Posttraumatic Stress Disorder: Posttraumatic stress disorder (PTSD) can develop in the wake of a traumatic event that is outside the usual human experience. A person either experiences direct or threatened injury, or witnesses the serious injury or death of another. In some cases, learning of the unexpected death or injury of a loved one can also bring on symptoms of PTSD. For a diagnosis of PTSD to be made, there must be both an identifiable terrifying event and a response of intense fear, helplessness and horror, as well as one or more characteristic symptoms. These include:

  • Re-experiencing of the event through nightmares, daytime flashbacks, or physical sensations that recall the feelings present during the event. In children, this can take the form of repetitive play that contains aspects of the traumatic event.
  • Numbing and shutting down feelings and memory. Feeling detached from others. Dissociating from the distressing memories and feelings.
  • Hyperalertness to danger. The individual often has difficulty shutting down the fight-or-flight response that was quite appropriately activated during the event. This causes sleeplessness, irritability, difficulty with concentration, and general restlessness, and sometimes the development of an exaggerated startle.
  • Hypervigilance and avoidance of any situation associated with the event.

These symptoms significantly disrupt an afflicted person’s daily life. Depending on the type of traumatic event, the person might react with distrust of others, avoidance of anyone or anything that reminds them of the event, or lack of confidence in their ability to keep themselves safe.

Case Study: Joanne, age 32, is involved with the first man that really counts in her life. As the couple has become more intimate, Joanne has started to have flashbacks about an uncle who touched her sexually when she was only eight. She is distressed to find that she is shutting down feelings about her boyfriend and distancing herself from him. Although she has been sexual with other men, she says she can’t stand to let herself be sexual with someone she loves and trusts. She startles easily and reports a general increase in anxiety. She is very angry that she has to deal with the feelings about the incidents with her uncle that happened so long ago. She says that she thought she had gotten beyond all that. Joanne is struggling with PTSD.

More information on anxiety disorders is available from the National Institute of Mental Health at:

Last reviewed:
On 3 Oct 2005
By John M. Grohol, Psy.D.