Understanding

PTSD

Produced by the National Center for PTSD | July 2010 

U.S. Department of Veterans Affairs 

www.ptsd.va.gov

Have you, or someone you love 

Been through combat? 

Lived through a disaster? 

Been raped? 

Experienced any other kind of traumatic event? 

Have you ever thought that painful memories of that experience were still causing problems for you or a loved one?

You may have heard of PTSD—posttraumatic stress disorder—on the news or from friends and family, and wondered 

what it is, or whether you or someone you know has it. 

This booklet will help you understand what PTSD is. You’ll learn how to get help for yourself, a friend, or a family 

member. It includes stories from people who have gotten help for their PTSD and have returned to their normal lives, 

activities, and relationships.

The important thing to remember is that effective treatment is available. 

This guide covers:

What Is PTSD? .....................2 

Getting Help........................6

Resources.............................8

You don’t have to live with your symptoms forever.
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What Is PTSD?

PTSD

Posttraumatic stress disorder, or PTSD, can occur after 

someone goes through, sees, or learns about a traumatic 

event like:

•	 Combat exposure

•	 Child sexual or physical abuse

•	 Terrorist attack

•	 Sexual/physical assault

•	 Serious accident

•	 Natural disaster 

Most people have some stress-related reactions after a 

traumatic event. If your reactions don’t go away over time 

and they disrupt your life, you may have PTSD.

See the next few pages for common reactions to trauma 

and PTSD symptoms.

How Common Is PTSD?

Many Americans have had a trauma. About 60% of men 

and 50% of women experience at least one traumatic event. 

Of those who do, about 8% of men and 20% of women will 

develop PTSD. For some events, like combat and sexual 

assault, more people develop PTSD.

Men 8% Develop PTSD

61% 

Experience 

Trauma

Women

20% Develop PTSD

51% 

Experience 

Trauma
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What Are Some Common Stress Reactions after a Trauma?

It is normal to have stress reactions after a traumatic event. Your 

emotions and behavior can change in ways that are troubling to you.

Fear or anxiety 

In moments of danger, our bodies prepare to fight our enemy, flee 

the situation, or freeze in the hope that the danger will move past 

us. But those feelings of alertness may stay even after the danger 

has passed. You may:

•	 feel tense or afraid

•	 be agitated and jumpy

•	 feel on alert

Sadness or depression 

Sadness after a trauma may come from a sense of loss---of a loved 

one, of trust in the world, faith, or a previous way of life. You may:

•	 have crying spells

•	 lose interest in things you used to enjoy

•	 want to be alone all the time

•	 feel tired, empty, and numb

Guilt and shame

You may feel guilty that you did not do more to prevent the trauma. 

You may feel ashamed because during the trauma you acted in ways 

that you would not otherwise have done. You may:

•	 feel responsible for what happened

•	 feel guilty because others were injured or killed and you 

survived

Anger and irritability

Anger may result from feeling you have been unfairly treated. 

Anger can make you feel irritated and cause you to be easily set 

off. You may:

•	 lash out at your partner or spouse

•	 have less patience with your children

•	 overreact to small misunderstandings

Behavior changes 

You may act in unhealthy ways. You may:

•	 drink, use drugs, or smoke too much

•	 drive aggressively

•	 neglect your health

•	 avoid certain people or situations

Most people will have some of these 

reactions at first, but they will get better 

at some time. If symptoms last longer 

than three months, cause you great 

distress, or disrupt your work or home life, 

you should seek help.
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What Are the Symptoms of PTSD?

PTSD has four types of symptoms.

Reliving the event (also called reexperiencing) 

Memories of the trauma can come back at any time. 

You may feel the same fear and horror you did when the 

event took place. You may have nightmares or feel like 

you’re going through it again. This is called a flashback. 

Sometimes there is a trigger—a sound or sight that causes 

you to relive the event.

•	 Seeing someone who reminds you of the trauma may 

bring back memories of the event.

•	 You may think about the trauma at work or school 

when you need to concentrate on something else.

Avoiding situations that remind you of the event

You may try to avoid situations or people that trigger 

memories of the traumatic event. You may even avoid 

talking or thinking about the event.

•	 You may avoid crowds, because they feel dangerous.

•	 If you were in a car accident or if your military convoy 

was bombed, you may avoid driving.

•	 Some people may keep very busy or avoid seeking 

help. This keeps them from having to think or talk 

about the event.

Feeling numb 

You may find it hard to express your feelings. This is 

another way to avoid memories. It may also be hard to 

remember or talk about parts of the trauma.

•	 You may find it hard to experience your emotions.

•	 You may not have positive or loving feelings toward 

other people and may stay away from relationships.

•	 You may not be interested in activities you used to 

enjoy, like spending time with family and friends.

Feeling keyed up (also called hyperarousal) 

You may be jittery, or always on the alert and on the 

lookout for danger. You might suddenly become angry or 

irritable. This is known as hyperarousal.

•	 You may want to have your back to a wall in a 

restaurant or waiting room.

•	 A loud noise can startle you easily.

•	 If someone bumps into you, you might fly into a rage.

Real Stories: Teresa

“Now I’ve got a great support 

team. I owe a tremendous 

thanks to my counselor.”

On a military mission, the truck in front of Teresa’s 

went over a roadside bomb, and there were no 

survivors. She was badly injured in the explosion, 

but the person in the seat where Teresa was 

supposed to have been was injured much worse. 

Teresa felt guilty about that.

After returning home, Teresa started having 

nightmares and panic attacks. The awful images 

of that day haunted her. The medicines she was 

prescribed for her anxiety and sleep problems 

didn’t seem to help. She didn’t want to leave 

the house, go to work, or do anything. One day 

she lost control and verbally abused her platoon 

leader. Her first sergeant stepped in and insisted 

that she see a psychiatrist. 

Teresa was diagnosed with PTSD. She’s doing 

better thanks to treatment at her local VA. 

Although Teresa’s problems have not gone away, 

she now has a great support team to help her. 
www.ptsd.va.gov 5

What Other Problems Do People 

with PTSD Experience?

People with PTSD may feel hopelessness, shame, or 

despair. Employment and relationship problems are also 

common. Depression, anxiety, and alcohol or drug use 

often occur at the same time as PTSD. In many cases, the 

PTSD treatments described in the Getting Help section 

will also help these other disorders, because the problems 

are often related and the coping skills you learn work for 

all of them.

How Likely Is a Person to Develop 

PTSD after a Trauma?

How likely you are to get PTSD can depend on things like:

•	 How intense the trauma was or how long it lasted

•	 If you lost someone you were close to or if you were hurt

•	 How close you were to the event

•	 How strong your reaction was

•	 How much you felt in control of events

•	 How much help and support you got after the event

Some groups of people may be more likely than others 

to develop PTSD. You are more likely to develop PTSD 

if you:

•	 Are female or a minority

•	 Have little education 

•	 Had an earlier life-threatening event or trauma

•	 Have another mental health problem

•	 Have family members who have had mental health 

problems

•	 Have little support from family and friends

•	 Have had recent, stressful life changes

Real Stories: Frank

“It was nice to know there was a 

reason for what I was doing.”

Frank served our country in Vietnam. Before 

the war, he had been a happy person, but 

he rarely smiled once he came home. 

For many years, Frank didn’t talk about 

Vietnam, thinking he would spare people. 

He started drinking more. He had a short 

temper, and had to have his back to the 

wall in restaurants because he kept thinking 

someone was after him. He couldn’t hold a 

job or have a successful relationship. He just 

felt that something was wrong. Frank didn’t 

realize it, but he was having many of the 

symptoms of PTSD.

Frank went to the VA, where he was 

diagnosed with PTSD and given treatment 

and support. He’s doing much better now.

“I would definitely recommend 

any Veteran go and get help.”
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G etting Help

When Should a Person Get 

Evaluated for PTSD?

If you continue to be upset for more than three months, 

seek help. You can feel better!

Who Can Conduct an Evaluation, 

and What Does It Consist of?

PTSD is usually diagnosed in one or two sessions. Your 

doctor or a mental health professional will evaluate you. 

You will be asked about your trauma and symptoms. You 

may also be asked about other problems you have. Your 

spouse or partner may be asked to provide information.

The Department of Veterans Affairs has a PTSD 

questionnaire that you can take online. You can also take 

the screening test below. 

If you find that you answered “yes” to many of the 

questions asked, you may have PTSD. It is best to talk to a 

mental health professional to find out for sure.

PTSD Screen

In your life, have you ever had any experience that was so frightening, horrible, or upsetting that, 

in the past month, you:

❑ Have had nightmares about the experience or thought about it when you did not want to? 

❑ Tried hard not to think about the experience or avoided situations that reminded you of it? 

❑ Were constantly on guard, watchful, or easily startled? 

❑ Felt numb or detached from others, activities, or your surroundings?

Current research recommends that if you answered “yes” to any three items, you should seek 

more information from a mental health care provider. A positive screen does not mean that you 

have PTSD. Only a qualified mental health care practitioner, such as a clinician or psychologist, can 

diagnose you with PTSD.
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What Treatments Are Effective for PTSD?

There are good treatments available for PTSD. The 

two main types are psychotherapy, sometimes called 

“counseling,” and medication. Sometimes people combine 

psychotherapy and medication. 

Psychotherapy 

Cognitive Behavioral Therapy (CBT) is the most effective 

treatment for PTSD. CBT usually involves meeting with 

your therapist once a week for 3-6 months. There are 

different types of CBT that are effective for PTSD. 

Cognitive Processing Therapy (CPT) is a CBT in which 

you learn skills to better understand how a trauma changed 

your thoughts and feelings. It will help you see how you 

have gotten “stuck” in your thinking about the trauma. It 

helps you identify trauma-related thoughts and change 

them so they are more accurate and less distressing.

Prolonged Exposure (PE) therapy is a CBT in which you 

talk about your trauma repeatedly until the memories are 

no longer upsetting. You also go into situations that are safe 

but which you may have been avoiding because they are 

related to the trauma.

Eye Movement Desensitization and Reprocessing (EMDR)

involves focusing on distractions like hand movements or 

sounds while you talk about the traumatic event. Over time, it 

can help change how you react to memories of your trauma.

Medication 

Selective Serotonin Reuptake Inhibitors (SSRIs) can 

raise the level of serotonin in your brain, which can 

make you feel better. The two SSRIs that are currently 

approved by the FDA for the treatment of PTSD are 

sertraline (Zoloft) and paroxetine (Paxil).

Sometimes, doctors prescribe medicines called 

benzodiazepines for people with PTSD. These medicines 

are often given to people who have problems with 

anxiety. While they may be of some help at first, they 

do not treat the core PTSD symptoms. They may lead 

to addiction and are not recommended for long-term 

PTSD treatment.

Real Stories: Gina

Gina had a great job, a loving husband, and a beautiful home. But 

she was miserable. Some days, a kiss from her husband would 

make her heart start pounding, and she would feel very afraid. She 

did not realize that these panicky feelings were flashbacks—the 

rexperiencing of the feelings that she had felt when she was a small 

child and couldn’t protect herself. 

Gina sought help. She went to a therapist, and finally revealed that 

her uncle had repeatedly sexually abused her as a child. Her therapist 

diagnosed PTSD, and started cognitive behavioral therapy with Gina. 

Therapy taught her to challenge her thoughts and feel less distress. 

She still has occasional flashbacks and panic attacks, but they’re now controllable, and she knows they will 

pass. Before, she thought she’d always have to live with the flashbacks and bad feelings. Now, she can go 

weeks without thinking about the abuse, and she feels certain that someday it will be years.

“You can be a normal thriving 

person and have mental 

health issues, get help for 

those, and still be okay.”
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R esources

How Can I Learn More About PTSD?

View the multimedia companion to this brochure and 

other resources at www.ptsd.va.gov/public/

In a Crisis?

•	 Call 911

•	 Go to an emergency room

•	 Call 1-800-273-TALK (1-800-273-8255) 

(Español: 1-888-628-9454) 

Veterans, go to 

www.suicidepreventionlifeline.org/Veterans to 

chat live with a crisis counselor

Where Can I Get Help for Myself 

or a Family Member?

These links are accessible online at http://www.ptsd.

va.gov/public/where-to-get-help.asp

•	 Where to Get Help for PTSD

•	 Mental Health Services Locator

•	 VA PTSD Program Locator

This guide was created by the National Center for PTSD, U.S. Department of Veterans Affairs. The Center conducts research and 

education on trauma and PTSD. Our website offers extensive information, educational materials, and multimedia presentations 

for a variety of audiences, including Veterans and their families, providers, and researchers. Website: www.ptsd.va.gov