened to someone close. Examples include serious accidents, violence, abuse, disaster, combat, and life-threatening illness.

Distress after trauma is common and, for many people, eases over the following weeks. Post-traumatic stress disorder is considered when difficulties persist beyond that period, or begin later, and continue to interfere with daily life. Not everyone who experiences trauma develops the condition.

It commonly involves unwanted memories of the event, avoidance of reminders, changes in mood and thinking, and a heightened sense of threat. Presentation varies considerably: some people describe vivid intrusive memories, others describe emotional numbness, irritability, or difficulty feeling safe.

Post-traumatic stress disorder is treatable, and psychological therapies developed specifically for trauma have good evidence. Appropriate care depends on the individual and is decided with a qualified health professional.

This page is educational and is not intended to diagnose a mental health condition or replace evaluation by a qualified health professional. If you are struggling with the effects of trauma, support is available.

Experiences associated with post-traumatic stress disorder are usually described in four broad groups. A person may recognise some more than others.

Unwanted re-experiencing of the event can include:

• intrusive memories that arrive unbidden;
• distressing dreams or nightmares;
• a sense of reliving the event, sometimes vividly; and
• strong physical reactions to reminders.

Avoidance can include staying away from places, people, conversations, or activities connected to the event, and trying not to think or talk about it.

Changes in thinking and mood can include persistent negative beliefs about oneself or others, ongoing fear, anger, guilt or shame, loss of interest, feeling detached from people, and difficulty experiencing positive emotions.

Changes in arousal and reactivity can include feeling constantly alert for danger, being easily startled, irritability or anger, difficulty concentrating, difficulty sleeping, and reckless behaviour.

These experiences vary in combination and intensity, and can change over time. They may also occur after other stressful experiences, in other mental health conditions, following head injury, or alongside substance use. This information should not be used as a checklist to diagnose post-traumatic stress disorder.

Some people also experience thoughts of self-harm or suicide. If that applies to you, please see our crisis resources page for how to find urgent support in your location.

Diagnosis requires an appropriate clinical assessment that considers the nature of the event, the pattern and duration of difficulties, their impact, and alternative explanations.

Post-traumatic stress disorder follows exposure to a traumatic event, but exposure alone does not determine who develops it. Most people exposed to trauma do not go on to develop the condition, and it is not a sign of weakness or of having responded incorrectly.

Factors discussed in the research and clinical literature include:

• the nature of the event, including its severity, duration, and how close the person was to it;
• repeated or prolonged exposure, including trauma occurring in childhood;
• experiences involving intentional harm by another person;
• injury sustained during the event, or fearing for one's life;
• limited support afterwards, or ongoing instability and stress;
• previous trauma or existing mental health conditions; and
• individual differences in how the body and brain respond to threat.

Factors associated with better outcomes include support from people around the person, being able to talk about the experience when ready, and access to appropriate help early.

Because head injury, physical illness, medication effects, and substance use can produce overlapping experiences, assessment usually considers general health alongside mental health.

Several conditions involve responses to stressful or traumatic experiences, and post-traumatic stress disorder often occurs alongside others. Distinguishing between them is part of assessment.

Immediately after a traumatic event, acute stress reactions are common and may resolve without becoming a longer-term condition. Adjustment reactions to difficult life changes are also distinguished from post-traumatic stress disorder. Where trauma has been prolonged or repeated, particularly in childhood, some classification systems recognise a more complex presentation.

Depressive conditions, anxiety conditions, dissociative experiences, and substance use frequently occur with post-traumatic stress disorder. The presence of one does not exclude another, and identifying what else is present can change what care is appropriate.

Physical factors can also resemble or complicate the picture, including head injury sustained during a traumatic event, chronic pain, and sleep disorders.

Because of this overlap, assessment considers the whole picture rather than any single experience: what happened, when difficulties began, how they have developed, medical history, and current medications and substances.

Post-traumatic stress disorder is treatable, and psychological therapies developed specifically for trauma have the strongest evidence. Which approach is appropriate depends on the individual, the nature of the trauma, other health conditions, personal preference, and what is available locally. These decisions are made with a qualified health professional.

Trauma-focused psychological therapy is the usual first consideration. Recognised approaches help a person process memories of the event and reduce avoidance, at a pace they can manage, with a practitioner trained in that method. Being able to feel reasonably safe and stable is generally addressed before or alongside work that focuses directly on the trauma.

Medication is also used, particularly certain antidepressants. Whether medication is appropriate, which type, and for how long are decisions for a prescribing clinician together with the person concerned, taking account of other conditions and other medicines.

Supportive measures are often discussed alongside treatment, including sleep, reducing alcohol and other substances, maintaining contact with trusted people, and practical help with circumstances that keep stress high. These are not substitutes for assessment or treatment.

Recovery is not always steady, and approaches may be adjusted over time. If difficulties are worsening, or distress feels unmanageable, contact a qualified health professional. If there is immediate risk of harm, see our crisis resources page for how to find urgent support.

MOMD does not provide individual treatment advice and does not recommend starting, stopping, or changing any medication.

System

Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR)

Classification

Posttraumatic Stress Disorder

Category

Trauma- and Stressor-Related Disorders

Source

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR)

System

International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM)

Classification

Post-traumatic stress disorder

Code

F43.1

Category

Mental, Behavioral and Neurodevelopmental disorders

Source

International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM)