For example, people may also be diagnosed with PTSD after being sexually assaulted or raped, experiencing a natural disaster, or being in a car accident. “It could impact anyone,” says Tara Emrani, PhD, a psychologist based in New York City. PTSD has a range of symptoms that vary in severity, especially depending on which event first triggered the PTSD, says Elspeth Ritchie, MD, the chair of psychiatry at MedStar Washington Hospital Center in Washington, D.C. Dr. Ritchie retired from the army in 2010 and has been working with veterans and members of the military for more than 30 years. About 6 out of every 10 men and 5 out of every 10 women in the United States will experience at least one trauma in their lives. Of course, not all trauma will lead to PTSD. But about 6 percent of the total population of the country will have PTSD at some point in their lives, and 12 million adults have PTSD in any given year, according to the National Center for PTSD. (1) While everyone can feel off after a distressing experience, Dr. Emrani says if your symptoms persist for three months or longer, you may have PTSD. “For your symptoms to be diagnosed as a disorder, they have to actually impact your daily life activities and your ability to function,” she says. Emrani further explains that symptoms can appear at varying times after the traumatic event, sometimes three or even six months afterward, and come and go based on triggering events. (2) The condition could turn chronic for some, while for others symptoms might dissipate after six months with treatment. (2) Here is an overview of the different symptoms of PTSD.

What Are the Main Symptoms of PTSD?

Reexperiencing Symptoms This could involve flashbacks or reliving the memory of the trauma repeatedly. If you have these symptoms, bad dreams or terrifying thoughts might pop into your head unexpectedly. (2)Avoidance Symptoms This involves trying at all costs to avoid any potential triggers (be it an event, a conversation, or a thought) that could remind you of your trauma. Often, this symptom causes individuals to become withdrawn. (3)Hyperarousal Symptoms If you have this symptom, you might always be on the alert and vigilant, looking for a potential danger around every corner. You could have difficulty with sleep, have a hard time concentrating, or be easily startled by a loud noise. (4)Cognition and Mood Symptoms You might have difficulty remembering key moments of what happened during your trauma; you could experience feelings of guilt or blame over what happened to you; or you might lose any sense of enjoyment in activities you normally love. You might feel alienated from those around you, like friends and loved ones. (2)

“I have experience working with veterans and members of the military who often report experiencing nightmares and flashbacks to past trauma,” she says. (4) Emrani explains that these symptoms can occur at any time because triggers are everywhere. You could be driving down a road of a past accident and flash back to that traumatic event. You might be watching a movie that depicts an abusive relationship that could force you to recall negative experiences that came from one you had. Simple words, physical markers, and even scents could all be triggers that cause you to think back to the trauma. (4)

What Are Examples of Avoidance Symptoms of PTSD?

Given what a charged, negative experience encountering these triggers can be for a person, Emrani adds that many people with PTSD will try to avoid these triggers as much as possible. Avoidance symptoms are self-explanatory — they involve the act of staying away from triggers that force you to remember a negative event or emotion that stems from the trauma. “Many people will try to avoid these triggers altogether,” Emrani says. “This is a big thing for people with PTSD — they might want to avoid talking about or thinking about the trauma from the past.” For example, if you have experienced a natural disaster, you may avoid the location where that disaster occurred; if you were in a car accident due to a fallen bridge, you may avoid bridges; if you are a military veteran with PTSD that stems from an experience at war, you may avoid crowded places reminiscent of war zones; and if you are a victim of sexual assault, you may avoid intimate relationships, she explains. Avoidance symptoms could be tied to events that happened decades or years ago. Ritchie says some veterans she has worked with might avoid the sound of helicopter propellers or plane engines because they might remind them of bad experiences in a combat zone. “These people will be jittery, will always be on alert, [and] looking for danger around every corner. Think of this as being hyperalert and looking out for danger,” she says. “These people will have trouble sleeping, will be worried. Their concentration might suffer. These people might get irritable or angry easily.” Hyperarousal symptoms could also be shown in people becoming highly aggressive and given to angry outbursts. (2)

What Are Some of the Cognition and Mood Symptoms That Stem From PTSD?

Cognition and mood symptoms might be less obvious to people who are just meeting someone with PTSD and might not know what trauma the person has been through. That’s because, instead of an outburst of anger, like throwing a piece of furniture across a room, these symptoms involve how a person feels internally. These symptoms might reveal themselves in the form of a person feeling alienated from their environment or moving away from friends or family members. (2) “People with these symptoms will show some negative beliefs and feelings about their life. They may experience a lack of joy or have negative thoughts about themselves and feel shame or guilt,” Emrani adds. “These people might have negative feelings about others or fear that other people are out to get them. They might think bad things will happen to them or the world.” (4) She warns that similar symptoms like these might sometimes show themselves in people after any traumatic experience and might not necessarily be PTSD. This could involve depression or other mood disorders, which commonly coexist with PTSD. (7) If you’ve experienced a traumatic event, it’s normal to withdraw out of fear or confusion over what happened. These symptoms will often subside. But if symptoms persist, you may need to be evaluated for PTSD.

How Do PTSD Symptoms Vary in Men and Women?

How does PTSD vary between the sexes? It’s a common question, but there isn’t much research out there that explores the possible differences, though one study on PTSD treatment differences in men and women found scant variations in their symptoms. The researchers found that both men and women showed signs of shame, but women tended to experience self-guilt more regularly than men. While both sexes were angry about their trauma, men tended to express their PTSD symptoms through anger and aggression more than women. (8) Women are also more likely to feel anxious and depressed than men, but both sexes could develop physical health problems. (9) “More women than men have PTSD symptoms that relate back to sexual assault, while many men have had experiences in combat situations, like veterans,” Ritchie adds. One study found that men were more likely than women to have irritability and resort to drug and alcohol use to respond to their trauma. (10) Ritchie says divorce rates are high among people with PTSD, and she says that the condition can make maintaining a healthy relationship very difficult. For a reference point, the National Center for PTSD reports that veterans with PTSD were found to be 2 times more likely than vets without the disorder to divorce. (11) That said, if you are struggling with mental distress after a trauma, consider talking to your doctor. You can get help to deal with the emotional effects of traumatic experiences, whether or not you’re ever diagnosed with PTSD. You may have PTSD if you experience all of these symptoms for at least one month: (2)

At least one reexperiencing symptomAt least three avoidance symptomsAt least two hyperarousal symptoms

Ritchie says PTSD is most often diagnosed by a mental health professional using a questionnaire. (12) Psychologists and psychiatrists want to evaluate just how persistent the symptoms are and how embedded they are in a person’s day-to-day life. A medical professional will ask you to describe your symptoms as part of a psychological examination.

Concerned You or a Loved One Has PTSD? When to See a Doctor

Emrani says that some people might show symptoms much longer than three to six months after going through trauma. She says that triggers could pop up at surprising moments. Someone who hasn’t been showing signs following the traumatic event could watch a movie that reminds them of their car accident and then be triggered. (2) “Sometimes, symptoms could disappear and appear again with no real warning. Basically, if this keeps persisting chronically, you need to seek medical attention and be evaluated,” she says. (2) Ritchie says many people feel comfortable bringing up concerns about possible symptoms with their primary care doctor, who will then refer them to a psychiatrist or psychologist to carry out the psychological testing. (2) The National Center for PTSD has a few other suggestions on how to help a loved one deal with PTSD symptoms: (13)

Plan activities. Make an effort to engage your loved one in fun activities that could distract from concerns over the trauma. For example, go on a picnic or a relaxing day trip together.Get up, out, and moving. The center recommends going for a bike ride or a hike.Build a support system. Ritchie says that often people with PTSD can feel isolated in their diagnosis. The National Center for PTSD recommends that people engage with their families and surround themselves with an encouraging support system to fend off this sense of isolation. (13)

Emrani stresses that if you are experiencing thoughts of suicide or severe depression, seek out medical attention. Given that many people with PTSD feel a sense of shame over their condition, she urges avoiding drawing inward and instead approaching your doctor or therapist if your symptoms keep persisting with or without treatment. If you have suicidal thoughts, contact the Suicide & Crisis Lifeline by texting or calling 988. Additional reporting contributed by Lynn Marks

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