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 challenges that interfere with their day-to-day life. In these instances, they may be experiencing post-traumatic stress disorder.
Any intensely distressing experience might qualify as traumatic, but common traumatic events range from upsetting events, like an accident or the loss of a loved one, to more extreme events, such as sexual assault, war, or natural disaster. In some cases, PTSD can also be caused by hearing about a traumatic event that a loved one has undergone, rather than experiencing such an event directly.
Prevalence of PTSD
It is estimated that:
- 7.7 million Americans ages 18 and older have PTSD
- 67% of people who are exposed to mass violence develop PTSD 
- 18.5% of returning veterans report symptoms of PTSD and/or depression 
There may be gender differences in PTSD development as well; research shows that women are twice as likely as men to develop PTSD, and often wait longer to seek help managing their symptoms.
Anyone who has experienced a traumatic event may develop PTSD. Examples include – but are far from limited to:
- First responders
- Individuals who have gone through physical or sexual assault or abuse
- Women who have experienced a traumatic childbirth
Causes of PTSD
Some people develop PTSD after experiencing a very frightening event, or after prolonged or repeated experience of very stressful traumatic events. Some examples of the kind of traumatic experiences that can lead to PTSD include:
- Car accidents
- Natural disasters
- Physical or sexual assault
- Sexual abuse, neglect, or other mistreatment in childhood
- Serious health problems
- 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. A person of any age, gender, sex, culture or ethnicity can develop PTSD.
Researchers think that some factors may increase our vulnerability to developing PTSD following trauma, including:
- A past experience of depression or anxiety
- Not having much support from family or friends
- Genetic components – for example, having a parent with a mental health concerns
Symptoms of PTSD
Symptoms of PTSD vary widely, but clinical 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 one month or more.
- 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.
Symptoms related to negative changes in thought or mood, which can include any of the following, among others:
- Persistent anger, 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
- Emotional numbness or lack of energy
Some people also experience physical symptoms including headaches, digestive issues, and/or changes in eating or sleeping habits.
Types of PTSD
There are different types of PTSD, which 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 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 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 disasters, 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:
See a therapist who takes a trauma-informed approach
Find a therapist who can help you better understand your psychological and emotional responses to trauma, 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. 
Because the stillness and contemplation these practices often require can be triggering for those who have gone through traumatic experiences, 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 PTSD, 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 hotline to your phone
If you’re having thoughts of suicide or need immediate support, you can always call the National Suicide Prevention Hotline at 1-800-273-8255.
The Substance Abuse and Mental Health Services Administrationhotline at 1-800-622-4357 can also help you locate resource and treatment options. Please visit our page on Immediate Help for additional regional and national resources.
Therapy types for PTSD
Different types of therapy have been found to be helpful for treating PTSD.
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 talking therapy that can been adapted to help people with PTSD.
You’ll learn to reduce your distress by gradually examining your traumatic experience and creating more helpful thoughts and beliefs about it. You’ll also learn skills for coping and regulating your feelings.
This version of CBT was developed to help children 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, although researchers are not yet sure exactly how it works. 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.
Through psychodynamic therapy, you’ll explore how previous experiences shape how you think, feel and behave today. It can help you to address your trauma experience without exposing yourself to reminders of your trauma.
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 your emotions.
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.
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 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 of 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 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.