What Is PTSD, Exactly?

Illustration by Keila Gonzalez
Illustration by Keila Gonzalez

This informational guide, part of POPSUGAR's Condition Center, lays out the realities of this health concern: what it is, what it can look like, and strategies that medical experts say are proven to help. You should always consult your doctor regarding matters pertaining to your health and before starting any course of medical treatment.

The following article includes discussion sexual assault and suicide in addition to PTSD. Please proceed thoughtfully.

When you experience something scary or dangerous — a car accident, say, or a natural disaster — it can make you feel unnerved and unable to function as you usually would. If that feeling lasts for more than a month and has a noticeable, negative impact on your life and emotional well-being, your natural stress reaction may have transformed into post-traumatic stress disorder, a mental health condition that affects 12 million adults in the US in a given year.

Understanding PTSD

Most of us experience at least one traumatic event in our lives, but that doesn't always lead to PTSD, the National Center for PTSD reports. Rates of the disorder are high among the military — up to 17 percent of those who served in the Iraq war experience it, for instance, likely due to the intense and/or prolonged nature of the stress that veterans are exposed to. In general, though, about six percent of people will have PTSD at some point in our lives — and more women than men.

Symptoms vary from person to person, but there are four common clusters of PTSD symptoms, according to Tara Galovski, PhD, director of the Women's Health Sciences Division at the National Center for PTSD. The first goes by the general term "reexperiencing." "You relive the trauma over and over through intrusive thoughts, flashbacks, and nightmares," Dr. Galovski says.

The second cluster of symptoms — avoidance — stems from the first. People with PTSD may try to avoid things that remind them of the traumatic event, so they may refuse to talk about it, use drugs or alcohol, work, or overexercise to numb their feelings.

The third cluster is negative thoughts and feelings, like feeling numb and losing interest in things you used to enjoy, viewing the world as dangerous, or feeling guilt and shame about the event. "It can be hard to maintain close relationships because people with PTSD can have difficulty trusting others," Dr. Galovski says.

And the fourth is feeling jittery, on edge, and always on the lookout for danger, which can affect sleep and concentration.

Causes of PTSD

Any type of traumatic event can trigger PTSD, but there are factors that may contribute to the likelihood of a person developing the disorder. These include:

  • Sexual assault and intimate partner violence, which affect everyone, although women and trans people experience it more often than men. "Rape is linked to some of highest rates of PTSD because it's so damaging emotionally and physically," Dr. Galovski says. In fact, 30 percent of women experience PTSD nine months after a sexual assault, and 94 percent experience PTSD symptoms during the two weeks after.
  • Having a comorbidity, like anxiety and depression, according to Andrea Roberts, PhD, senior research scientist at the Harvard T.H. Chan School of Public Health.
  • Inherited factors, including your temperament or a family history of anxiety and depression, according to the Mayo Clinic.
  • Differences in the brain. For instance, some evidence indicates that people with smaller hippocampus (an area of the brain related to learning and memory) may be more susceptible to developing PTSD in response to trauma, although more research is needed before experts can definitively say there's a link, according to the journal Nature Neuroscience. The disorder itself may literally change the brain as well, according to research in JAMA Psychiatry. The study found that people with PTSD have hyperresponsive amygdalas, the part of the brain that responds to fearful situations. This may increase anxiety and contribute to symptoms.

The Most Effective PTSD Treatments

Two types of therapy have been shown to be particularly effective at decreasing the severity of, or even curing, PTSD. One is cognitive-processing therapy, which helps people understand how the trauma affected their thoughts and feelings. "Changing how you think about trauma can change how you feel," Dr. Galovski says. "For instance, if you think being raped was your fault because you were wearing a short skirt, CPT can help you see that your behavior had nothing to do with it."

Another helpful approach: prolonged-exposure therapy, in which you remember and talk about the traumatic event over and over until the memories no longer trigger symptoms. "It's very effective at helping people get unstuck," Dr. Galovski says.

The treatments aren't easy because they force people with PTSD to do the one thing they least want to do: talk about the trauma. But if you can stick with it, the payoffs are worth it. "Treatment works," Dr. Roberts says. "PTSD is associated with an increased risk of suicide, but you don't have to suffer. I encourage anyone who thinks they might have the disorder to seek help."

If you or someone you know is struggling with PTSD, the National Alliance on Mental Illness has resources available including a helpline at 1-800-950-NAMI (6424). Or, in a crisis, text NAMI to 741741. You can also dial 988, the nation's new mental health crisis hotline.