Post-Traumatic Stress Disorder (PTSD)

Post-traumatic stress disorder (PTSD) is a mental health condition that some individuals develop after exposure to a traumatic event.

It’s normal to experience intense fear, anxiety, and sadness during and after a traumatic experience. For some people, these feelings subside on their own over time. But for others, living through such experiences can lead to mental health problems that interfere with their day-to-day life. In these instances, they may be experiencing post-traumatic stress disorder (PTSD).

Any intensely distressing experience might qualify as traumatic, but common traumatic events range from upsetting events, like an accident or the unexpected death of a loved one, to more extreme events, such as sexual assault, intimate partner violence, war, or natural disaster. In some cases, PTSD can also be caused by hearing about a traumatic event that a loved one has undergone or traumatic memories, rather than experiencing such an event directly.

There are mental illnesses related to PTSD. Although the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) classifies PTSD and adjustment disorders as trauma and stress-related disorders, post-traumatic stress disorder should not be confused with adjustment disorder which is the unusually severe reaction to relatively normal circumstances and life stressors, not necessarily a life-threatening event.

Prevalence of PTSD

It is estimated that:

  • 12 million people in the US are living with PTSD
  • About 6% of the population will develop PTSD at some point in their lives [1]


  • 11-20% of returning war veterans report PTSD symptoms depending on their service era [2]

There may be gender differences in PTSD development as well; research shows that women are twice as likely as men to develop PTSD after a traumatic event happened, and often wait longer to seek PTSD treatment to manage their symptoms according to the American Psychological Association.

Anyone who has experienced a traumatic event may develop PTSD. Examples include – but are far from limited to:

  • First responders
  • Veterans
  • Individuals who have gone through physical or sexual assault or abuse
  • Women who have experienced a traumatic childbirth
  • Friends or family members of someone who has experienced extreme trauma

Causes of PTSD

Some people develop post-traumatic stress disorder after experiencing a very frightening event, from ongoing trauma, or after prolonged or repeated experiences of very severe stress. Some examples of the kind of traumatic experiences that can lead to PTSD include:

  • Car accidents
  • Natural disasters
  • Sexual or physical assault
  • Sexual abuse, neglect, or other mistreatment in childhood
  • War
  • Serious health problems
  • Torture
  • Indirectly, by learning of another person’s trauma. For example, learning of a violent death of someone you love may lead to PTSD.

Scientists do not yet know exactly why some people develop PTSD and others do not, but experiencing symptoms of PTSD is never a sign of weakness or failure. PTSD affects people differently; a person of any age, gender, sex, culture, or ethnicity can develop PTSD.

Researchers think that some risk factors may increase our vulnerability to developing PTSD following trauma, including:

  • A past experience of trauma
  • Not having much support from family or friends
  • Genetic components – for example, having a parent with mental illness

Dealing with increased stress post trauma, or personally having a history of mental illness, substance abuse, or other mental health problems can be additional risk factors.

Symptoms of PTSD

Symptoms of PTSD vary widely, but clinical PTSD diagnosis requires the presence of symptoms from each of the following categories. For an acute trauma reaction to become clinical PTSD, symptoms must persist for more than a month.

  • Intrusive symptoms like flashbacks and/or nightmares: You may find yourself reliving the memory of the traumatic event or having nightmares about trauma.
  • Avoidance symptoms: You might avoid thoughts or experiences that remind you of the traumatic event.

Indications related to negative thoughts or mood symptoms can include any of the following, among others:

  • Angry outbursts, persistent irritation, sadness, or mood swings
  • Intense anxiety and difficulty relaxing
  • Feelings of guilt or shame, possibly including a sense that the trauma was somehow your fault
  • Arousal symptoms like being easily startled, tense, or jumpy
  • Emotional numbness or lack of energy
  • Control symptoms like self-destructive behavior including substance abuse

In addition to these behavioral symptoms, some people also experience physical symptoms including headaches, digestive issues, and/or changes in eating, or sleep problems.

Types of PTSD

If you’re struggling with PTSD, you have a variety of options for treatment. These include:

  • PTSD with delayed onset: In this type of PTSD, symptoms begin more than six months after the traumatic event.
  • PTSD with dissociation: For some people, the mood symptoms described above are accompanied by feelings of unreality, as if you were not actually present during the traumatic event and may not be present even in your current day-to-day life. This type of PTSD has its own clinical diagnosis and may be treated differently.
  • Acute Stress Disorder: Acute Stress Disorder involves the same kinds of experiences and symptoms as PTSD, but it has a shorter duration of one month or less. If this disorder lasts longer than one month, it becomes clinical PTSD.
  • Collective trauma: Collective trauma is not a diagnosis, but rather a particular subset of traumatic experience that can often lead to PTSD. Collective traumas apply to an entire group, community, or even nation, with individual reactions varying within the group.

Examples of this kind of trauma include war, genocide, mass shootings, natural phenomena, and some effects of climate change.

What to do if you’re experiencing symptoms of PTSD

If you’re struggling with PTSD, you have a variety of options for treatment. These include:

Seek mental health services and see a therapist who takes a trauma-informed approach.

  • Find a therapist who can help you better understand your psychological and emotional responses to traumatic stress, and who will use proven techniques to help improve your symptoms and mood.
  • Find a therapist who can help you better understand your psychological and emotional responses to traumatic stress, and who will use proven techniques to help improve your symptoms and mood.

See more tips below on selecting a therapist.

Work with a trained practitioner to learn mindfulness practices. Some studies have shown that meditation and mindfulness practice can help reduce mental health symptoms related to trauma. [4] Because the stillness and contemplation these practices often require can be triggering for those who have gone through traumatic stress, you should seek individual guidance from a mental health professional. They may recommend that you start with short, simple practices, and can help if they observe any unintended increases in distress.

Learn grounding techniques to bring you back to the present moment. If you are having intense, overwhelming symptoms, getting in touch with the five senses – sight, smell, touch, sound, and taste – may help to immediately “ground” and connect you with the present.

Seek out (or accept) social support. Given the intense stress of post-traumatic stress disorder, you might feel like withdrawing from family and friends. But their emotional and practical support can help you to adjust back to normal life. It can help to talk things over with family and friends, when you feel ready to do so.

Consider medical support. Consider checking in with your physician or making an appointment with a psychiatrist for review. In some cases, medication can help to manage some PTSD symptoms.

Add the number of a useful hotlines to your phone.

Therapy types for PTSD

Different types of therapy have been found to be helpful for treating PTSD. Left untreated, PTSD can develop into a worse psychiatric disorder as many of its symptoms can be individually diagnosed as mental disorders.

Some types of therapy involve being exposed (gently and carefully) to reminders of the traumatic event, while other types of therapy provide support without exposure.

Learn more by reading about the different therapy types below, and then choosing the one that feels like the best personal fit for you.

  • Cognitive behavior therapy (CBT): CBT is a type of talk therapy that can been adapted to help people with PTSD. You’ll learn to reduce your distress by gradually examining your traumatic stress and creating more helpful thoughts and beliefs about it. You’ll also learn skills for coping and regulating your feelings.
  • Trauma-focused CBT: Very young children develop PTSD and this version of CBT talk therapy was refined to help youth and adolescents struggling with PTSD. Parents are usually also involved and trained to provide supportive, caring responses to help restore the young person’s feeling of safety.
  • Eye movement desensitization and reprocessing (EMDR): This therapy helps to reduce symptoms of PTSD by reprocessing the memory of the event so that it is experienced in a different way (American Psychiatric Association). In EMDR, you’ll make side-to-side eye movements, often while following your therapist’s fingers, while recalling aspects of the traumatic event.
  • Prolonged exposure therapy: This is another version of CBT modified to treat PTSD. You’ll learn strategies for managing your emotions and thoughts. Then, with your therapist’s support, you gradually approach your trauma memories and learn that they do not need to be feared or avoided.
  • Psychodynamic therapy: Through psychodynamic therapy, you’ll explore how previous experiences shape how you think, feel and behave today. It can help you to address feelings related to your trauma experience without exposing yourself to reminders of your trauma.
  • Interpersonal therapy: This is another type of therapy that may help if you don’t want to expose yourself to reminders of your trauma. Interpersonal therapy focuses on how you are doing currently. It builds communication skills and social support, as well as teaching you how to regulate and manifest positive emotions.
  • Group therapy: Many people find it helpful to attend therapy with people who are going through a similar experience. This can help you to understand PTSD and learn strategies for managing it. Sharing experiences with others can help you to realize that other people would have reacted and felt the same as you in the situation. This can look like a survivor’s group or family therapy depending on the nature of the trauma.

How to look for in a therapist who specializes in treatment for PTSD

The best-fitting type of therapist varies from person-to-person. It will depend on individual factors, treatment preference, your location, and finances.

When selecting a mental health professional, it can be helpful to consider the following factors:

Confirm medical education and licensure to practice in your state.

  • Ensure that your prospective mental health professional has a current license. This ensures that your therapist has completed the appropriate level of education to practice.
  • When browsing through therapists on Zencare, you can rest assured that all our therapists have already been vetted.

Seek specialization in a trauma-informed approach: Look for a therapist who has completed specialized training in a therapy for treating PTSD, such as those discussed above. For example, you might look for the following additional training in therapists’ biographies:

  • The TF-CBT national therapist certification program provides accredited training that therapists must complete in order to be certified TF-CBT practitioners.
  • The Center for the Treatment and Study of Anxiety provides a certification program for Prolonged Exposure Therapy.

Assess potential for a personal fit and strong therapeutic alliance:

  • Prioritize the potential for developing a strong working relationship with your therapist.
  • This trusting relationship, called the “therapeutic alliance” can have a significant impact on the effect of therapy.
  • As some PTSD therapies involve exposure to reminders of your trauma, it’s important that you feel safe, comfortable, and trust your therapist. Find a therapist who is willing to work with you at your pace, and not pressure you into exposure to trauma reminders before you feel ready.

Ask questions about their practice on your initial call: The best way to gauge how you might feel about your prospective therapist is to ask for a preliminary phone call. Most therapists will be happy to do so. This gives you the opportunity to ask about your therapist’s:

  • Education and training
  • Experience with working with people who have PTSD
  • What type of therapy they suggest, and what that will be like
  • If they are open to working with you in the type of therapy you think would be a good fit for you
  • Whether they will collaborate with your other health care providers; for example, if another practitioner is prescribing medication to help you manage your PTSD symptoms
  • Participation in insurance plans and cost of therapy

It’s typically a good idea to speak to a few different therapists before making your mind up.

New to therapy? Learn about how to find a therapist here.