At any given time, approximately 5% of adults in the United States show symptoms of post-traumatic stress disorder (PTSD), a mental health condition that appears in response to traumatic events. PTSD is more than a bad memory; it is a complex collection of potentially debilitating symptoms that can disrupt someone’s life. 

In this article, Ability Central addresses the symptoms and early signs of PTSD, as well as PTSD’s distinct types. We answer questions like:

• What are the symptoms of PTSD?
• What is an intrusive memory in PTSD? 
• What is avoidance in PTSD? 
• What cognitive or mood changes come with PTSD?
• What behavioral changes come with PTSD? 
• Are there different types of PTSD?
• What is the difference between normal stress response, acute stress response, and PTSD?
• What other conditions often co-exist with PTSD?
• How do I seek a diagnosis for PTSD?
• How can I find a PTSD therapist near me? 

What are the symptoms of PTSD?

People with PTSD often experience alarming and distressing symptoms like involuntary memories, nightmares, paranoia, and mood swings. These symptoms stem from a traumatic event, usually something that threatened the person’s life or physical and spiritual wellbeing. 

In some cases, people can develop PTSD if they witness or hear about traumatic events that happen to a stranger or a loved one. Whatever the underlying trauma may be, PTSD symptoms can be disruptive and debilitating, interfering heavily with someone’s relationships, career, education, and day-to-day life. 

PTSD symptoms generally fall into four categories: intrusive, avoidance, cognitive/mood changes, or behavioral changes (also known as “arousal and reactivity” symptoms).

What are the intrusive symptoms of PTSD? 

Intrusive symptoms of PTSD, most often thought of as PTSD intrusive memories or PTSD involuntary memories, are one of the most familiar aspects of post-traumatic stress disorder. Intrusive PTSD symptoms cause someone to re-live or re-experience the source of their trauma.

The most invasive of these intrusive PTSD memories is called a flashback, a dissociative reaction to a trigger that causes someone with PTSD to lose their sense of reality and “re-live” the exact events of their trauma. A PTSD flashback may “take over” someone’s sense of self or reality, making it truly feel like history is repeating itself. 

Other intrusive PTSD symptoms include: 

• Involuntary, unwanted memories.
• Physiological reactions to triggers, like increased heart rate, blood pressure, and breathing.
• “Flight, fight, or freeze” instincts.
• Nightmares.

What are PTSD avoidance symptoms? 

PTSD avoidance symptoms make someone “avoid” or refuse to interact with things, people, or places that remind them of their trauma. 

Avoidance symptoms of PTSD include:

• Refusing to think or talk about traumatic events.
• Avoiding or “cutting off” people associated with trauma.
• Avoiding sensitive locations, such as extending one’s commute to avoid the scene of a car accident.

Avoidance in PTSD can wreak havoc on relationships, particularly if what someone with PTSD avoids is something central to communication. For example, someone with PTSD from domestic violence or abuse may fear and avoid conflict, allowing small issues to snowball until they become large, potentially relationship-ending confrontations. 

To learn more about how PTSD affects communication, see Post-Traumatic Stress Disorder: What Should I Do if I’m Diagnosed with PTSD? and Navigating the Long-term Challenges of Post-Traumatic Stress Disorder (PTSD): Finances and Support Options.

What cognitive or mood changes come with PTSD?

Depression and anxiety are the most common cognitive or mood symptoms of PTSD. Someone with PTSD may experience changes to the way they think, make decisions, or communicate. They may face volatile, uncontrollable emotions or feelings of social and physical disconnect from the world around them.

Cognitive and mood changes associated with PTSD include:

• Negative, long-lasting emotions like fear, anger, shame, guilt, or horror. 
• Memory problems, particularly the inability to remember certain aspects of the original trauma.
• Distorted thoughts about the trauma, like incorrectly blaming themselves or others for what occurred.
• Emotional detachment, or an inability to make and maintain connections with other people. 
• Numbness or lack of emotion, such as no longer enjoying activities or feeling unable to experience happiness or other positive emotions. 
• Negative, distorted feelings about self-worth, decision-making, or other people’s actions and emotions.  

What behavioral changes come with PTSD? 

Many people diagnosed with PTSD experience drastic changes in their personality, routine, or mental well-being. This disruption expresses itself through behavioral changes and conflict in relationships.

Behavioral symptoms of PTSD include:

• Mood swings. 
• Sudden, uncontrollable bursts of anger or crying. 
• Self-destructive or reckless behavior, like substance abuse or dangerous driving. 
• Hypervigilance, or being hyper-aware and overly watchful of one’s surroundings. 
• Being easily startled.
• Problems with concentration.
• Fatigue and/or insomnia.
• Eating and sleeping too much or too little. 

These behavioral changes can lead to problems at school, at work, and in relationships, especially if someone has not yet been diagnosed with PTSD or doesn’t understand where these symptoms are coming from.

Are there different types of PTSD?

Doctors diagnose different types of PTSD based on someone’s symptoms, their triggers, and how long they’ve been experiencing this trauma response.

• Normal stress response, or the immediate reaction to a single traumatic event, involves PTSD symptoms that last for less than a month. If untreated, normal stress response can turn into PTSD.
• Acute stress disorder involves PTSD symptoms that start a few days or weeks after the initial trauma. Like normal stress response, acute stress disorder can resolve on its own or with treatment, and risks worsening to PTSD if left untreated.
• Dissociative PTSD, seen most often in people with childhood trauma, causes emotional detachment, a loss of reality, and “out of body” experiences. Someone with dissociative PTSD may experience amnesia or memory issues related to their trauma. In addition to other PTSD symptoms, someone with dissociative PTSD may feel they no longer belong in places that used to give them comfort, like their workplace, hometown, or friend circle.
• Uncomplicated PTSD is linked to one traumatic event rather than multiple. Typically, uncomplicated PTSD responds well to therapy and other treatments and resolves within a few months or years. 
• Complex PTSD (or CPTSD) is caused by multiple or prolonged exposures to trauma, like living through a war, child abuse, or domestic abuse. 
• Comorbid PTSD, also called co-morbid PTSD or co-existing PTSD, appears alongside other mental health conditions like substance use disorder, panic disorder, or bipolar disorder. 

What is the difference between normal stress response, acute stress response, and PTSD?

Normal stress response and acute stress response are sometimes considered early “stages” of PTSD. If left untreated, both disorders can lead to PTSD. The main difference between normal stress response, acute stress response, and PTSD is time: 

• Normal stress response symptoms appear immediately after trauma.
• Acute stress response symptoms appear days or weeks after trauma.
• PTSD symptoms can appear anytime after trauma, including years later, and last for at least a month. 

Treatment for each stress disorder depends on the specifics of someone’s trauma, as well as the severity and frequency of their symptoms. 

What other conditions often co-exist with PTSD?

When PTSD appears alongside another mental health condition, it is called comorbid or co-existing PTSD. About 78.5% of people with PTSD also experience a comorbid condition. 

The most common conditions that affect people with PTSD include:

• Addiction
• Anxiety
• Chronic pain
• Depression
• Disruptive behavior disorders (like oppositional defiant disorder and conduct disorder)
• Eating disorders
• Obsessive-compulsive disorder (OCD)
• Panic disorders
• Phobias
• Physical and communication disabilities
• Social anxiety
• Speech disorders, like muteness, stuttering, or echolalia
• Substance abuse

How do I seek a diagnosis for PTSD?

There is no one test to diagnose PTSD. Instead, a doctor diagnoses PTSD based on someone’s:

• Exposure to trauma
• Symptoms 
• Medical history
• Mental health history

To be diagnosed with PTSD, someone must experience at least:

• One intrusion symptom
• One avoidance symptom
• Two cognitive or mood symptoms
• Two behavioral symptoms

These symptoms must last for at least one month to qualify for a PTSD diagnosis, after which a doctor may recommend therapy, medication, or other treatments. 

To learn more about PTSD treatment, see Post-Traumatic Stress Disorder: What Should I Do if I’m Diagnosed with PTSD? 

How can I find a PTSD therapist near me? 

If you believe you or a loved one may have PTSD, Ability Central’s service locator tool can connect you with a nonprofit that specializes in helping people find the help they need both for diagnosis and support.

For more information about PTSD, see:

• Post-Traumatic Stress Disorder (PTSD): Causes, Types, and Communication Impacts
• Post-Traumatic Stress Disorder: What Should I Do if I’m Diagnosed with PTSD?
• Navigating the Long-term Challenges of Post-Traumatic Stress Disorder (PTSD): Finances and Support Options