Posttraumatic Stress Disorder (PTSD)

Reviewed/Revised Sep 2024
VIEW PROFESSIONAL VERSION
Get the full details

What is posttraumatic stress disorder (PTSD)?

Posttraumatic stress disorder (PTSD) is when memories of a highly upsetting event keep coming back, over and over, to invade your thoughts. This lasts for more than a month and can go on for much longer. These memories can be very scary, realistic, and upsetting.

  • PTSD starts within 6 months of a highly upsetting event

  • Life-threatening events can cause intense, long-lasting upset, worry, and nervousness

  • You may relive the event in your mind, have nightmares, or avoid anything that reminds you of the event

  • Treatment may include exposure therapy and antidepressant medicine

What causes PTSD?

PTSD can happen when you (or someone you are close to) experiences a highly upsetting event. You may feel haunted by the intense fear, helplessness, or horror you or someone else felt during the event.

Events that can cause PTSD include:

  • Being in war or combat

  • Experiencing or witnessing rape and violence

  • Natural disasters (such as a hurricane)

  • Serious car crashes

About 1 out of 10 people will have PTSD sometime in their lifetime. Children can also have PTSD.

What are the symptoms of PTSD?

PTSD has several types of symptoms:

  • Intrusion symptoms

  • Avoiding anything that reminds you of the event

  • Negative thinking or mood

  • Changes in alertness

Intrusion symptoms include:

  • Repeated, unwanted memories of the event that keep coming back

  • Nightmares of the event

  • Flashbacks (reliving your memory of the event as though it's currently happening)

  • Strong emotional or physical distress when something reminds you of the event (such as getting in a boat after a near-drowning accident)

Symptoms of negative thinking include:

  • Not being able to remember important parts of the event (dissociative amnesia)

  • Feeling emotionally numb or disconnected from other people

  • Depression—feeling tired and sad most of the time, or having a hard time sleeping or paying attention

  • Less interest in activities you used to like

  • Feelings of guilt about the event

  • Feeling only negative emotions (such as fear, anger, or shame) and may be unable to feel happy or satisfied or to love

Symptoms of a change in alertness and reactions include:

  • Hard time falling asleep or paying attention

  • Easily scared or constantly watching out for danger

  • Giving little thought to putting yourself in a dangerous situation

  • Angry outbursts

How can doctors tell if I have PTSD?

Doctors look for a connection between your symptoms and any highly upsetting events you or your loved ones have experienced. They ask how it stops you from doing daily activities.

How do doctors treat PTSD?

Treatment includes:

  • Exposure therapy, when your therapist has you imagine being in situations that remind you of a highly upsetting event or remember the event—for example, therapists may have you imagine being in the park where you were attacked and talk you through the event you're imagining so that you feel safe and calm (over time, this helps many people feel better)

  • Antidepressant medicine, especially selective serotonin reuptake inhibitors (SSRIs)

  • Medicine that can help you not have nightmares

Long-term PTSD may not go away but often gets better over time even without treatment. However, for some people, PTSD severely affects daily living, and they continue to need treatment.

quizzes_lightbulb_red
Test your KnowledgeTake a Quiz!
Download the free Merck Manual App iOS ANDROID
Download the free Merck Manual App iOS ANDROID
Download the free Merck Manual App iOS ANDROID