The symptoms of post-traumatic stress disorder (PTSD) are very specifically defined and revolve around three main clusters of symptoms. Each of the clusters has a number of ways that it is expressed, and individuals may experience some or all of these indicators. A certain number of symptoms are required for a diagnosis of PTSD, but individuals may also experience distress from subclinical or subthreshold PTSD, which describes a situation that does not present all the symptoms required for a formal diagnosis, but provides enough symptoms to cause unease. The three clusters for PTSD symptoms are:
Reexperiencing describes feeling that the trauma is happening again. It may come through upsetting thoughts, memories, dreams, nightmares and night terrors that intrude on life without any triggers. Dreams and nightmares can make it difficult to get sufficient sleep, which in turn creates other problems. Nightmares may replay the trauma in its entirety or just elements of it.
Flashbacks fall into this category and describe a realistic situation that feels as if the trauma is replaying. Distress also occurs through a direct reminder of the trauma, such as through news reports, movies, or some other prompt. It’s important to note that the reliving these memories creates real, physical distress in the body that may resemble a panic attack. While the distress may start with memories, it may also begin with a physical sensation, such as tingling in a wound site. Anniversaries marking the trauma may also bring on reminders and reexperiencing symptoms.
Avoidance and Numbing
The second cluster of symptoms describes the avoidance of anything associated with the trauma and a general numbing out. Avoidance can be experienced in a number of ways, including a purposeful evading of anything associated with the trauma (such as talking about it), and a purposeful avoidance of anything that brings on memories of the trauma.
Numbing describes a distinctly reduced interest in activities that previously held interest. Sometimes numbing creates a situation where the individual simply cannot remember exactly what happened, even if it was an important detail. The following are descriptions of numbing behavior and feelings:
- While the individual may choose to self-isolate, they can also feel abandoned. The person may neglect him or herself, discontinuing exercise and a healthy diet.
- Individuals with PTSD report feeling detached, unconcerned, separated or estranged from others, even loved ones. This can significantly impair marital and romantic relationships.
- Emotions are deadened, and the individual may seem flat, unable to show a full range of feelings. The individual with PTSD may exhibit a drastic change in personality.
- Along with depression, there is often survivor guilt and an expectation of an early death. There may be a sense of hopelessness and despondency.
The third and final cluster is a high state of arousal and a sense of constantly being on guard. The person displays a high level of watchfulness, always on the alert for possible harm. Sleep is often disturbed and there is difficulty concentrating. It is very taxing to maintain this high state of hyper-vigilance, and the individual often displays anger, shouting and fighting. They are easily distraught. If they are caught off-guard, the sense of surprise and fear can be exaggerated.
In addition, an individual may display self-destructive and impulsive behavior, while feeling physical distress and feelings of guilt and shame.
PTSD symptoms can show up immediately after the trauma or many years after the actual event. Many individuals experience some symptoms immediately afterw, but over a few weeks the symptoms decrease and eventually stop. While prompt treatment is important, start with a thorough evaluation from an experienced mental health professional to ensure your symptoms align with a diagnosis of PTSD. Therapy and prescription medicine might be recommended.