Post-traumatic stress disorder
Also known as PTSD, post-traumatic stress disorder, Posttraumatic stress disorder
A mental disorder where a past trauma keeps being relived, avoided and guarded against.
At a glance
In plain words
Reliving, Avoiding, On guard …
See all 4What each symptom cluster looks like
Intrusion: memories that come back, Intrusion: triggers, Avoidance of places and activities …
See all 8Where it comes from
Old names, Vietnam and DSM-III
See all 2What the research says
Therapy first, Medication helps less, Prevention …
See all 4Connections
Psychological trauma, Complex post-traumatic stress disorder and 15 others
See all 17
Also on this page: Key facts · Links · Sources · Related pages
- PTSD can develop after a traumatic event such as assault, abuse, war or disaster.
- Its core is reliving the event, avoiding reminders and staying on high alert.
- Symptoms must last more than a month.
- Most people who face trauma do not develop it.
- Trauma-focused psychotherapy is the first-line treatment, ahead of medication.
Why it matters
- It is the condition most trauma therapies, including EMDR, were built and tested for, so it anchors the whole trauma field.
Key facts
- In short
- A mental disorder that develops from experiencing a traumatic event1
- Core symptoms
- Re-experiencing (intrusive memories, nightmares, flashbacks), avoidance, and a sense of current threat2
- Duration
- Symptoms last more than a month after the event1
- How common
- About 3.5% of US adults in a given year and 9% over a lifetime; 0.5–1% a year in much of the world1
- Recognized
- 1980, in the American Psychiatric Association's DSM-III1
- Treatment
- Trauma-focused psychotherapy (prolonged exposure, cognitive processing therapy, EMDR); SSRIs or SNRIs as first-line medication1
In plain words
-
Reliving1
The event comes back through intrusive memories, flashbacks and nightmares.
-
Avoiding1
People steer clear of trauma-related thoughts, feelings, places and conversations.
-
On guard1
An increased fight-or-flight response: hypervigilance and a strong startle reaction.
-
Who is at most risk1
Interpersonal violence such as rape, assault and child abuse carries more risk than accidents or natural disasters.
What each symptom cluster looks like
-
Intrusion: memories that come back4
Memories can return at any time and feel very real and scary; nightmares are common. Some people feel they are going through the event again, which is called a flashback.
-
Intrusion: triggers4
Seeing, hearing or smelling something can bring the event back. News reports, seeing an accident or hearing fireworks are typical trauma reminders.
-
Avoidance of places and activities4
Someone may avoid crowds because they feel dangerous, stop driving after a car accident or a convoy bombing, or avoid earthquake films after an earthquake.
-
Avoidance of thoughts4
People may keep very busy, or avoid getting help, so they do not have to think or talk about the event.
-
Mood and thinking: beliefs4
A person may come to think "the world is completely dangerous, and no one can be trusted", or feel guilt and shame, wishing they had done more to stop it.
-
Mood and thinking: numbness4
Some feel numb, unable to have loving feelings toward others, lose interest in things they used to enjoy, or cannot remember parts of the event.
-
Arousal: on guard4
People may feel jittery and always on the lookout for danger, be startled by a loud noise, and find it hard to sleep or concentrate.
-
Arousal: anger and risk4
Some suddenly become angry or irritable, or act in unhealthy ways such as smoking, misusing drugs or alcohol, or driving aggressively.
Where it comes from
What the research says
-
Therapy first1
Trauma-focused psychotherapies have the most evidence and are first-line in almost all guidelines; many have high drop-out rates.
-
Medication helps less1
SSRIs or SNRIs are moderately helpful for about half of people; benzodiazepines may worsen outcomes.
-
Prevention1
Early help works for people with early symptoms, not when given to everyone exposed regardless of symptoms.
-
NICE on EMDR3
NICE says offer EMDR to adults with PTSD more than 3 months after non-combat trauma.
Connections
Related
- Psychological traumaTopicPTSD is one outcome of trauma
- Complex post-traumatic stress disorderTopicICD-11 pairs PTSD with complex PTSD
- EMDR (Eye movement desensitization and reprocessing)TopicA first-line treatment in most guidelines
- Cognitive behavioral therapyTopicProlonged exposure and cognitive processing therapy are CBT-based
- MindfulnessTopicMindfulness-based interventions can help with post-traumatic stress
- Arnoud ArntzPersonResearches imagery rescripting for PTSD
- Bessel van der KolkPersonServed on the DSM PTSD committee for the 1980 and 1994 editions
- Eye Movement Desensitization and Reprocessing (EMDR) Therapy: Basic Principles, Protocols, and ProceduresBookThe condition EMDR was first developed for
- EMDR: The Breakthrough Therapy for Overcoming Anxiety, Stress, and TraumaBookTrauma and PTSD are its first subject
- Francine ShapiroPersonDesigned EMDR to treat it
- Internal Family Systems Skills Training Manual: Trauma-Informed Treatment for Anxiety, Depression, PTSD & Substance AbuseBookOne of the conditions it addresses
- ShameTopicShame is increasingly recognised as a central process in PTSD
- The Body Keeps the Score: Brain, Mind, and Body in the Healing of TraumaBookDiscusses the effects and treatment of traumatic stress
- Trauma and Recovery: The Aftermath of Violence—From Domestic Abuse to Political TerrorBookExtends the diagnosis beyond combat veterans
- Trauma-Focused ACT: A Practitioner's Guide to Working with Mind, Body, and Emotion Using Acceptance and Commitment TherapyBookOne of the main conditions it treats
- Traumatic Stress: The Effects of Overwhelming Experience on Mind, Body, and SocietyBookA research summary of the disorder
- Window of toleranceTopicLinked to narrowed or unstable windows
Links
Sources
- Post-traumatic stress disorder (Wikipedia) (opens en.wikipedia.org)
- Complex post-traumatic stress disorder (Wikipedia) (opens en.wikipedia.org)
- Post-traumatic stress disorder, NICE guideline NG116 (2018): Recommendations (opens nice.org.uk)
- PTSD Basics (U.S. Department of Veterans Affairs, National Center for PTSD) (opens ptsd.va.gov)
Last checked against its sources today
Is something on this page wrong or out of date? Tell us
The line under a date fills as time passes: empty when new, then one equal share each for a day, a week, a month and a year. For episodes and other items it is full at 2 years; for "last checked", at a year. A striped line means the date is known only to the month or year.