Make saving on Rx even easier

Get the Free SingleCare app

(23,450)
Open app
Close Menu
Hello
Explore

PTSD symptoms: What are the early signs of PTSD?

Medically reviewed by Anne Jacobson, MD, MPH
Board-Certified Family Physician
Updated Apr. 10, 2024  •  Published Oct. 19, 2023
Fact Checked
Woman talking to therapist: PTSD symptoms

Overview: What does PTSD feel like?

Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after someone experiences or witnesses a traumatic event that involves life-threatening physical harm. This may include events such as natural disasters, violence, sexual assault, severe illness, or car accidents. PTSD can also develop in people who are exposed to secondhand details of the event or know someone who has experienced trauma. PTSD has complex, distressing, and debilitating symptoms, including unwanted and intrusive re-experiencing of the event, behaviors to avoid thoughts or reminders of the event, negative emotions and thoughts, and hyperarousal symptoms such as irritability, aggression, or always being “on guard.”

Key takeaways:

  • PTSD is a common health condition that can affect anyone regardless of age, sex, race, or ethnicity. Find updated PTSD statistics here.

  • Signs of PTSD include intrusive symptoms (such as nightmares, unwanted thoughts, and flashbacks), negative changes in thinking or emotion (such as amnesia, guilt, shame, or fear), avoidance, and reactivity (such as irritability, aggression, and getting startled easily). 

  • Serious symptoms of PTSD that indicate a person may harm themselves or others require immediate medical attention.

  • PTSD is caused by an impairment in a person’s ability to process a traumatic event. You may be at greater risk for developing PTSD symptoms if you are a woman, have a personal or family history of mental health conditions, , experienced childhood adversity, or are repeatedly exposed to traumatic events (such as emergency medical personnel). .

  • PTSD requires a medical diagnosis.

  • PTSD generally requires treatment. PTSD symptoms usually improve or resolve with appropriate treatment.

  • Treatment of PTSD may include cognitive behavior therapy (CBT), talk therapy, and antidepressants. Read more about PTSD treatments here.

  • Untreated PTSD could result in complications like depression, anxiety, substance abuse, dementia, disability, suicidal thoughts, and suicide.

  • Use coupons for PTSD treatments like Prozac (fluoxetine), Paxil (paroxetine), and Effexor (venlafaxine) to save up to 80%.

What are the early signs of PTSD?

PTSD is not diagnosed until people have had symptoms of PTSD and problems functioning for at least one month. Some people with PTSD will first experience symptoms of acute stress disorder in the days following a traumatic event. Acute stress disorder is different from a typical stress reaction. Symptoms of an acute stress reaction include:

  • Intrusive thoughts and memories re-experiencing the traumatic event

  • An inability to feel happy or positive feelings

  • Dissociation: feeling separated from oneself or reality

  • Avoidance symptoms: making an effort to avoid memories, thoughts, feelings, or external reminders associated with the traumatic experience

  • Arousal symptoms such as irritability, angry outbursts, trouble sleeping, being “on guard,” inability to concentrate, or getting startled easily

Studies have shown that some people who experience traumatic events are more likely to develop PTSD later on. Symptoms that may increase the likelihood of PTSD after a traumatic experience include:

  • Having dissociative reactions to trauma

  • Feeling afraid for your life during the experience

  • Feeling mentally defeated (broken and helpless)

  • Thinking a lot about the experience

  • Lacking good support systems from friends and family

Other PTSD symptoms

PTSD involves a wide range of symptoms that fall into four categories: intrusion, avoidance, negative thoughts and mood, and arousal and reactivity. These symptoms must be related to a traumatic event, are experienced for at least a month, and significantly affect a person’s ability to function. 

Intrusion symptoms involve unwanted thoughts, memories, and images that replay the traumatic experience. They include:

  • Unwanted, repeated, and upsetting memories of traumatic events

  • Repeated nightmares that involve aspects of the traumatic events

  • Flashbacks—involuntarily re-experiencing or reliving an event while partly or entirely separated from current reality

  • Intense reactions to reminders of the experience

Avoidance symptoms mean that people with PTSD try to avoid anything that reminds them of traumatic events:

  • Avoiding memories or thoughts of the event

  • Avoiding people, objects, or places that are reminders of the event 

Negative thoughts and moods include:

  • Inability to remember some or all aspects of traumatic events

  • Chronic negative beliefs about oneself or others

  • Persistently blaming oneself or others

  • Persistent negative feelings like guilt, shame, fear, or anger

  • Feeling alienated from other people

  • Chronic inability to feel happy or positive

People with PTSD are often “on guard” and easily excited, which are called arousal symptoms:

  • Irritability, angry outbursts, and aggression (sometimes for no reason)

  • Reckless or self-destructive behaviors

  • Being constantly “on guard” (hypervigilance)

  • Getting startled easily or out of proportion to the situation

  • Difficulty concentrating

  • Sleep problems

These are the core symptoms of PTSD. However, people may have additional dissociative symptoms. Dissociation happens when people disconnect from themselves or reality. This can happen in one of two ways:

  • Depersonalization: a person disconnects from their identity, memories, and feelings as if they’re an outside observer looking at themselves

  • Derealization: a person looks at the real world as if it were not real, like a dream or hallucination 

PTSD vs. acute stress disorder symptoms

The symptoms of PTSD and acute stress disorder (ASD) are nearly identical. The same types of traumatic experiences bring them on. The only difference is the onset and duration of the symptoms. 

Acute stress disorder symptoms appear within three days to one month after the traumatic event. PTSD symptoms can appear months after a traumatic event. In acute stress disorder, symptoms are experienced for less than a month. Symptoms must persist for longer than a month to be considered PTSD. 

Acute stress disorder is not an early stage of PTSD. Only about 1% to 11% of people diagnosed with ASD develop PTSD. Additionally, over half of people diagnosed with PTSD did not experience acute stress disorder symptoms following a traumatic event.

When to see a doctor for PTSD symptoms

As with any mental health issue, get help if your thoughts, feelings, or behaviors significantly interfere with daily life, work, or relationships. Unfortunately, people with PTSD may avoid getting medical help until they have other mental health problems, such as depression, anxiety, substance use, or suicidal thoughts. 

Regardless of diagnosis, go to an emergency room if you or a loved one exhibits behaviors that threaten harm to themselves or others.

PTSD is diagnosed with a detailed history of the symptoms. Determining the traumatic event that precipitated the symptoms is part of making a diagnosis. But people with PTSD may not be ready to discuss it. For that reason, a diagnosis can be made based on symptoms, duration, and a person’s ability to function. 

To properly assess symptoms and functioning, a mental health professional will often perform a mental status examination, a psychological equivalent of a physical exam. The clinician may use a PTSD clinical assessment or scale to score symptoms and problems of PTSD. A physical exam and blood tests may also be necessary to rule out physical causes of the symptoms.

Complications of PTSD

Unresolved PTSD can result in a number of psychiatric and neurological complications, including:

  • Depression

  • Anxiety disorders

  • Panic disorder

  • Substance abuse disorder

  • Social withdrawal and isolation

  • Disability

  • Dementia

  • Suicide

How to treat PTSD symptoms

Based on the evidence, the most effective treatment for PTSD is cognitive behavior therapy (CBT). CBT is a short-term psychotherapy in which a therapist helps a person with PTSD change distorted thoughts and negative emotions and learn self-management skills that involve:

  • Exposure to details of the event or triggers to recondition negative responses and emotions

  • Processing and changing beliefs that cause emotional responses and reactions

  • Coping strategies and skills

  • Managing distress

  • Regulating emotional responses

  • Learning healthy emotional responses

The American Psychological Association recommends 4 types of therapy for PTSD, which include:

  • Cognitive behavioral therapy

  • Cognitive processing therapy

  • Prolonged exposure therapy

  • Cognitive therapy

Other forms of therapy that may be helpful for some people include:

  • Eye movement desensitization and reprocessing (EMDR)

  • Narrative exposure

  • Brief eclectic psychotherapy

  • Trauma-focused cognitive behavior therapy (for children, adolescents, and their family members)

A mental health professional may also prescribe medications to control symptoms. First-line medical treatments are SSRIs and SNRIs, commonly used as antidepressants or anxiety medications. 

Signs that PTSD is getting better

People do recover from traumatic and life-threatening experiences. People with PTSD can achieve remission and recovery. Signs that PTSD symptoms are improving include:

  • Improvement on a PTSD assessment

  • Physical symptoms such as blood pressure and heart rate returning to normal

  • Sleeping becomes easier

  • Memories or reminders of the event no longer trigger a significant response

  • Daily life and function return to normal

  • If there’s a flare-up, you know what to do to calm down and feel better

Most importantly, PTSD is treatable

Healthcare professionals are confident that PTSD is treatable. People can recover with therapy and sometimes medications. The therapy isn’t always easy, but it’s better than the alternative. If you’re struggling with symptoms of PTSD, see a licensed clinical psychologist, psychiatrist, or another mental health professional. Only an experienced clinician can untangle the complex of symptoms to determine the correct diagnosis and appropriate treatment. 

What’s next? Additional resources for people with PTSD symptoms

Test and diagnostics

Treatments

Scientific studies and clinical trials

Medically reviewed by Anne Jacobson, MD, MPH
Board-Certified Family Physician

Anne Jacobson, MD, MPH, is a board-certified family physician, writer, editor, teacher, and consultant. She is a graduate of University of Wisconsin School of Medicine and Public Health, and trained at West Suburban Family Medicine in Oak Park, Illinois. She later completed a fellowship in community medicine at PCC Community Wellness and a master's in Public Health at the University of Illinois-Chicago. She lives with her family near Chicago.

...