Post-traumatic stress disorder (PTSD) is characterized as an anxiety problem that people sometimes experience after witnessing or being involved with a traumatic event, such as a fire, a war, an accident or the like. Often, people with PTSD have persistent frightening thoughts and memories of their ordeal and feel emotionally numb, especially with people they were once close to.

PTSD, once referred to as shell shock or battle fatigue, was first brought to public attention by war veterans, but it can result from any number of traumatic incidents. These include kidnapping, serious accidents such as car or train wrecks, natural disasters such as floods or earthquakes, violent attacks such as a mugging, rape, or torture, or being held captive. The event that triggers it may be something that threatened the person’s life or the life of someone close to him or her. Or it could be something witnessed, such as mass destruction after a plane crash.

No matter what trauma was experienced or witnessed, some people with PTSD repeatedly relive the trauma in the form of nightmares and disturbing recollections during the day. They may also experience sleep problems, depression, feeling detached or numb, or being easily startled. They may lose interest in things they used to enjoy and have trouble feeling affectionate. They may feel irritable, more aggressive than before, or even violent. Seeing things that remind them of the incident may be very distressing, which could lead them to avoid certain places or situations that bring back those memories. Anniversaries of the event are often very difficult.

PTSD can occur at any age, including childhood. The disorder can be accompanied by depression, substance abuse, or anxiety. Symptoms may be mild or severe–people may become easily irritated or have violent outbursts. In severe cases they may have trouble working or socializing. In general, the symptoms seem to be worse if the event that triggered them was initiated by a person–such as a rape, as opposed to a flood.

Ordinary events can serve as reminders of the trauma and trigger flashbacks or intrusive images. A flashback may make the person lose touch with reality and reenact the event for a period of seconds or hours or, very rarely, days. A person having a flashback, which can come in the form of images, sounds, smells, or feelings, usually believes that the traumatic event is happening all over again.

Not every traumatized person gets full-blown PTSD, or experiences PTSD at all. PTSD is diagnosed only if the symptoms last more than a month. In those who do have PTSD, symptoms usually begin within 3 months of the trauma, and the course of the illness varies. Some people recover within 6 months, others have symptoms that last much longer. In some cases, the condition may be chronic. Occasionally, the illness doesn’t show up until years after the traumatic event.

Whether the traumatic event is experienced or witnessed, one of the defining characteristics of posttraumatic stress disorder (PTSD) is that the event involves the actual or perceived threat of serious injury or death to the person or others. Traumatic events can include, but are not limited to, the following:

  • Human violence (e.g., rape, physical assault, domestic violence, kidnapping or violence associated with military combat)
  • Natural disasters (e.g., floods, earthquakes, tornadoes or hurricanes)
  • Accidents involving injury or death
  • Sudden, unexpected death of a family member or friend
  • Diagnosis of a life threatening illness

It should be emphasized that most people who are exposed to traumatic events do not develop PTSD and many people with symptoms after a trauma show gradual improvement with time.

However, in some cases, PTSD symptoms may be present and negatively impact on the person’s life (for example, impairing work, studies or relationships with others). In such cases, PTSD may be present. Persons with posttraumatic stress disorder commonly display three types of symptoms:

  • Intrusive re-experiencing symptoms are when a person has memories, flashbacks or nightmares of the event(s).
  • Avoidant or numbing symptoms are when a person withdraws from people or activities that are reminders of the traumatic event.
  • Hyperarousal symptoms are when a person is easily startled, irritable, on edge or has trouble falling asleep.

When children have PTSD, symptoms are expressed in different ways. For example, children may re-experience the traumatic event through repetitive play (e.g., a child who witnessed a robbery may reenact the robbery again and again using her toys).

Researchers have suggested that PTSD tends to be more intense and lasts longer when the traumatic event involves human violence. They have also found good evidence that the likelihood of developing PTSD increases with the severity, length and proximity of exposure to the traumatic event.

According to The American Psychiatric Association’s official diagnostic manual, a person has chronic PTSD if symptoms last for three months or longer. When PTSD symptoms last less than three months, this is considered acute PTSD. It may also be noted that in some people, PTSD symptoms can begin long after the traumatic event, which is called “delayed-onset PTSD.”