Post-traumatic stress disorder – aka PTSD – is one condition but has different subtypes depending on an individual’s symptoms.
Not everyone reacts to traumatic events in the same way or experiences the same symptoms. Each person’s response is unique.
Also, not everyone who experiences trauma will develop post-traumatic stress disorder (PTSD). You might have experienced the same type of trauma as someone else and be affected differently.
PTSD often begins with a normal stress response that may develop into PTSD. Some people might not even be aware they are having symptoms of PTSD.
Stress disorders and PTSD can have similar symptoms and even present in the same way. But there are some differences in the way each type is managed.
PTSD might begin with a normal stress response, but not all stress responses develop into PTSD.
Normal stress responses affect the nervous, endocrine, and immune systems. The physiological effect of the stress response activates the fight-or-freeze response in the body.
This response allows the body to either fight or leave the situation and activates adrenaline. Events that may trigger a normal stress response include:
- high amounts of stress and tension
After the threat is over, the body turns to pre-arousal levels. Normal stress responses do not often have long-term affects or disrupt day-to-day life.
The best treatment for normal stress response is psychotherapy (talk therapy) and support from loved ones. Having someone to talk with or vent to can help ease stress and anxiety.
Group therapy might also be helpful.
Similar to PTSD, acute stress disorder can also develop after a traumatic event. However, symptoms can start between 3 days and 1 month after the event.
According to the Department of Veterans Affairs, approximately 6-33% of individuals can develop acute stress disorder within 1 month of a traumatic event. This rate is different for each type of trauma.
For example, after a car accident, approximately 13-21% of individuals have a chance of developing acute stress disorder, compared to 20-50% of individuals after a rape, assault, or mass shooting.
Symptoms of acute stress disorder are similar to PTSD and can occur after you have:
- directly experienced a trauma
- witnessed an event as it occurred to someone close to you
- learned that an event happened to someone close to you
- have repeated exposure to extreme or repeated details of a traumatic event
Treatment for acute stress disorder often includes psychotherapy, including cognitive behavioral therapy (CBT). Older studies show that CBT helps to reduce symptoms and decreases the likelihood that symptoms will develop into PTSD.
Dissociative PTSD was added to the new version of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013. A key feature of this form of PTSD is dissociative symptoms (depersonalization or derealization) and emotional detachment.
Other characteristics of dissociative PTSD include:
- higher levels of co-occurrence with other mental health conditions
- dissociative flashbacks and dissociative amnesia
- more significant history of early life trauma
- more severe PTSD symptoms
There is still ongoing research on treatment for this type of PTSD. However, experts believe that exposure-based therapy might be helpful for managing these symptoms. These include:
- cognitive processing therapy (CPT)
- prolonged exposure (PE)
- eye movement desensitization and reprocessing (EMDR)
- narrative exposure therapy (NET)
Individuals with this type have similar symptoms to other types of PTSD, such as re-experiencing the trauma and avoiding places or people related to the trauma.
But the main difference between this one and others is that it does not coexist with other mental health conditions such as depression.
Uncomplicated PTSD is also one of the most commonly diagnosed and is highly responsive to treatment.
Complex PTSD occurs when repeated, or multiple, traumas happen over a period of months, or even years, instead of a traumatic event that happens once and is over – such as a violent attack or car accident.
Chronic trauma associated with complex PTSD symptoms can occur in childhood or adulthood and can cause issues in relationships and behaviors.
Complex PTSD can also present through physical health symptoms such as fatigue and chronic pain.
Treatment for this type of PTSD often takes longer, and recovery often happens at a much slower rate. A highly structured management plan is often designed specifically for you and delivered by a team of trauma specialists.
Individuals with co-morbid PTSD also have at least one co-occurring mental health condition. Some common co-occurring conditions include:
Co-morbid PTSD is also a common type as many people have one or more mental health conditions with PTSD. Treatment for this type often includes treating both symptoms of PTSD and the other mental health condition.
If you think you have PTSD, there are many ways to find help. You can try these find-a-therapist tools to find a mental health professional who specializes in trauma.
- American Psychiatric Association
- American Psychology Association
- Anxiety & Depression Association of America
- Sidran Institute
For information on inpatient services or treatment facilities, the Substance Abuse and Mental Health Administration (SAMSA) offers a Behavioral Health Services Locator.
The Department of Veterans Affairs designed a PTSD Coach app to provide education about PTSD. The app also has a self-assessment tool and tools to help manage symptoms.
Some other places where you can find support and forums include:
- Real Warriors
- My HealtheVet
- In Transition
- Military OneSource, part of the Department of Defense network of support
If you think a loved one could be experiencing PTSD, the National Alliance on Mental Illness offers some helpful guides:
There are many ways the body may respond to a traumatic event, and everyone responds differently.
No two people’s reactions are the same. While one person might develop PTSD after a traumatic event, another might not.
If you’re experiencing symptoms of PTSD, you are not alone. And whether the traumatic event happened to you or you witnessed it, you can find help and support.