Recognizing PTSD

Recognizing PTSD, by Jill Drummond

Are you wondering if you or a loved one are experiencing symptoms of PTSD?  I’m glad you’re wondering.  Because the first step toward getting needed help is awareness.  So let’s start by looking at several categories of symptoms that make up this complex disorder we call PTSD.

Re-experiencing Symptoms

The most dramatic symptoms of PTSD, and the ones we seem to hear most about, are the “re-experiencing symptoms.”  PTSD affects people who have experienced or witnessed a terrifying event, often involving violence. The memory of such a traumatic event might return at any time.  Here are some examples of re-experiencing symptoms:

    • unpleasant intrusive memories
    • “flashbacks,” where a person feels as if they are actually going through the event again.  They might feel the same emotions (fear, horror) and body sensations (racing heart, rapid breathing, sweating) that they experienced at the time the event took place.  This is what we call a “fight-or-flight” response.
    • Nightmares, which can also feel very real.

Re-experiencing symptoms can be triggered by things that tap into the old memory.  These triggers can include sounds, sights, smells, or almost anything that is similar to some aspect of the original event.  Examples of common triggers are cars backfiring, helicopters flying overhead, unwanted sexual advances (for a rape victim), news reports, images in the media, the smell of burning fuel, etc.

Avoidance Symptoms

Another group of symptoms includes avoidance behaviors.  There is a natural human tendency to try to avoid situations that remind us of a horrifying event or that bring on distressing feelings and re-experiencing symptoms.  A person may begin to avoid situations or people that remind them of the event, and may avoid talking or thinking about it.  Some common avoidance behaviors include:

  • avoiding crowds
  • isolating from other people
  • avoiding places and events that remind them of the trauma
  • keeping overly busy and distracted to prevent thinking about the event
  • drinking or using drugs to avoid unpleasant feelings (“self-medicating”).

Anything done to excess may become an avoidance behavior, if its purpose is to push away unpleasant memories and feelings or to avoid certain situations.

Hyperarousal Symptoms

Hyperarousal means that a person’s nervous system is aroused to an unnecessarily high level, even when there are no real threats present.  A person with PTSD might:

  • feel always on the alert, on the lookout for danger.
  • have trouble falling or staying asleep.
  • be easily startled by loud noises or sudden movements.
  • have trouble concentrating or staying focused.
  • feel more comfortable sitting with their back against a wall in a public place.
  • feel anxious, jittery, irritable and easily angered.  Anger can flare into rage.
  • react to small stressors with an exaggerated response.

Subtler Symptoms

Here are the symptoms I want you to pay particular attention to.  I think of this last category as the “subtler symptoms.”   They are less obvious than re-experiencing, avoidance, or hyperarousal symptoms.   The reason they’re important is that sometimes, during treatment, they take a back seat to the more dramatic symptoms.  They’re not as easy to spot, and a vet (or trauma survivor) may not be talking about them.  And if they aren’t treated, they can become painfully unpleasant chronic effects of PTSD, long after the more dramatic symptoms have subsided.

So let’s take a look at some of the subtler symptoms of PTSD.  Many people with PTSD experience negative changes in their emotions and beliefs, which can leave them feeling devoid of the normal pleasure they once felt in being alive.  They may:

  • think the world is completely dangerous and that no one can be trusted.
  • experience a continuous sense of dread.
  • have a hard time relating to and getting along with their spouse, family and friends, especially with those who have never been exposed to the same trauma.
  • feel disconnected and emotionally cut off from others, and may begin to withdraw from close relationships.
  • lose interest in things they used to enjoy, or feel generally numb.
  • have trouble feeling positive feelings at all.
  • have trouble imagining a future for themselves.
  • feel guilt at surviving when others didn’t, which may rob them of the enjoyment of being alive.

All of the above symptoms can bring on feelings of depression and hopelessness.  If there is sleep deprivation because of the fear of nightmares, or if there is substance abuse, the symptoms of depression often worsen.  In some cases, a PTSD sufferer may feel the only way out of their suffering is to end their life.

Many of the symptoms I’ve just described stem from the same underlying mechanism, the changes in the brain and nervous system caused by the traumatic events that led to PTSD.  The VA and other trauma experts now consider PTSD to be an actual physical injury to the brain and nervous system, not just a psychological or emotional issue. This discovery has led to recent improvements in treatment methods. For more on this subject, read our article PTSD – An Injury To The Nervous System.

In order to be diagnosed with PTSD, a person must have a certain number of symptoms within these categories.  If you think that you, or your loved one, is experiencing PTSD, a mental health counselor (or a Vet Center readjustment counsellor) can make the diagnosis and get you hooked up with the help you need.  Even if you don’t meet the full criteria for PTSD, any of the above symptoms can be very troublesome.  Click here to learn how counseling at a Vet Center can be a great support. The counseling they offer can help you understand PTSD and how it affects people.  It can alleviate or reduce many distressing symptoms, and teach you tools for managing your own emotions and reactions.  Couples counseling can be very helpful in bringing spouses closer as a “team” in dealing with PTSD and addressing the spouse’s “secondary PTSD.”

If you think that you, or someone you know, is suffering from PTSD, the best gift you can give yourself or your loved one is the gift of counseling.   It may turn out to be one of the best decisions you’ve ever made.


There’s a wonderful website – Make The Connection – launched by the VA to help veterans and their families find support.  It’s full of brief videos by veterans who have experienced PTSD.  Here’s their invitation to you:

“Hear honest and candid descriptions from Veterans of what life was like for them with PTSD.  A variety of Veterans – men and women, younger and older – share their emotions, actions and symptoms, how they learned they had PTSD, and what they did to get on a path to recovery.”

Please let us know what you think about their website and whether you found this article helpful.