Why Do Some People Get PTSD and Others Do Not?

Post-traumatic stress disorder, or PTSD, is a mental health condition that affects up to 8% of the general population. Though PTSD occurs after witnessing or living through a traumatic event, not everyone who experiences a traumatic event gets PTSD. Similarly, not everyone who experiences the same traumatic event develops PTSD symptoms.

Here, we’ll explore what we know about the risk of developing PTSD after a traumatic event.

What is PTSD, and what are the symptoms?

PTSD is a mental health disorder that some people develop after experiencing or witnessing a traumatic or life-threatening event. These may be experiences such as:

• Sexual assault or abuse

• Domestic violence

• Physical assault or injury

• Military combat

• Natural disasters like a major flood or tornado

• Mass casualty events, such as a mass shooting

• Witnessing death or other physical violence

• A serious motor vehicle accident

• Childbirth trauma, such as the loss of a baby

After a distressing event, PTSD may manifest through the following types of symptoms:

• Re-experiencing: Nightmares, flashbacks, or terrifying thoughts related to the trauma

• Avoidance: Staying clear of places that trigger reminders of a traumatic event or keeping busy to forget the incident

• Arousal and reactivity: Difficulty sleeping, being easily frightened, tenseness, or irritability

• Cognitive and mood symptoms: Inability to recall important aspects of the traumatic event, self-blame or guilt, problems focusing, or loss of interest in once-enjoyable activities

Children may have different PTSD symptoms than adults. For example, children under 6 years old may:

• Wet the bed after being toilet trained

• Have difficulty speaking

• Be unusually attached to a parent or adult

Does everyone develop PTSD after a traumatic experience?

Not everyone who experiences a traumatic event develops PTSD. Around 70% of U.S. adults experience some type of trauma at least once in their lifetime. But only a small number of these people — about 8% — develop symptoms that meet the criteria for a PTSD diagnosis.

Researchers are still unsure why some people develop PTSD. But they have identified several risk factors. For example, genetics may contribute to your PTSD risk. We’ll explore some other factors below. 

Types of trauma that have a higher association with PTSD

Any trauma can lead to PTSD. However, research suggests that directly experiencing a traumatic event or being injured may increase your risk for PTSD. For example, as many as 20% of soldiers coming back from war zones in Afghanistan and Iraq were diagnosed with PTSD.

Sexual assault and other types of sexual trauma have also been linked to an increased likelihood of developing PTSD. In fact, one study showed that approximately 45% of women who survived a rape developed PTSD. 

How socioeconomic factors change the risk of developing PTSD

Socioeconomic factors refer to characteristics about your life such as income, education, and access to food, housing, and healthcare. Research has linked various aspects of having a lower socioeconomic status to higher rates of PTSD. For example:

• Racial-based discrimination can have serious physical effects on victims, and when prolonged, can cause PSTD symptoms. 

• Food insecurity, or not having enough access to food, has been tied to PTSD, anxiety, and depression in both adults and children.  

• Refugees and asylum seekers face a significantly greater risk of developing PTSD because of exposure to threats of torture, a lack of basic human necessities like food and shelter, or separation from their families. 

How risk and resilience factors affect PTSD development

While risk factors increase a person’s likelihood of developing PTSD, resilience factors decrease the likelihood. Having multiple resilience factors can help protect you from developing PTSD after a traumatic event. 

Risk factors include:

• Experiencing childhood trauma

• Experiencing severe or repeated trauma

• Working in a high-risk job, like as a member of the armed forces

• Being taken into foster care as a child

• Being a refugee or asylum seeker

• Having no or very little social support

• Having a personal or family history of mental health or substance use issues

Resilience factors, on the other hand, include:

• Getting social support from loved ones or joining a support group

• Finding positive ways to cope with the traumatic event, such as art-based therapies like reading, writing, or music

• Learning to manage emotions such as fear

• Avoiding unhelpful coping mechanisms, such as misusing substances or pulling away from other people

• Reaching out for professional mental health support if needed

One study also found that hope, optimism, and feeling confident in your abilities may help prevent PTSD. Working with a mental healthcare provider can help you find ways to build your confidence and sense of well-being.

How to get help for PTSD

If you experienced a traumatic event and are having trouble coping, it’s a good idea to speak with your healthcare provider. They can help you determine if you have PTSD as well as recommend treatment options. 

Treatment for PTSD typically includes a combination of psychotherapy and medication. You can find mental health professionals who specialize in PTSD by searching the following websites: 

• Psychology Today

• Good Therapy

• Therapy Den

• EMDRIA Therapist Directory

• QPoC Therapist Directory

• Gaylesta (LGBTQ therapists)

• InnoPsych (BIPOC therapists)

• Open Path Psychotherapy Collective (low-cost therapy)

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Written by:

Kara-Marie Hall, RN, BSN, CCRN

Kara-Marie Hall, RN, BSN, CCRN, is a registered nurse who specializes in writing health content that connects with everyone — no matter where they are in their health journey. She has over 10 years of clinical experience in a variety of specialties, including critical care, surgery, and hospice.

Edited by:

Renée Fabian, MA

Renée Fabian is the senior pet health editor at GoodRx. She’s worked for nearly 10 years as a journalist and editor across a wide range of health and well-being topics.

Reviewed by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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