What is complex PTSD?

In some cases, traumatic experiences can last for months, or even years. Sometimes this is called complex PTSD . In addition to the PTSD symptoms listed above, people with complex PTSD can also: Have a hard time managing strong emotions Have suicidal thoughts Feel like “damaged goods” Have strong feelings of helplessness, guilt, and failure Struggle to maintain relationships with others Have many physical symptoms

20 Signs and Symptoms of PTSD

Key takeaways:

Traumatic experiences can lead to post-traumatic stress disorder (PTSD).
PTSD is a mental health condition with many different symptoms, including flashbacks, mood changes, and a feeling of being on edge.
There are a range of treatments that can help you recover from PTSD, such as medications, mental health therapy, community support, and coping strategies.

Many people will have at least one traumatic experience as an adult. Accidents, natural disasters, and other upsetting events are an inevitable part of life. After such an experience, it’s perfectly normal to feel stressed, afraid, or angry. Many people also have headaches, stomachaches, and trouble sleeping.

Most people who experience a traumatic event don’t develop post-traumatic stress disorder (PTSD) — a mental health condition with ongoing trauma-related symptoms. But about 6% of people in the U.S. will experience PTSD at some point in their lives. So, how do you know if you have PTSD? We’ll review what it feels like to have PTSD, how to recognize the signs and symptoms, and how you can get help.

Who is most likely to get PTSD?

Anyone can develop PTSD. In the U.S., about 6% of people will have PTSD in their lifetime.

You can get PTSD from any type of personal experience. This could mean:

Being directly involved in a traumatic experience
Hearing about something that happened to a friend, family member, or stranger
Seeing something upsetting on the news, internet, or social media
Being repeatedly exposed to trauma while at work
Experiencing trauma in your community

Examples of common traumatic experiences include:

Accidents
Injury and illness
Physical and sexual assault
Neglect and abuse
War
Natural disaster
Death

After experiencing trauma, certain groups of people are more likely to get PTSD. All of the following put you at higher risk for PTSD:

Having a history of childhood trauma
Serving in the armed forces, especially if you were deployed
Being a member of a marginalized group
Being female
Having another mental health condition, like anxiety or depression
Lacking social support after the traumatic event

What are the 20 signs of PTSD?

There are four categories of PTSD symptoms. PTSD is diagnosed when someone experiences at least one symptom in all four categories for at least a month. These are 20 signs of PTSD symptoms grouped in the four categories of PTSD symptoms.

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1. Re-experiencing symptoms (1 or more needed for diagnosis)

Different thoughts and feelings can lead to re-experiencing symptoms. This is when you relive a traumatic event. This can happen in different ways, including:

Upsetting memories
Nightmares
Flashbacks
Emotional reaction when you encounter a reminder of the trauma
Physical reaction when you encounter a reminder of the trauma

2. Avoidance symptoms (1 or more needed for diagnosis)

Avoidance symptoms lead you to change how you think or act. This can mean:

Avoiding memories, thoughts, or feelings that remind you of the traumas
Avoiding people, places, or activities that remind you of the trauma

3. Changes in thinking and mood (2 or more needed for diagnosis)

PTSD can lead to significant changes in how you think and feel. Changes in thinking and mood include:

Problems remembering part or all of the trauma
Negative thoughts about yourself, your future, or the world
Blaming yourself or others
Negative feelings like fear, guilt, or anger
Being less interested in your normal activities and hobbies
Feeling detached from other people
Having a hard time feeling happy or optimistic

4. Symptoms of feeling on edge (2 or more needed for diagnosis)

Arousal and reactivity symptoms, or feeling on edge, can show up in different ways, including:

Feeling irritable or having angry outbursts
Engaging in reckless or self-destructive behavior
Feeling tense or “on guard”
Being easily startled
Having trouble with concentration or memory
Having sleep problems

Are there different subtypes of PTSD?

Yes, there are two PTSD subtypes. If you have a subtype, this means you have the usual PTSD symptoms — but also have PTSD with dissociation, delayed PTSD, or both.

PTSD with dissociation

People with this subtype have an extra PTSD symptom called “dissociation.” Dissociation is a state of mind where you feel disconnected from yourself, or out of touch with your surroundings.

People who dissociate sometimes feel like they are “watching” themselves from the outside, as if they were a character in a movie. Severe dissociation can also cause amnesia (memory loss), or problems interacting with others.

Delayed PTSD

People with this subtype don’t have full PTSD symptoms until at least 6 months after experiencing trauma. This happens in about 1 in 4 people with PTSD.

What does PTSD feel like?

PTSD feels different for everyone. This is partly because trauma is an individual experience. For example, a war veteran with PTSD may have different symptoms than someone who was physically assaulted.

PTSD also has lots of different symptoms — 20 in total. You only need to have six of these symptoms to be diagnosed with PTSD. This means two people could be diagnosed with PTSD, but each may have very different symptoms.

How do I know if I have PTSD?

To be diagnosed with PTSD, the following must apply to you:

You’ve experienced trauma.
You’ve had symptoms for at least 1 month.
Your symptoms interfere with your daily life.
Your symptoms aren’t caused by substance use.
Your symptoms aren’t caused by another medical problem.

You must also have at least six different PTSD symptoms.

What can trigger PTSD symptoms?

Some PTSD symptoms can be constant, like low mood and negative thoughts. But other symptoms can come and go — and can even be “triggered” by certain experiences.

Triggers can be anything that reminds you of the traumatic event. This can be something obvious, like experiencing a car accident and then hearing about one on the news. But triggers can also be more subtle, like a certain time of day, the quality of the air, or even a subtle smell or taste.

Common triggers include:

Smells
Sounds
Tastes
Images
Being touched
Certain locations
Certain situations
Words and phrases
Newspapers and social media

Can you treat PTSD?

Yes, there are treatments that can help you manage PTSD. PTSD treatments include medications, mental health therapy, community support, and coping strategies.

Certain types of mental health therapy are especially helpful for PTSD, including:

Cognitive processing therapy (CPT)
Prolonged exposure (PE)
Eye movement desensitization and reprocessing (EMDR)
Peer support groups

If you’re struggling with symptoms of PTSD, consider talking with a healthcare professional. Organizations like the National Center for PTSD and Sidran Institute offer a wide variety of free resources, including educational materials, ideas for coping strategies, and even a free smartphone app. They can also help you find professional care — either for yourself or a loved one.

Frequently asked questions

Yes, you can recover from PTSD. How long PTSD symptoms last depends on different factors, such as the trauma and the treatments that you’ve used. Remember that some PTSD symptoms may come and go, while you may experience other symptoms in a more constant way. No matter your situation, there’s support available to help you manage your symptoms.

There are many strategies to calm PTSD, but there’s no single best or fastest approach. If you’re experiencing a PTSD flashback, remind yourself that the traumatic event isn’t actually happening. Practice mindfulness and use grounding techniques like taking deep, slow breaths and naming things you can see, hear, and smell. Take note of things that trigger your PTSD and what works best for you to calm your symptoms.

In some cases, traumatic experiences can last for months, or even years. Sometimes this is called complex PTSD. In addition to the PTSD symptoms listed above, people with complex PTSD can also:

Have a hard time managing strong emotions
Have suicidal thoughts
Feel like “damaged goods”
Have strong feelings of helplessness, guilt, and failure
Struggle to maintain relationships with others
Have many physical symptoms

No. Race-based traumatic stress (RBTS) is a disorder where physical and mental symptoms are caused by experiencing and witnessing race-based trauma and discrimination. It’s different from PTSD, even though many of the symptoms are similar. Though not an official mental health diagnosis, many health professionals now recognize and treat RBTS.

The bottom line

Many people experience a traumatic event at some point in their lives, but most people don’t develop post-traumatic stress disorder (PTSD). Though different factors can increase your risk, such as having a history of childhood trauma, serving in the armed forces, and living with another mental health condition.

Everyone experiences PTSD differently, but there are symptoms to watch for. If you (or someone close to you) has experienced trauma, and you’re having ongoing symptoms, think about reaching out. Help is always available.

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Written by:

Sarah Gupta, MD

Sarah Gupta, MD, is a licensed physician with a special interest in mental health, sex and gender, eating disorders, and the human microbiome. She is currently board certified by the American Board of Psychiatry and Neurology.

Edited by:

Alex Eastman, PhD, RN

Alex Eastman, PhD, RN, is a California-based registered nurse and staff medical editor at GoodRx, where he focuses on clinical updates and Latino health.

Reviewed by:

Farzon A. Nahvi, MD

Farzon Nahvi, MD, is an emergency medicine physician and author of “Code Gray: Death, Life, and Uncertainty in the ER.” He works at Concord Hospital in Concord, New Hampshire, and teaches at the Geisel School of Medicine at Dartmouth.

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