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People who have been exposed to traumatic experiences may notice any number of symptoms in almost any combination. The symptoms for PTSD are divided into three categories, as described below.
Intrusive Re-experience of the Trauma
People with PTSD frequently re-experience the trauma through distressing recollections. This is sometimes called a flashback, reliving experience or abreaction. The person may have intrusive pictures in his/her head about the trauma, have recurrent nightmares or may even experience hallucinations about the trauma. Intrusive symptoms sometimes cause people to lose touch with the "here and now" and react in the same fight-or-flight ways that they did when the trauma originally occurred. For example, many years later a victim of child abuse may hide trembling in a closet when feeling threatened, even if the perceived threat is not abuse-related.
People with PTSD work hard to avoid anything that might remind them of the traumatic experience. They may try to avoid people, places or things that are reminders, as well as numbing out emotions to avoid painful, overwhelming feelings. Numbing of thoughts and feelings in response to trauma is known as "dissociation." People with PTSD will typically use drugs or alcohol to avoid trauma-related feelings and memories.
Symptoms of psychological and physiological arousal are very distinctive in people with PTSD. They may be very jumpy, easily startled or irritable and may have sleep disturbances like insomnia or nightmares. They may seem constantly on guard and may find it difficult to concentrate. Sometimes persons with PTSD will have panic attacks accompanied by shortness of breath and chest pain.
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