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What Is Post-Traumatic Stress Disorder?

Ms. Rona Ackerman, Social worker and psychotherapist, treats PTSD, loss and bereavement
15 June 2025

Post-Traumatic Stress Disorder, or PTSD, is a long-lasting response to a traumatic event that puts a person's physical or mental health at risk. To put it another way, a situation in which stress lasts long after the event is over.
PTSD may manifest in a variety of unique symptoms, some physical and some mental:

  • Invasiveness: you repeatedly relive the traumatic event through dreams or flashbacks.
  • Excessive arousal: difficulty sleeping and concentrating, feelings of guilt and shame, and low mood.
  • Aversion: tendency to avoid things that remind you of the traumatic event, making you emotionally detached.

That is one way to describe the tension that people with PTSD feel: on the one hand, they want to forget about the traumatic event, but on the other, they have an overwhelming urge to do it again.

Most people recover on their own after a traumatic event. For some with PTSD, symptoms may quickly subside, but for others, PTSD can persist. This disorder significantly affects not only the individual but also their family, friends, acquaintances, coworkers, and employers.

It's important to remember that there is hope for recovery. Despite being distressing, the experience can lead to positive change and personal growth. When someone with PTSD struggles to see a path to healing, a supportive environment plays a crucial role. Recognizing symptoms, offering support, understanding, and helping the person seek therapy are vital steps in aiding recovery and preventing further trauma.

Post-Traumatic Stress Disorder (PTSD) is a long-lasting reaction to a traumatic event that threatens a person's physical or mental health. It can happen after things like a serious physical attack, terrorist attack, natural disaster, or car accident.

Symptoms

PTSD can show up in many different ways, both physically and mentally. If you notice any of the following symptoms in yourself or someone close to you, it's important to seek a professional diagnosis:

Repetitive, involuntary thoughts about the event can affect the mind, making it feel as if the event is happening again. These thoughts can appear in various ways:

  • Dreams: reliving all or part of the event in dreams. These dreams may include representations or images from the traumatic event and express the associated feelings and sensory memories.
  • Flashbacks: recreating the event or any part of it in your mind.
  • Memories: remembering the event through sights, sounds, smells, or tastes.
  • Distress: experiencing distress when a "trigger" causes you to relive the event.

A trigger can cause a response linked to the traumatic event, activating the body’s alarm system (such as a noise, smell, or sight). This leads to a heightened state of alertness, where the person feels the need to stay "on guard," resulting in several symptoms:

  • Difficulty falling and staying asleep
  • Trouble focusing or concentrating
  • Irritability, impatience, or outbursts of anger
  • Feelings of guilt and shame
  • Low mood, possibly leading to depression

A tendency to avoid triggers, such as situations, people, events, places, actions, thoughts, and feelings that may bring back the traumatic memory, is common. This avoidance can include:

  • Sense of alienation and detachment (feeling disconnected or numb from others)
  • Emotional numbness (a lack of emotional response, including difficulty experiencing positive feelings)
  • Lack of enjoyment and motivation (feeling unmotivated or unable to engage in activities)

A Normal Reaction to an Abnormal Situation

To recognize PTSD, it's important to understand what trauma is and when it turns into PTSD. When someone experiences a traumatic event that overwhelms them, they may face a variety of physical, emotional, cognitive, and behavioral symptoms. Feeling this way is a "normal response to an abnormal situation." While the intensity and severity of the event can influence the likelihood of developing PTSD, they are not the only factors. Multiple events of varying severity can also lead to PTSD. Each person's reaction is unique, meaning different individuals may respond differently to the same event.

Possible Responses to a Traumatic Event

  • Physical Responses: nausea, tremors, dry mouth, rapid heartbeat, difficulty breathing, weakness, chest pain, vomiting, abdominal pain.

  • Cognitive Responses: intrusive thoughts, flashbacks, confusion, trouble concentrating, memory issues, feeling disconnected from time, difficulty thinking clearly.

  • Emotional Responses: anxiety, fear, depression, denial, panic, feeling overwhelmed, anger, guilt, uncertainty, irritability.

  • Behavioral Responses: withdrawal and detachment, avoidance, suspicion, sleep problems and nightmares, changes in appetite, restlessness, constant alertness, even aggression.

When trauma becomes PTSD

Most people who are traumatized will get better on their own, and the traumatic event will become a painful but distant memory over time. Some people, though, will have symptoms that do not go away and may even become chronic, meaning they will last for a long time. Not everyone with PTSD has symptoms right away. For these people, the trauma does not affect them, but the symptoms start months later, usually because of something.

To better understand the stages of PTSD development and gain insight into your condition (or that of someone close to you), it's important to consider how long it takes for symptoms to emerge:

  • Within 48 hours
    Stress reaction
  • Within one month
    Acute stress reaction
  • Over one month
    Post-traumatic stress disorder
  • Within 48 hours from the event, this is known as an acute stress reaction (ASR). This kind of reaction can happen to almost anyone who goes through a traumatic event.
  • Within one month after the event, it is customary to diagnose it as an acute stress disorder (ASD).
  • Over one month from the event: if symptoms are intense and last for over one month, this is Post-Traumatic Stress Disorder (PTSD).

In some cases, the reaction to a traumatic event may not appear immediately but can be delayed, showing up months or even years later.

Recent, important events, like wars, can make it hard to see where this timeline ends and the next one begins. This is especially true when betrayal makes the experience worse, like when someone feels abandoned, brutalized, or like they have lost their humanity. In these situations, up to 30% of those affected may develop PTSD symptoms.

Since we can’t predict who will develop PTSD, it's crucial to seek professional mental health care early on to help process the trauma and prevent PTSD from developing.

In conclusion, those suffering from PTSD often face a struggle between two extremes: a desire to avoid the memory of the traumatic event and a powerful, uncontrollable urge to relive it.

Healing and recovery are possible

Trauma, whether it is mental or physical, is an existential threat that changes the way a person sees the world. When someone else causes the trauma, it can shake our most important moral and religious beliefs, leaving the person feeling alone, empty, and without faith or trust for others. The person may feel helpless and unable to take back control of their life because of their fragmented memory of the event.

It is important to remember, though, that trauma can also bring about change and give you a chance to grow and develop as a person. If the person is having a hard time seeing that they can get better, the support of their environment becomes very important. This includes providing the tools for effective communication, showing recognition, offering empathy, and encouraging the person to seek professional help from a therapist.

Ms. Rona Ackerman is the Deputy Director of ELAH Center for Coping with Loss, Grief, Trauma and Mental Pain