PTSD Signs & Symptoms

Learn about post-traumatic stress disorder

Post-traumatic stress disorder, or PTSD, is a mental health disorder that is characterized by the development of distressing symptoms following exposure to one or more traumatic events. The types of trauma that may lead to PTSD include, but are not limited to, military combat, physical assault, sexual violence, severe automobile accidents, natural disasters, and sudden catastrophic medical events. PTSD can result from directly experiencing these events or from witnessing them occur to someone else.

Individuals who have PTSD may experience recurrent distressing memories of the traumatic event or events, nightmares related to the trauma, and dissociative reactions (or flashbacks) where they feel as though they are re-experiencing the event. As a result of these and other involuntary reactions, people with PTSD may alter their behaviors to avoid events or experiences that remind them of the traumatic event. They may also experience involuntary changes in mood, attitude, and perception.

When a person who is already struggling with a substance use disorder develops PTSD, the experience can be exponentially more difficult. One unfortunately common way that individuals with PTSD attempt to avoid, preclude, or lessen the impact of painful memories is to abuse alcohol or other drugs. When the individual in questions has already developed a substance use disorder, his or her reliance upon the drug on which he or she has become dependent may deepen, and may be accompanied by other forms of substance abuse. Though intoxication may offer fleeting respite from painful memories, substance abuse will only serve to exacerbate symptoms and complicate efforts to overcome both the substance use disorder and the PTSD.

Clearly, individuals who are dealing with a substance use disorder and co-occurring post-traumatic stress disorder are in need of professional treatment. With effective care, these individuals can experience relief from their symptoms, address the issues that contributed to the development of their disorders, and learn healthy coping skills that will allow them to achieve long-term recovery.

PTSD statistics

About 3.5% of individuals in the United States will experience PTSD in any 12-month period, and the lifetime risk of developing this disorder is about 8.7%. The risk of developing PTSD is higher among women than among men. According to the National Center for PTSD, about 10% of women will develop this disorder during their lives, compared with about 4% among men. Experts estimate that between 20% and 43% of adults with PTSD also have a substance use disorder, compared to a substance abuse rate of between 8% and 25% among the general population. Among combat veterans with PTSD, the substance abuse rate is 75%.

Causes and risk factors for PTSD

The one element that is necessary for post-traumatic stress disorder to occur is a traumatic event or series of events. However, a variety of additional factors may influence whether or not an individual’s response to that trauma will develop into PTSD:

Genetic: Research indicates that certain genotypes may lessen or increase the likelihood that a person who has been exposed to trauma will develop PTSD as a result of that experience.

Environmental: Prior to the traumatic event, environmental influences such as poverty, lower educational progress, family history of mental illness, and childhood adversity may increase a person’s likelihood for experiencing PTSD. During and after the traumatic event, factors such as the severity of the experience, subsequent exposure to reminders of the event, additional adverse life events, and the lack of strong social support may contribute to the development of PTSD.

Risk Factors:

• Being younger at the time of the traumatic event or events
• Being female
• Being a member of a minority racial or ethnic group
• Low socioeconomic status
• Insufficient social support
• Experiencing interpersonal violence
• Lower education level
• Lower intelligence
• Poor coping skills
• Prior mental health issues

Signs and symptoms of PTSD

Post-traumatic stress disorder may reveal itself via a wide range of symptoms depending upon several factors. The following are among the more common signs and symptoms of PTSD:

Behavioral symptoms:

• Avoiding certain events, situations, or people
• Reckless or otherwise self-destructive behaviors
• Fighting, destruction of property, and other acts of violence
• Engaging in substance abuse
• Withdrawing from family or friends
• Diminished participation in important activities

Physical symptoms:

• Sleep disturbances
• Exaggerated startle response
• Hyperarousal

Cognitive symptoms:

• Memory problems
• Difficulty concentrating
• Vivid and disturbing nightmares
• Recurrent distressing memories
• Depersonalization
• Derealization

Psychosocial symptoms:

• Angry outbursts
• Persistent negative mood
• Hypervigilance

Effects of PTSD

Untreated post-traumatic stress disorder can have a profoundly negative impact on virtually all areas of a person’s life. The following are among the common negative effects that have been associated with PTSD:

• Substance abuse and addiction
• Injury to self or others due to violence or recklessness
• Inability to establish or maintain interpersonal relationships
• Family discord
• Diminished performance at work
• Job loss and unemployment
• Development of additional mental health disorders
• Homelessness
• Suicidal ideation
• Suicide attempts

PTSD and co-occurring disorders

People who experience PTSD are at significantly increased risk for developing symptoms that meet the criteria for another mental health disorder. The following are among the co-occurring disorders that most commonly occur alongside PTSD:

• Anxiety disorders
• Bipolar disorders
• Depressive disorders
• Major neurocognitive disorder
• Substance use disorders