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This information is for anyone who is experiencing post-traumatic stress disorder (PTSD), or who knows someone who is.

There  are several possible explanations for what causes PTSD. 

Psychological 

The psychological symptoms of PTSD are deeply unpleasant and distressing. However, these symptoms can make sense when we think about how our minds might work to protect us after a traumatic event.
 

Memory

After experiencing a traumatic event we might be unable or unwilling to remember it. Although it can be distressing to remember what has happened, doing so can help us to make sense of the event. This can be helpful for our mental health.

Intrusive thoughts or flashbacks

These can be seen as replays of what happened. They might force us to think about what has happened so we might be better prepared if it were to happen again. However, in PTSD these thoughts just cause us to feel distressed. 

Avoidance and numbing

It is tiring and distressing to remember a trauma. Avoidance and numbing can help you to stop thinking about what happened. However, they also stop you from making sense of your experiences.
 
Hypervigilance

If we are ‘on guard’, we might feel prepared to react quickly if another crisis happens. It can also give us the energy for the work that’s needed after an accident or crisis. However, it can also be exhausting and prevent us from doing things we used to enjoy. 

Physical 

Some of the physical symptoms that occur with PTSD occur because our bodies are trying to incorrectly process trauma. 

Adrenaline

This is a hormone our bodies produce when we are under stress. It helps to prepare our bodies for activities that need a lot of energy, for example, running or fighting someone off. When the stress disappears, the level of adrenaline should go back to normal. In PTSD, vivid memories of the stressful event can keep the levels of adrenaline high. High levels of adrenaline can make you tense, irritable and unable to relax or sleep well. 

The hippocampus 

This is a part of the brain that processes memories. High levels of stress hormones, like adrenaline, can stop it from working properly. This means that memories of the traumatic event aren’t processed. This can cause you to remember the event as though the risk is still present, rather than seeing it as something that happened in the past. 

Are there careers where someone is more likely to get PTSD? 

Anyone can get PTSD if they have experienced a traumatic event. However, some people have jobs that mean they are more likely to experience traumatic events. This means that the risk of them developing PTSD is higher than in other careers. These jobs can include: 

• Emergency service workers (e.g. police, fire brigade or ambulance staff) 
• Social workers 
• Intensive care staff 
• Military personnel and other people working in war zones 

When does PTSD start? 

The symptoms of PTSD can start immediately after a traumatic event, or even weeks or months afterwards. Usually, symptoms start within 6 months of the event. Sometimes symptoms will start after 6 months, though this is less common. Unfortunately, many people will not ask for help when their symptoms first start. 

PTSD cannot be diagnosed in the first month after a traumatic event. If you experience trauma symptoms straight away, and these are severe and prevent you from functioning, you might be experiencing an 'acute stress disorder'. 

Why doesn't everyone get PTSD after a traumatic experience? 

After a traumatic experience, many people will have some trauma symptoms for the first month or so. Many of these symptoms are normal reactions to experiencing real or perceived danger. You can think about them as your brain’s way of protecting you from harm. 
However, most people will process what has happened after a few weeks, or sometimes a little longer, and their stress symptoms will start to disappear. 

Research shows that certain groups of people are at increased risk of developing PTSD. The risk of developing PTSD is decreased if someone can: 

• access social support and 
• recover from the traumatic event in a ‘low stress environment’. 

What events are more likely to cause PTSD? 

Any traumatic event can cause PTSD, although the more disturbing the experience, the more likely you are to develop PTSD. For example, you might be more likely to develop PTSD if the event: 

• is sudden and unexpected 
• goes on for a long time 
• happens when you are trapped and can’t get away 
• is man-made 
• causes many deaths 
• causes mutilation 
• involves children. 

If you continue to be exposed to stress and uncertainty, this will make it more difficult for your PTSD symptoms to improve.

 
How do I know when I've got over a traumatic experience? 

You may have got over a traumatic event if you can: 

• think about it without becoming overly distressed 
• not feel constantly under threat 
• not think about it at inappropriate times. 

Why is PTSD not always diagnosed? 

There are a number of reasons why someone with PTSD might not be diagnosed. 

 

Stigma and misunderstanding 

People with PTSD will often avoid talking about how they are feeling so they don’t have to think about the traumatic event. Some people feel that the symptoms they are experiencing (for example, avoidance and numbing) are helping them to cope, and don’t realise that they are caused by PTSD. When someone is very unwell, they can find it hard to believe that they will return to how they felt before the traumatic event. This can put them off getting help. There is also a common misunderstanding that only people in the armed forces get PTSD. In fact, PTSD can happen to anyone, and every experience of PTSD is valid. 

Incorrect diagnosis 

Some people who have PTSD might be incorrectly diagnosed with conditions like anxiety or depression. Some people will have other psychological or physical health problems that mean their PTSD goes unnoticed. They might also have ‘medically unexplained physical symptoms’ such as: 

• gastrointestinal difficulties 
• pain syndromes 
• headaches 

These symptoms can mean that their PTSD is identified as something else.

Other challenges

Some people with PTSD might also have other challenges, such as relationship difficulties or dependence on alcohol or drugs. These might be caused by their PTSD, but can be more obvious than the PTSD itself. 

Can children get PTSD?

PTSD can develop at any age. As well as the symptoms of PTSD experienced in adults, children can also experience:

Frightening dreams
In children, these dreams may or may not reflect the actual traumatic event. 

Repetitive play
Some children will act out the traumatic event when they are playing. For example, a child involved in a serious road traffic accident might re-enact the crash with toy cars.

Physical symptoms
They might complain of stomach aches and headaches.

Fear that their life will end soon
They may find it hard to believe that they will live long enough to grow up.