Types of PTSD: Understanding the Different Diagnoses & Treatments

The 6 Types of PTSD

When it comes to post-traumatic stress disorder (PTSD), it’s important to recognize that it can manifest in different forms. Individuals can experience many different symptoms and triggers, which impact their ability to interact with the world in different ways.¹

By understanding these various types of PTSD, individuals can gain a deeper insight into the specific effects trauma can have on their mental health. From acute stress disorder (ASD) to complex PTSD (C-PTSD), identifying one’s type of PTSD can help them seek the appropriate treatment and support they need to heal and recover.

The six types of PTSD include:

1. Normal Stress Response

While PTSD symptoms can occur following traumatic events, not all individuals develop a disorder. Most individuals commonly experience a normal stress response to life stressors, such as illness, accidents, or surgeries. These symptoms generally subside without causing significant distress with coping skills and support.

Symptoms of a normal stress response include:

• Fearfulness
• Sadness
• Relief
• Anger
• Frequently thinking about the traumatic event
• Jumpiness or sweating
• Difficulty concentrating
• Falling out of a regular self-care routine
• Insomnia
• Feeling detached from others

2. Acute Stress Disorder

Acute stress disorder (ASD) is a type of PTSD that occurs immediately following a traumatic event and is characterized by specific symptoms. Individuals with ASD may experience heightened anxiety, persistent feelings of worry or fear, and intrusive thoughts related to the trauma. They may also exhibit an exaggerated startle response, constantly feeling on edge or easily startled by loud noises or sudden movements.

Symptoms of acute stress disorder may include:

• Heightened anxiety
• Exaggerated startle response
• Intrusive memories related to the traumatic event
• Persistent feelings of worry or fear
• Dissociative symptoms, such as feeling disconnected from reality or having an altered sense of time
• Avoidance behaviors, where individuals actively try to avoid anything that may remind them of the traumatic event

3. Uncomplicated PTSD

Uncomplicated PTSD typically develops from a single traumatic event, like PTSD after a car accident. People might experience intrusive thoughts, even when trying to avoid thinking about the event. They may exhibit increased irritability or anxiety in specific spaces that trigger trauma memories. Some may appear moody, which can strain relationships and impact the ability to navigate daily activities.

Symptoms of uncomplicated PTSD may include:

• Intrusive thoughts
• Avoidance behaviors
• Disruptive mood changes
• Changes in cognitive processing
• Slowed reaction time
• Lashing out at others when stressed

4. Dissociative PTSD

Dissociative-type PTSD is not a principal diagnosis but is still vital in considering treatment options. This type of PTSD includes typical symptoms alongside continuous or repeated PTSD-induced dissociative episodes.¹ These experiences occur outside the influence of substances or physical health issues.

Dissociative PTSD is common for those who have experienced significant abuse from family or childhood trauma. If untreated, dissociation can lead to a lifetime of lapses in attention and memory, potentially damaging overall success, relationships, and everyday functioning.

PTSD dissociation symptoms include:¹

• Depersonalization: Depersonalization refers to feeling detached from the body or mind.
• Derealization: To those experiencing derealization, the environment or world feels unreal, disconnected, or even dreamlike.

5. Complex PTSD

Complex PTSD (CPTSD) develops after multiple or repeated traumatic events.² Individuals may experience PTSD symptoms with more intensity and impairment, sometimes as anti-social and aggressive behavioral changes.

Sometimes, those who face abuse cannot remove themselves from the situation. The abuser may still reach out to them despite expressed wishes to cease contact. In turn, many struggle to process the impact of their traumas, leading to low self-esteem, impulsivity, and destructive thought processes.

Symptoms of complex PTSD may include:

• Difficulty regulating emotions, leading to intense mood swings
• Persistent feelings of shame, guilt, or self-blame
• Social isolation and withdrawal from others
• Difficulties in establishing and maintaining relationships
• Feelings of detachment or estrangement from oneself or others
• Cognitive difficulties, such as problems with concentration or memory
• Hypervigilance and an exaggerated startle response
• Chronic physical symptoms, such as headaches or stomachaches, without any identifiable medical cause
• Distorted self-perception, including a negative self-image or feelings of worthlessness
• PTSD flashbacks, intrusive memories, or night terrors related to the trauma
• Engaging in self-destructive behaviors, such as substance abuse or self-harm

6. Comorbid PTSD

Comorbid PTSD refers to the presence of PTSD alongside one or more other mental health conditions. It is common for individuals with PTSD to also experience other disorders, and this can further complicate their symptoms and treatment.

Common conditions that co-occur with PTSD include:

• Substance use disorder: Many individuals with PTSD struggle with addiction because they turn to drugs or alcohol as a way to cope with their symptoms, leading to the development of substance use disorders. This can create a vicious cycle where the substance use worsens the PTSD symptoms and vice versa.
• Depression: There is a strong association between PTSD and depression. Individuals with comorbid PTSD and depression often experience persistent feelings of sadness, hopelessness, and a loss of interest in activities they once enjoyed.
• Anxiety disorders: Conditions such as generalized anxiety disorder (GAD), panic disorder, and phobias commonly co-occur with PTSD. Additionally, individuals with PTSD may develop social anxiety. This can intensify feelings of worry, fear, and anxiety, making it more challenging to manage daily life.
• Dissociative disorders: Dissociative disorders, such as dissociative identity disorder (DID) or dissociative amnesia, may co-occur with PTSD. These disorders involve disruptions in memory, identity, perception, and consciousness.

How Are the Types of PTSD Diagnosed?

The diagnosis of different types of PTSD typically involves a comprehensive assessment conducted by mental health professionals. The evaluation may include a detailed discussion of the individual’s symptoms, experiences, and personal history, as well as diagnostic tests. The diagnostic process also involves ruling out other possible mental health conditions and considering the presence of comorbid disorders that may accompany PTSD.

Clinicians may use standardized diagnostic tools such as the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) to gather information. These assessment tools help in determining the specific type of PTSD and its severity, guiding the formulation of an appropriate treatment plan.

When to Seek Professional Help

If you are experiencing persistent and distressing symptoms such as flashbacks, nightmares, mood swings, avoidance behaviors, or difficulties with concentration and sleep, it may be time to consult a mental health professional. Additionally, if your symptoms interfere with your ability to work, maintain relationships, or engage in daily activities, finding a therapist or counselor can provide you with critical support.

An online therapist directory is a great way to find a therapist or counselor who provides trauma-informed care. You can filter for therapists in your area who take your insurance. If you prefer to see a therapist virtually, an online therapy service that takes insurance is a good alternative. Although finding support may seem overwhelming, professionals are ready to assist you in healing from trauma. Early intervention and professional assistance for your PTSD can help you to cope with your symptoms, process the trauma, and begin to move on.

Treatment for Different Types of PTSD

PTSD treatment typically involves a combination of therapy, medication, support groups, and education about PTSD and its effects. Because each of the different types of PTSD is unique, treatment is often tailored to the specific needs and preferences of each individual.

Therapy for trauma and PTSD is aimed at helping individuals process and manage trauma-related symptoms, address negative thought patterns, and develop coping strategies. Additionally, therapies may incorporate elements of mindfulness, stress management, and relaxation techniques to promote emotional regulation and resilience.

Therapy options for PTSD may include:

• Trauma-focused CBT (TF-CBT): TF-CBT is a structured therapy that combines cognitive and behavioral techniques to help individuals process traumatic experiences, challenge negative thoughts and beliefs, and develop coping skills to reduce symptoms of PTSD.
• Exposure therapy: Exposure therapy involves gradually and safely exposing individuals to situations, memories, or stimuli related to the traumatic event. The goal is to help them face and process their fears, decrease avoidance behaviors, and learn new ways to respond to triggers in a controlled and supportive environment.
• Cognitive processing therapy (CPT): CPT focuses on helping individuals identify and challenge negative or distorted thoughts related to their traumatic experiences. Through structured sessions, individuals learn to reframe and modify their thoughts in a more balanced and adaptive way, leading to a reduction in PTSD symptoms.
• Eye movement desensitization and reprocessing (EMDR): EMDR involves using bilateral stimulation, such as eye movements, to help individuals process traumatic memories and reduce the distress associated with them. This therapy aims to desensitize the individual to the traumatic material and aid in the integration of distressing memories.
• Hypnosis: Hypnosis for PTSD may be used as a tool to access and process traumatic memories, provide relaxation, and increase adaptive coping strategies. It is often used as an adjunctive therapy within a comprehensive treatment plan for PTSD.
• Mindfulness-based therapies: Mindfulness-based therapies, such as mindfulness-based stress reduction (MBSR) or mindfulness-based cognitive therapy (MBCT), involve training individuals to be present in the moment, observe their thoughts and feelings non-judgmentally, and develop skills to manage stress and regulate emotions. These therapies can be beneficial for reducing PTSD symptoms and improving overall well-being.

In addition to individual and group therapy, doctors may recommend various PTSD medications. Pharmaceutical options can help address PTSD and related symptoms, including depression or sleep issues. Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are some common prescriptions available for PTSD.³

Medications used in PTSD treatment may include:³

• Zoloft
• Paxil
• Prozac
• Amitriptyline
• Effexor
• Remeron (Mirtazapine)
• Serzone
• Tofranil
• Nardil

*These medications have a black box warning, the most severe warning from the FDA for the risk of suicidal thoughts and behaviors in certain people. You should talk with your doctor about these risks before starting this medication.

How to Cope With the Different Types of PTSD

Practicing self-compassion, engaging in relaxation techniques, establishing a daily routine, and seeking professional help are crucial steps in coping with the effects of all types of PTSD. It’s also important to focus on building a strong support system, whether through close friends, family, or support groups, to provide understanding and validation. Each person’s coping journey will be unique, so it’s essential to find a combination of strategies that best fit individual needs and preferences.

Here are healthy ways to cope with and overcome all types of PTSD:

• Build your support system: Seek support from trusted friends, family members, or support groups who can provide understanding, empathy, and validation.
• Practice self-compassion: Be kind and patient with yourself, recognizing that healing takes time. Engage in self-care activities that nurture your physical, emotional, and mental well-being.
• Engage in relaxation techniques: Practice deep breathing, progressive muscle relaxation, and meditation for PTSD to reduce stress and promote a sense of calm.
• Establish a routine: Establish a balanced daily routine to provide structure and stability, which can be grounding for individuals with PTSD.
• Utilize grounding techniques: Use grounding techniques for anxiety such as focusing on your senses or utilizing objects in your environment to bring your attention back to the present moment to reduce anxiety and dissociation.
• Educate yourself about PTSD: Learn about the symptoms, triggers, and coping strategies for PTSD, as this knowledge can empower you to better understand and manage your condition.
• Seek professional help: Work with a qualified mental health professional who specializes in trauma and PTSD. They can provide guidance, therapy, and tools tailored to your specific needs.
• Engage in physical activity: Regular exercise can help alleviate symptoms of PTSD by reducing stress, improving mood, and promoting better sleep.
• Practice stress management techniques: Incorporate stress management techniques such as journaling about the trauma, art therapy, or engaging in hobbies that provide a creative outlet and help process emotions.
• Avoid self-medication: Resist the urge to self-medicate as a way to numb or escape from PTSD symptoms. Instead, seek healthier alternatives and support. When you feel an urge rising, try to urge surf or check in with yourself with HALT.