Posttraumatic Stress Disorder

NAMI’s new graphic resource describes the differences between trauma and PTSD, offering information on symptoms, treatment, stress reduction strategies, and important myths vs. facts – with quotes from real people.

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Traumatic events — such as a motor vehicle crash, assault, military combat or natural disasters — can have lasting effects on a person’s mental health. While many people will have short term responses to life-threatening events, some will develop longer term symptoms that can lead to a diagnosis of posttraumatic stress disorder (PTSD). PTSD symptoms often co-exist with other conditions such as substance use disorders, depression and anxiety. A comprehensive health evaluation which can result in an individualized treatment plan is optimal.

Trauma is a deeply distressing or disturbing experience that overwhelms an individual’s ability to cope, often leading to lasting emotional, psychological, or physical effects. Trauma can result from a wide range of experiences, including but not limited to physical, emotional, or sexual abuse, accidents, natural disasters, violence, loss, or significant life changes. It also includes systemic and interpersonal experiences such as racism, discrimination, and marginalization, which can create ongoing harm and stress. Trauma can affect anyone, regardless of their background, and its impact can vary depending on the individual’s resilience, support systems, and the nature of the event. Healing from trauma often requires time, support, and appropriate interventions tailored to the individual’s experiences.

About 4.1% of the U.S. adult population (over 8 million people) experiences PTSD. Both older and more recent research suggest that women are more likely to experience PTSD than men.

A brief history of the diagnosis of PTSD

Traumatic events have been observed to have impacts on people for some time and are described as early as in Homer’s The Iliad written in about the 8th century. A formal diagnosis of PTSD was introduced with the launch of the third edition of the Diagnostic and Statistical Manual (DSM) published by the American Psychiatric Association in 1980. This was a direct result of many Vietnam Veterans returning with a constellation of symptoms that fit that diagnosis. Advocacy from rape victim groups also helped conceptualize PTSD to be more than a war injury.

Prior to that, “shell shock” (World War I) and “battle fatigue” (World War II) were the ways professionals conceptualized the impact of war trauma on soldiers. Over time it became clear that a subset of people exposed to the same life-threatening experiences would have similar symptoms. A diagnosis of PTSD added to the understanding of traumatic events as a cause of these symptoms and helped to focus research in this area.

In the most recent version of the DSM, PTSD has been moved into its own category — Trauma and Stressor Related Disorders — rather than being included as a type of anxiety disorder. This grew out of the research showing that anger, depression or dissociation may also result in traumatic responses and were more complex than anxiety symptoms.

Causes

PTSD can occur at any age and is directly associated with exposure to trauma. Adults and children who have PTSD represent a relatively small portion of those who have been exposed to trauma. This difference is not yet well understood but we do know that there are risk factors that can increase a person’s likelihood of developing PTSD. Risk factors can include prior experiences of trauma, having limited social or family support, dealing with other stressors before or after the event, or a personal or family history of mental illness or substance use.

We do know that for some, our “fight-or-flight” biological instincts, which can be lifesaving during a crisis, can leave us with ongoing symptoms. Because the body is busy increasing its heart rate, pumping blood to muscles, preparing the body to fight or flee, all our physical resources and energy are focused on getting out of harm’s way. Therefore, there has been discussion that the posttraumatic stress response may not a disorder per se, but rather a variant of a human response to trauma.

PTSD can be considered a consequence of our body’s inability to effectively return to “normal” in the months after its extraordinary response to a traumatic event.

Related Conditions

Someone with PTSD may have additional mental health conditions, including:

A person with PTSD may also experience thoughts of suicide or suicide attempts.

The presence of a co-occurring condition can make it more challenging to treat PTSD. It’s important to know that successfully treating PTSD almost always also improves the symptoms of these related illnesses and successful treatment of the related illnesses usually improves PTSD symptoms.

Reviewed and updated May 2025

Symptoms of PTSD typically emerge within three months of experiencing or being exposed to a traumatic event. However, in some cases, symptoms may not surface until years later. A diagnosis of PTSD requires a thorough evaluation with a trained professional. According to the National Center for PTSD, PTSD symptoms generally fall into these four categories:

Re-experiencing the traumatic event (also called intrusion), such as flashbacks, nightmares, or intrusive memories
Avoidance of reminders related to the trauma, including people, places, or conversations
Negative changes in mood and cognition, including emotional numbness, detachment from others, or difficulty experiencing positive emotions
Hyperarousal (also known as being “keyed up”), which involves symptoms like irritability, difficulty sleeping, trouble concentrating, and heightened startle response

Young children can also develop PTSD, and some of the symptoms are different from those of adults. Young children generally lack the ability to verbally express some aspects of their experience. Their behavior (such as clinging to parents) is often a better indicator of how they are doing than their words. Some children experience changes in their developmental trajectory, including slipping back into earlier behaviors (for example, a 4-year-old may begin having toileting accidents after having successfully completed potty training).

It is essential that a child be assessed by a professional who is skilled in the developmental responses to stressful events. A pediatrician or child mental health clinician can be a good start.

Reviewed and updated May 2025

Most people may experience one or more symptoms shortly after a traumatic event, but PTSD is diagnosed only when all four types of symptoms — re-experiencing the event, avoidance of reminders related to the trauma, negative changes in mood and cognition, and hyperarousal — persist for at least one month and cause significant distress or disruption in daily life.

Symptoms must be severe enough to significantly impair daily functioning, such as work, relationships, or personal well-being. Additionally, the symptoms must not be attributable to other illnesses, medications, or substance use. PTSD often coexists with other mental health conditions such as depression, anxiety, or substance use disorders.

Screening and Diagnosis Tools

To assess the possibility of PTSD, mental health professionals typically use a combination of interviews and standardized questionnaires. Common screening and diagnostic tools include:

Clinician-Administered PTSD Scale (CAPS): A structured interview to assess the presence and severity of PTSD symptoms
PTSD Checklist for DSM-5 (PCL-5): A self-report questionnaire that screens for PTSD symptoms and tracks their severity
Impact of Event Scale-Revised (IES-R): A tool to assess how recent traumatic events have affected an individual
Trauma Screening Questionnaire (TSQ): A brief screening tool for identifying individuals who may meet the PTSD criteria

While these screening tools are not diagnostic by themselves, they provide a helpful starting point for individuals to discuss their symptoms with a healthcare provider. If PTSD is suspected, a thorough evaluation is essential for an accurate diagnosis and the development of an appropriate treatment plan. Early intervention is crucial for managing symptoms and improving mental health.

Both the National Center for PTSD and Mental Health America offer free online screening tools, which can help individuals assess whether they may be experiencing PTSD and if professional help is needed.

Reviewed and updated May 2025

When people experience or are exposed to trauma, their biological and psychological responses can be intense and painful. Many people will move on with their lives with few or no symptoms, but for some, the intensity and pain remain. It’s common to feel like you should just “get over it,” but there are many well-studied treatment approaches that can address PTSD symptoms. Deciding to seek help can make a big difference in your overall health and wellbeing. The best treatment plan will include recommendations from a health care provider, your preferences related to therapy and medication, and consideration of other conditions you may have.

Most people find a combination of two approaches — psychotherapy and medication — offers the best results.

Receiving support and compassion immediately after a traumatic event is also critical. Some people will want to talk about the event, while others will find it troubling and overwhelming. It’s not helpful to force anyone to discuss a traumatic event until they are ready.

Psychotherapy

There are many different types of psychotherapy.

Research indicates that there are several therapeutic approaches that are more effective than others in addressing the symptoms of PTSD:

Cognitive Processing Therapy> is a type of cognitive behavioral therapy (CBT) that works to address the negative thinking and self-blame symptoms that may come with having PTSD. There is specific training for the psychotherapist and materials to guide this treatment.
Eye Movement Desensitization and Reprocessing (EMDR) was specifically designed to treat trauma. This therapy uses measured exposure to traumatic memories with alternating stimuli (eye movements are one of several options) in structured sessions with a health care professional certified to perform EMDR.
Exposure Therapy is a type of psychotherapy that enables a skilled practitioner to help people safely face what they find traumatizing so they can learn to cope effectively. One technique used in exposure therapy involves virtual reality programs that allow a person to experience the situation in which they experienced trauma to help process it.
Group Therapy with others who have similar experiences can help build resilience when someone feels alone and isolated. Group therapy helps lessen shame and provide support, as well as reduce feelings of helplessness. Groups for survivors of sexual assault and combat experiences frequently have members living with PTSD and related symptoms.

Ask your therapist if they are familiar with, or have been trained in, these techniques. If their answer is no, ask what approach they use in trauma psychotherapy. There are other effective approaches, but it is helpful to understand your health care professional’s experience in addressing PTSD. Consider asking your therapist, primary care doctor or health plan provider for a referral to a specialist in these treatments if you conclude they are the best match for you.

Medications

There is no one medication that treats all the symptoms of PTSD, but some medications can help with some symptoms and also increase the effectiveness of psychotherapy. When selecting a medication, you should also consider the presence of any other conditions such as depression or anxiety and how they may be impacted.

Antidepressants can be useful to help reduce symptoms of PTSD. Some serotonin reuptake inhibitors (SSRIs) have been approved by the FDA for the treatment of PTSD in adults and are often the first line of treatment. Be sure to be informed about medication uses and side effects and ask your doctor about the latest research in this field.
Other medication approaches are also available, although some are not FDA-approved specifically for the treatment of PTSD symptoms. Ask your doctor for more information about all medication options available.
Other biological interventions. Many states that have legalized marijuana for medical use, and it includes an indication for PTSD. To date, there has not been a randomized controlled trial on the effectiveness of marijuana for PTSD, so it’s difficult to assess its potential viability as a treatment. Research is also underway to assess the potential use of Methylenedioxymethamphetamine (MDMA) to augment psychotherapy for PTSD. MDMA is currently not legal in the U.S. and is not FDA approved for the treatment of PTSD.

Complementary Health Approaches

Recently, health care professionals have started including complementary and alternative methods into treatment regimens. Some methods that have been used for PTSD include:

Yoga
Aqua therapy
Acupuncture
Mindfulness and meditation strategies and practices

Service dogs are another option for non-traditional therapy for people experiencing PTSD. A service dog is by a person’s side 24 hours a day to help navigate daily stressors. Most animals come to the person pre-trained with a set of commands. The owner can rely upon the dog for help and as a reality grounding tool, which can help prevent a re-experience or other symptoms. These animals can also serve as a social buffer, an incentive to exercise and a de-escalation tool during times of stress.

The National Center for Complementary and Integrative Health has more information about alternative treatment approaches.

Reviewed and updated May 2025

If you, a family member or friend is experiencing symptoms of PTSD, there is help. NAMI is here to provide you with support and information about community resources for you and your family.

Find education programs and support groups at your local NAMI. If you have any questions about PTSD or want help finding support and resources, the NAMI HelpLine is available Monday through Friday, 10 a.m. – 10 p.m. ET. Call 800-950-6264, text “NAMI” to 62640, or email at [email protected].

In a crisis, call or text 988 (24/7) to reach the 988 Suicide & Crisis Lifeline. 988 also operates a Veterans Crisis Line: to call, dial 988 and press 1. You can also text 838255 or chat online.

Helping Yourself

Engaging in self-care while experiencing symptoms of PTSD can improve general wellbeing and help provide relief from symptoms. Exercise, healthy eating, and connecting with nature can all be helpful as part of an overall approach. Here are some additional suggestions:

Practice mindfulness. Techniques that use the senses to guide yourself back to the present are useful when you’re experiencing a flashback, feeling “outside of your body,” or recalling memories that are so painful they cause physical distress. Mindfulness can include things like focusing on breathing slowly and deeply, touching a piece of fabric or smelling something with a strong or soothing scent. Taking a course in mindfulness-based stress reduction (MBSR) is one way to learn how to incorporate mindfulness into your life.
Connect with others. Find emotional support from others living with PTSD. It’s helpful to share your thoughts, fears and questions with other people who have the same condition or similar experiences. Search for online message boards, virtual support groups, or in-person groups in your community. NAMI offers several resources, including the NAMI Peer-to-Peer educational program and NAMI Connection recovery support group, which are both led by and for people with mental health conditions.
Avoid recreational drugs and alcohol. These substances can disturb emotional balance and interact with prescribed medications.

Learn more about managing your mental health and finding support while living with mental illness.

Helping A Family Member Or Friend

As with any mental illness, encouragement and support of friends and family is very important. This is especially true for people who have experienced trauma. Learn about PTSD and trauma, offer to listen when a friend or family member wants to talk, and suggest activities to do together that you both enjoy. The National Center for PTSD has more information about supporting a loved one with PTSD.

Resources

NAMI’s Homefront Mental Health Resources page includes information on mental health and trauma, PTSD, stress responses, and effective self-care. Active duty, Veteran and military family members may find the content and personal testimonials especially helpful. Learn more about NAMI Homefront and Veteran mental health.

For teachers and other professionals who work directly with youth who may be exposed to trauma, NAMI TraumaInSight is a free, self-paced course helping enhance trauma awareness.

Additional resources:

Take the PTSD e-learning module now available
View the NAMI HelpLine Resource Directory, which provides links to a variety of mental health resources, including for PTSD and trauma
For advice from professionals, advocates, and other NAMI experts related to trauma and PTSD and other mental health topics, view past recordings of NAMI Ask the Expert series
Visit the National Center for PTSD website for more information and resources
Read this PTSD Help Guide, which offers a number of excellent tips for helping your loved one and yourself cope with the symptoms of PTSD