Signs & Symptoms of PTSD

What Is Post-Traumatic Stress Disorder?

A trauma is a shocking, dangerous, or life-threatening situation experienced firsthand or indirectly. Post-traumatic stress disorder (PTSD) is an impactful mental health condition created by a traumatic event.¹ This condition may start soon after the event and continue indefinitely.

Symptoms of PTSD

Compared to many other mental health disorders, particularly acute stress disorder, PTSD has a longer list of possible symptoms. Although not everyone will have every symptom, the condition can produce a variety of unwanted effects. The American Psychiatric Association (APA) recognizes four distinct symptom categories – intrusive, avoidance, thinking and mood, and arousal and reactivity – to help diagnose and track the disorder.

Here are the four categories of PTSD symptoms:²

1. Intrusive Symptoms

Intrusive symptoms emerge in the person’s thinking without warning. Intrusive outcomes are often uncomfortable and almost always related to trauma, but they could be connected to other stressful experiences or situations as well.

Intrusive symptoms of PTSD include:

• Distressing memories of the trauma are repetitive and intrusive, meaning they can come suddenly and without a trigger
• Recurrent nightmares and dreams related to the trauma, either by content or the feelings they produce, or PTSD night terrors where you wake up screaming
• Powerful reactions, such as PTSD flashbacks, where the person feels like the trauma is happening all over again
• Distress when presented with reminders of the trauma

In children with PTSD, intrusive symptoms may look different. Symptoms of intrusive memories in children dealing with trauma include playing in ways that display themes linked to the trauma itself, like car crashes or abuse. Children may also report scary dreams, but they might not remember the content upon waking.

2. Avoidance Symptoms

Avoidant behaviors and symptoms involve the person with PTSD going out of their way to limit their exposure to any trauma reminders. Even if the trauma triggers cannot be avoided fully, they will go to great lengths to minimize their exposure. The expectation is that by avoiding all triggers, they can avoid the impact of PTSD. Unfortunately, this plan does not work as intended.

Avoidance symptoms of PTSD are:

• Efforts to avoid thoughts, feelings, and memories about the trauma and anything related to the trauma
• Efforts to avoid any people, places, activities, conversations, items, and situations that remind the person of the trauma
• Ending relationships, hobbies, or a job to limit contact with a trigger

3. Thinking & Mood Symptoms

Thinking and mood symptoms are common following a traumatic experience. The person could note a significant rise in erratic and unpredictable mood changes or thinking patterns that begin to impact their life and relationships.

Thinking and mood symptoms of PTSD are:

• Memory problems, including the inability to remember certain parts or themes of the trauma
• Negative beliefs or expectations of self or the world; in other words, the person might feel like they are bad, broken, or useless, and the world is scary, dangerous, or full of sick people
• Blaming one’s self for the trauma by reworking or adjusting the cause and effect (e.g., they think the trauma occurred because they are a lazy, foolish, or gullible)
• Being in a negative emotional state with anger, guilt, shame, fear, or other undesirable emotions
• Showing less interest or participation in hobbies, activities, sports, or interests
• Feeling disconnected or detached from loved ones
• Struggling to feel wanted or positive emotions like happiness, joy, and love

A person could experience a chronically, consistent level of these symptoms, or they could report violent fluctuation in symptoms from day to day or even hour to hour. At their worst, the symptoms can result in suicidal thoughts or actions.

4. Arousal & Reactivity Symptoms

After a trauma, people are typically irritable and on guard as a way to protect themselves from pending threats and harm. Sadly, these responses tend to be overreactions that only make matters worse. Plus, being in this heightened state of alert is draining, leading to emotional exhaustion and mental fatigue.

Arousal and reactivity symptoms of PTSD are:

• Irritability, intense anger, or displays of verbal or physical aggression
• Reckless, impulsive, and dangerous behaviors
• Hypervigilance or a heightened state of alert
• Oversensitive startle response (e.g., being jumpy or on edge)
• Trouble falling asleep, staying asleep, or getting good rest
• Trouble paying attention at home, work, or school

Signs of PTSD

The signs of PTSD represent numerous changes to a person’s thinking, feeling, and behavioral patterns. Many of PTSD’s effects will be “invisible” and only experienced by the individual with the condition; others will be more obvious and visible to even the most casual observer.

Signs of PTSD are:^2,3,4

• Being easily distracted and inattentive during conversations;
• Forgetting things easily
• Drifting off like they are paying attention to something that is not present
• Avoiding certain people, places, or activities
• Exhibiting unsteady or unwanted emotional states
• No longer participating in activities they used to like
• Isolating and ignoring friends and loved ones
• Irritability and angry outbursts that seem unprovoked
• Being jumpy and reactive to loud noises or certain situations
• Constantly scanning the environment looking for danger
• Appearing tired or sleep deprived

Note that just because one person with PTSD displays a specific sign does not mean that another will show the same indicators. Some people could be sad, stay in their room all day, and hesitate to go anywhere. Others could be energetic, restless, and irritable as they scan their surroundings for any sense of danger, overreacting when faced with the smallest perceived threat.

Like with other mental health conditions, people with PTSD may note a fluctuation or evolution of symptoms over time. They may show signs of aggression and anger initially before shifting to a depressed and isolated presentation.

Signs of PTSD In Women

Women are between two and three times more likely than men to have PTSD. They are more likely to suffer intense traumas, like sexual abuse, and the trauma impacts their development and personality since incidents often occur when they are young.⁵

Common signs of PTSD in women are:⁵

• Increased defensiveness and sensitivity: a woman with PTSD may become defensive and hurt by others, even when those people intended to help
• Being more emotionally-focused: women may be more tearful, sad, and expressive
• More interest in social support: a woman with PTSD will be more likely to contact and confide in others for support and assistance

Signs of PTSD In Men

Men tend to be older when they experience trauma, which can result in different symptoms. Some gender differences can also exist in regard to irritability, alcohol use, and isolation. In the end, though, there is a limited distinction between men with PTSD and women with PTSD.⁵

Here are common signs of PTSD in men:⁶

• Increased irritability, anger, and aggression: men tend to channel their sadness and fear into anger and hostility
• Higher use of alcohol: rather than explore healthy coping skills, men with PTSD may pursue increased substance use as a way to self-medicate
• Isolation: men may feel compelled to conceal their symptoms by hiding from others

Signs of PTSD In Children

Depending on their age, children may not be comfortable or able to verbally express their unique experience with PTSD and trauma. That means concerned adults will have to pay extra attention to the signs of PTSD in children. Some may show mild differences in their routines, behaviors, and moods; others could begin to act like completely different people.

Some common signs of PTSD in children are:²

• Frightening and scary dreams with little awareness of the dreams’ content or meaning
• Repetitive play with themes and aspects of the trauma
• Reenactment of the traumatic event through play
• Decreasing school performance
• Poor compliance at home or in school with increased defiance and acting out
• Less interest in playing with friends or participating in activities
• Changing moods with irritability and sadness

When to Get Help For PTSD Symptoms

When it comes to PTSD, there is no such thing as getting help too early or too often. It may take weeks or months for symptoms to fully develop, but beginning treatment with a mental health professional can help manage symptoms before they escalate. Start your search for a therapist in an online therapist directory. 

A variety of professional treatment options have been proven effective for PTSD, including cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT). Before finding a therapist, consider different types of therapy.

Here are available styles of therapy used to treat PTSD:

• Eye movement desensitization and reprocessing (EMDR)
• Cognitive processing therapy (CPT)
• Trauma-informed care
• Alternative and complementary therapies like brainspotting and EFT tapping

Final Thoughts

PTSD symptoms present a great challenge to the individual and their loved ones, but progress is always possible. Knowing the signs and symptoms of PTSD can give someone the information they need to move forward and get the professional assistance they need.