PTSD: When the Past Takes Over the Present
The threat is gone. Why is my nervous system still on alert?
After a traumatic experience, your sense of safety can continue to be impacted long after the danger has passed. A slammed door may trigger a startle response. A particular smell may bring back an unwanted memory. Or you may find yourself fearful or on edge, even in perfectly safe situations. These reactions can be confusing, especially if you (and others) feel you should have moved on from what happened.
Post-traumatic stress disorder (PTSD) is one of the most common mental health disorders in the United States.[1] Fortunately, PTSD is treatable; with appropriate, evidence-based care, many people experience meaningful improvements in their symptoms and quality of life.
While a trusted mental health professional should assist you in exploring individualized, trauma-focused treatment options appropriate to your situation, this article aims to provide you with a better understanding of PTSD by exploring:
- The nature, signs, and symptoms of PTSD.
- Potential causes and types of PTSD.
- Diagnosis of PTSD and effective treatment options.
- How individualized, trauma-focused treatment at Mission Connection can help.
What Is PTSD? Understanding How Trauma Affects the Mind and Body
Post-traumatic stress disorder (PTSD), a debilitating condition that can develop after exposure to a deeply traumatic event, can have a long-term impact on how you feel, think, sleep, and navigate everyday life.[1]
It is entirely normal to have emotional and physical reactions to traumatic events. For many people, these responses gradually decrease in frequency and intensity over time. If symptoms persist beyond a month, intensify, and begin to impact your ability to function, it may be time to seek professional support and assessment from a mental health professional.
What Does PTSD Feel Like? Recognizing the Signs and Symptoms
PTSD can manifest in a number of clinically significant ways, ultimately leading to emotional overwhelm, intense physical distress, and feelings of extreme helplessness.
Symptoms can be separated into four distinct categories:[2]
Re-Experiencing:
- Dreams/nightmares related to the event
- Flashbacks and/or recurring memories of the event
- Emotional distress and/or physical distress as a result
Avoidance:
- Avoiding thoughts, feelings, or conversations related to the event
- Avoiding people, places, or activities that are reminders of the event
Arousal & Reactivity:
- Hypervigilance
- Sensitive startle response
- Sleep disturbances
- Poor concentration
- Irritability, aggression, and/or angry outbursts
- Risky, reckless, or destructive behavior
Cognition & Mood:
- Increased social isolation
- Difficulty feeling positive emotions
- Loss of interest in previous activities
- Negative thoughts about self and/or the world
- Difficulty remembering aspects of the event
- Intense feelings of blame directed toward oneself or others
- Ongoing negative emotions (fear, anger, guilt, shame, etc.)
Why Do Some People Develop PTSD After Trauma?
The National Institute of Mental Health identifies several risk factors that make individuals more susceptible to PTSD.[2] These include:
- Lack of social support.
- Repeated and/or childhood trauma.
- Subsequent and ongoing life stressors.
- Sustaining serious injuries from the event.
- Occupational/environmental exposure.
- Personal/family mental health history.
It is important to note that having these risk factors does not guarantee a future PTSD diagnosis.
Additionally, PTSD doesn’t look the same for everyone. Some people move on from a traumatic experience without developing PTSD, while others find themselves in chronic survival mode. Individuals who go through similar experiences can also have varied responses. While some might constantly scan their surroundings, others may withdraw or become emotionally numb.
Most importantly, developing PTSD is not a sign of weakness, nor is it anything to be ashamed of.
How Can PTSD Present Differently from Person to Person?
The different variations of PTSD are categorized by symptom onset, extent of impact, and nature of the trauma experienced. Commonly discussed subtypes include:[3]
- Uncomplicated PTSD.
- Complex PTSD.*
- Delayed Expression PTSD.
- Dissociative PTSD.
Each describes a different pattern of trauma-related symptoms and experiences, although these categories can overlap. Understanding the distinctions can help explain why two people who have lived through traumatic experiences may respond in very different ways.
The following chart explains the key characteristics and differences between the four types of PTSD.
| Type | Key Characteristics | What Makes It Different |
| Uncomplicated PTSD | Flashbacks, nightmares, avoidance, and feeling constantly on edge. | Core PTSD symptoms following a traumatic experience. |
| Complex PTSD (C-PTSD)* | PTSD symptoms alongside shame, difficulty managing emotions, and relationship struggles. | Often associated with prolonged or repeated trauma. |
| Delayed Expression PTSD | Symptoms become severe enough to meet PTSD criteria six months or more after trauma. | Symptoms may emerge gradually rather than immediately. |
| Dissociative PTSD | Feeling disconnected from yourself or as though the world around you isn’t real. | Includes recurring feelings of depersonalization or derealization. |
* Complex PTSD is recognized as a separate diagnosis in the ICD-11.
Mission Connection is here to help you or your loved one take the next steps towards an improved mental well-being.
Diagnosing PTSD: When Trauma Symptoms Become More Than a Passing Response
While there are self-screening tools for PTSD widely available online, their purpose is to determine the need for you to see a psychiatrist or any other mental health professional who is licensed to diagnose patients.
Only a qualified mental health professional can conduct a clinical assessment to evaluate your recent trauma exposure, symptoms and their duration, level of functional impairment, and co-occurring conditions.
To receive an official PTSD diagnosis from your provider, your symptoms must meet the American Psychiatric Association’s criteria. More specifically, in order to be diagnosed with PTSD, an adult must have all the following for at least 1 month:[2]
- At least one re-experiencing symptom
- At least one avoidance symptom
- At least two arousal and reactivity symptoms
- At least two cognition and mood symptoms
Finding a Way Forward: Treatment Options for PTSD
The most effective and well-supported treatments for PTSD are trauma-focused therapies.[4][5] Research from the National Center for PTSD even indicates that therapy is generally more successful and has longer-lasting results than medication alone.
Prolonged Exposure Therapy (PE): individuals gradually and safely address trauma-related memories, feelings, and situations so they feel less frightening over time.
Cognitive Behavioral Therapy (CBT): CBT focuses on the connection between your thoughts, feelings, and behaviors. When you experience a trauma, your brain may form distorted beliefs about safety, blame, and danger. CBT helps recalibrate your nervous system by utilizing these interventions:
- Cognitive Restructuring: Identifying, challenging, and reframing negative thoughts
- Controlled Exposure: Gradually addressing trauma-related memories, feelings, or real-life triggers to confront fear and avoidance
- Skill Building: Practicing relaxation training, deep breathing, stress management, and crisis coping strategies
- Psychoeducation: Learning about common physical and emotional reactions to trauma
Cognitive Processing Therapy (CPT): A form of CBT that helps individuals identify, process, and challenge negative beliefs resulting from the trauma.
Eye Movement Desensitization and Reprocessing (EMDR): Individuals focus on traumatic memories while engaging in side-to-side eye movements or hand taps, which helps reduce the intensity of the memories
Additionally, certain medications have been approved by the FDA to help alleviate anxiety, low mood, and intrusive thoughts. Alternative approaches – like yoga, exercise, meditation, mindfulness, and support groups – can reduce isolation, alleviate sleep issues, and improve overall nervous system health.
What Does Recovery from PTSD Look Like?
If you have PTSD, recovery is within reach and generally happens in progressive stages. Many individuals undergo treatment until they no longer meet the clinical DSM-5 criteria for a PTSD diagnosis. For others, symptoms may not disappear completely, but they become much less intense, allowing people to regain control, stability, and a better quality of life.
It’s important to remember that healing and progress are not linear. Setbacks are expected, temporary, and a normal part of processing trauma.
When Is It Time to Seek Help for PTSD?
First and foremost, if you are experiencing thoughts of self-harm or suicide, seek emergency care immediately by calling 911 or going to the nearest emergency room.
If your PTSD symptoms are significantly impacting your ability to function, you should consider seeking professional help in the form of either inpatient hospitalization or residential, trauma-focused treatment. Signs of severely impaired functioning include:
- Extreme emotional and physical distress from symptoms.
- Consistent, unmanageable flashbacks and panic attacks.
- Growing curiosity around and/or engaging in self-destructive behaviors.
- Unstable home, academic, or occupational environment.
- Dealing with complex trauma and/or co-occurring disorders.
- Ineffective outpatient treatment or medication(s).
Treatment can provide you with the opportunity to process your trauma in a safe environment with the support of dedicated professionals.
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Get Help to Recover From PTSD at Mission Connection
Many people choose not to seek help until their symptoms and lives become unmanageable. You don’t need to wait until you’ve lost three nights of sleep or freeze at the sound of sirens approaching. Treatment is available to you from the earliest stages of your trauma-processing journey.
At Mission Connection, we provide outpatient, trauma-focused treatment that includes individual therapy, group therapy, and medication management. Our convenient blend of telehealth and in-person care is tailored to meet your needs. Mission Connection’s clinicians are highly trained in a variety of therapeutic modalities, ensuring that you are offered comprehensive, individualized care.
Mission Connection is Joint Commission-accredited with locations in California, Virginia, and Washington. We also accept most major insurance providers.
Healing doesn’t mean forgetting what happened or pretending it didn’t affect you. It means learning to process those experiences in a way that allows you to feel safer in the present, regain a sense of stability, and feel more hopeful about the future. You’ve already made it through the experience – you deserve support as you navigate what comes next.
Reach out to us online or call us at 866-458-3875 to find out how we can support you.
