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November 3, 2023

Is It PTSD?: A Symptom Guide

PTSD emerges in the aftermath of experiencing or witnessing a deeply distressing or traumatic event. But what exactly qualifies as a "trauma," and how does it manifest in terms of symptoms?

Sofia Noori, MD, MPH
Is It PTSD?: A Symptom Guide

Post-traumatic stress disorder (PTSD) emerges in the aftermath of experiencing or witnessing a deeply distressing or traumatic event. But what exactly qualifies as a "trauma," and how does it manifest in terms of symptoms?

Defining Trauma

At its core, trauma refers to the exposure to a life-threatening injury or event that overwhelms one’s ability to cope. Commonly experienced traumas include car accidents, mass shootings, physical or sexual assault, and intimate partner violence (IPV). 

However, the event doesn’t have to happen directly to you for it to be distressing — in fact, trauma reactions can also occur when a person witnesses or learns about a life-threatening event. Examples may include witnessing violence between parents or having a loved one suddenly pass away. In addition, you don’t need to experience physical harm to suffer a trauma. Verbal abuse, such as experiencing credible threats against one’s life, are included in trauma’s definition. Such events can inflict emotional scars and profoundly alter the way one perceives the world and themselves.

Symptoms of PTSD can be grouped into four primary categories:

1. Intrusive Thoughts & Flashbacks

One of the hallmarks of PTSD is the recurring, involuntary reliving of the traumatic event. This can manifest as:

  • Flashbacks: Vivid, almost out-of-body experiences that make the individual feel they're undergoing the trauma again
  • Nightmares: Disturbing dreams related to the incident
  • Intrusive Thoughts and Emotions: Unwanted trauma-related thoughts and emotions that pop into a survivor’s mind at any moment
  • Profound Distress to Triggers: Strong emotional or physical responses to reminders of the trauma

2. Avoidance & Emotional Nurturing

Individuals with PTSD might sidestep situations, places, or people reminiscent of the trauma. This includes:

  • Dodging certain places: Avoiding locations, things and activities that serve as reminders to the trauma
  • Evading conversations and thoughts: Skirting around discussions about the incident, and avoidance of  thinking about the trauma

3. Negative Alterations in Thoughts & Mood

A profound shift in thought patterns and mood is common among trauma survivors. Symptoms can involve:

  • Pervasive negativity: Feeling constantly angry, irritable, and disinterested in life, or an inability to experience positive emotions, such as happiness, hope, and creativity
  • Distorted beliefs: Persistent and exaggerated negative beliefs of oneself, others, or the world (e.g., “I am bad,” “The world is a dangerous place,” or “It’s my fault the trauma happened”) 
  • Emotional detachment: Feeling distant from loved ones and disconnected from oneself
  • Memory challenges: Difficulty recalling important aspects of the trauma

4. Hyperarousal & Persistent Alertness

Hyperarousal is an ever-present state of heightened alertness for someone with PTSD, because their fight-flight-freeze response is constantly activated. Symptoms include: 

  • Hypervigilance and increased startle response: A perpetual feeling of tension, being on edge, and worrying that anything can happen at a moment’s notice. 
  • Sleep disturbance: Challenges with falling or staying asleep are among the most common PTSD symptoms
  • Heightened behavioral reactions: Increased irritable or angry outbursts at others
  • Concentration issues: Difficulties concentrating and focusing on tasks
  • Reckless behavior: Engaging in risky or dangerous behaviors, such as driving too fast and substance use

Common Co-Occurring Issues

PTSD’s effects are felt both physically and emotionally. In an effort to numb and avoid the distressing consequences of trauma, survivors may also engage in a number of unhealthy behaviors. Common related issues include: 

  • Substance use: While survivors attempt to self-manage their distress, it can  unfortunately lead to more avoidance of the issue at the heart of PTSD. 
  • Suicidal thoughts: Many survivors develop suicidal and self-harm behaviors as a way to escape or numb their pain 
  • Somatic symptoms: Some survivors develop physical reminders of their psychological distress, such as worsening migraines, new pains, and heart palpitations 

Furthermore, PTSD often exacerbates existing physical conditions by magnifying their intensity and overall impact on one's  well-being. Studies have even shown a strong association between trauma and chronic pain, migraines, and GI issues such as irritable bowel syndrome (IBS). 

Getting Help for PTSD

The development of PTSD after a trauma can vary based on the nature of the traumatic event, individual personalities, and subsequent support (or lack thereof). It's also noteworthy that symptoms might surface long after the traumatic incident — sometimes remaining dormant for years before being activated by a specific event or memory.

If you or someone you know is showing signs of PTSD, seek professional help. Early intervention can decrease the severity of symptoms and hasten the journey to recovery. By raising awareness about PTSD's effects, we can empower survivors to rise above their trauma rather than being defined by it.

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