Checklist of Post Traumatic Stress Disorder (PTSD) symptoms

PTSD symptoms – for non-professionals

Since you’ve landed here, I suspect you’re at a very low point in your life. You’re looking for the symptoms of PTSD because you probably want to connect the dots to figure out what’s really wrong with you.

You wouldn’t have come here, though, if you weren’t already suspecting that you’re suffering from post-traumatic stress.

So, my aim is to help you get some clarity.

I’ve listed the Post-Traumatic Stress Disorder symptoms you (or perhaps a loved one) may be experiencing if you’ve been involved in, or witnessed, a traumatic event.

Don’t jump to the conclusion that you definitely have Post Traumatic Stress Disorder!

Let’s start with the most common symptoms (further down, you’ll find a ‘PTSD test’)…

10 common symptoms of PTSD

1. Images of the traumatic event coming to mind against your will
2. Recurrent nightmares – you may even delay going to bed until you’re absolutely exhausted, fearful of what sleep may bring
3. Flashbacks – suddenly feeling as if you were in the middle of the event again – reality just disappears (one of the most distressing PTSD symptoms)
4. Intense distress when confronted with reminders of the trauma; you feel out of control of your feelings
5. Stress, anxiety and panic
6. Avoiding anything associated with the event, for example – can’t watch that programme, go down that road, meet those people, read a newspaper, watch a news bulletin – just in case…
7. Inability to recall significant parts of the trauma
8. Feeling detached from others as if you’re trapped in a bubble and can’t connect with people
9. Feeling numb (see above)
10. Having little interest in the things you used to enjoy – you feel like you just can’t be bothered

These symptoms, however distressing, are typical and to be expected immediately after a traumatic event.

As a therapist, I’d only be concerned for you so quickly after the trauma if you had an acute stress reaction. This would be a continued overwhelming feeling of panic with a high level of distress.

If you are suffering from an acute stress reaction, I highly recommend you access professional help as soon as possible.

Visit a local clinic at the very least. Or, however difficult you may find it, talk to a mental health counsellor online to start the process of identifying the best treatment in your particular situation.

What exactly is Post Traumatic Stress Disorder?

Watch this video (opens in a new tab) to learn more about PTSD.

How is PTSD diagnosed?

The diagnosis is made by filling in a specially designed questionnaire and means of a (structured) interview with a suitably qualified mental health professional.

That person could be a psychiatrist or psychologist, but depending on in which country you reside, it may be another mental health specialist.

The questionnaire and interview are based on the Diagnostic and Statistical Manual 5 (opens in a new tab).

This is the manual used by mental health professionals to classify mental health problems. It’s meant to help professionals decide on the best treatment (more on that further down).

A proper diagnosis is essential for insurance purposes and to help you, ideally, get the right kind of treatment (see further down).

PTSD cannot be self-diagnosed.

Be aware though, that it’s possible for you to feel worse and still not have Post-Traumatic Stress Disorder. This is due to the vagaries and limitations of the DSM.

As a therapist, it matters much more to me how distressed you are and how the symptoms are affecting you than whether or not you fit the precise label of PTSD.

However, the precise diagnosis of PTSD is important with regards to your insurance and fast access to, often limited, specialist services.

Further potential signs and symptoms of PTSD and other mental health problems

What it’s like to have PTSD

I suspect you’ve become, very understandably, wrapped up in thinking about what’s happened to you.

You’re super aware of how you’re feeling much of the time. You’re focusing on getting yourself through the day and coping with yet another sleepless night.

You’ll probably recognise the following, though not necessarily PTSD symptoms but definite signs of severe mental distress:

• You’re irritable for much of the time, hitting out at loved ones (see my article on effective ways to deal with anger).
• You don’t want to talk about what’s happened.
• You spend the days just sitting and staring in front of you.
• You delay going to bed, fearing going to sleep and getting nightmares.
• You feel guilty for being ‘nasty’ towards loved ones and not shouldering responsibilities. Or alternatively, taking on stuff with an overzealousness that is potentially equally damaging.
• You don’t believe anybody will understand what you went through, what it was like and how it is now.
• You feel guilty for not being able to be part of the team.
• You avoid going to particular places or anywhere at all.
• You don’t want to see anybody.
• You suffer from mood swings.
• You appear to feel angry all the time for no apparent reason (see also my articles: Anger management tips and Anger management counselling
• You may lash out easily – verbally and maybe even physically.
• You appear preoccupied much of the time with little or no spare capacity for paying attention to loved ones.
• You appear less loving because you’ve shut off feelings you can’t cope with, so other (positive) emotions automatically get shut off also.
• You may no longer be interested in making love (see my article on what to do when your physical relationship is ear-enough non-existent).
• You may have started drinking more alcohol or taking other legal or illegal substances.
• You’re hypervigilant – on guard much of the time.
• You’re feeling tired – everything you do (or nothing at all) costs too much energy.
• You may also recognise many of the signs of a nervous breakdown.

Not wanting to talk about it

Avoidance – a symptom of PTSD

You don’t want to talk about what happened, so you shut yourself off from your loved ones and avoid other people as much as possible.

You don’t want to admit that you’re in psychological distress to anyone else (or even yourself).

And you don’t want to hurt anybody by excluding them, but you have your reasons:

• You’re convinced there’s nothing to be gained by talking about it, and it’ll likely make you feel worse.
• You’re terrified speaking out will trigger another flashback.
• You don’t think anybody can truly understand, but they might pretend they, and that’s worse.
• You fear they would judge you as ‘weak’ if they were to discover how vulnerable you are on the inside.
• You expect they wouldn’t know what to say anyway or say the wrong thing.
• You want to protect your loved ones from the ‘gory’ details and know how bad it really was.
• You don’t want your spouse and children to worry about you, particularly if they’re already carrying one or more of life’s burdens.

You may not even want to think about what happened. So you make jolly well sure you’re busy with often frantic activity. Anything to avoid being confronted with thoughts about the traumatic experience(s).

OR, you can’t be bothered to or are incapable of doing anything else but think about what happened.

You feel trapped in a cycle of ruminating and re-experiencing events.

You may be consumed with thoughts of ‘what ifs and associated feelings of guilt for having survived /or ‘having let the side down’.

You become preoccupied with making life manageable and attempt to take control of everything (and everyone) around you.

You’re alive, but you know you’re not living your life, and in your darkest moments, you may hate that life and even consider ending it.

Symptoms of PTSD after witnessing a traumatic event?

Research has shown that witnessing a traumatic event can cause the same trauma symptoms as directly experiencing a traumatic event.

You might be at risk of developing post-trauma symptoms if an aspect of the event resonates with you.

For example, if it involved:

• a child of the same age as yours
• someone doing the same job as you
• someone driving the same car as you
• a team member in the same mission as you
• someone with similar circumstances to you, and so on.

If you’ve witnessed a traumatic event – particularly if it involved people close to you – the information in this article counts for you too.

Survivor’s guilt – yet another symptom of PTSD?

Some survivors of catastrophic events feel guilty because they survived when others didn’t. Some feel guilty because they think they should/could have done more to help others. This is a known phenomenon and if you feel like that, know that you’re not alone.

Let me explain…

In an emergency, your instincts take over.

Your brain switches to autopilot. Instead of the conscious part of your brain, the autopilot directs operations. It’s superbly capable of giving you the best possible chance of survival. A flush of hormones ensures that your brain and your whole body are immediately prepared to run the fastest you’ve ever run. And that you become stronger than you’ve ever been.

Significantly, during a traumatic event, the unconscious part of your brain filters out all information except that which is necessary for you to escape.

So, even if you’d seen people you could have helped, the drive to save yourself is an unconscious one and overwhelming. It would have left little space for you to contemplate the fate of other people.

So why, then, do some people have the capacity to take charge, step in to help and reach out to someone else?

Those people’s life experiences, genetic makeup, mental and physical strength, and resilience have all prepared them to deal with trauma differently. It just is what it is!

There’s every possibility that eventually (maybe sooner than you think), you’ll develop a completely different perspective of the world.

You may get a newfound respect for life and an associated sense of meaning and purpose. There’s every chance you’ll recover! I’m rooting for you!

There’s every possibility that eventually (maybe sooner than you think) you develop a completely different perspective of the world. You may get a newfound respect for life and an associated sense of meaning and purpose.

There’s every chance you’ll recover!

How quickly should you recover after a traumatic event?

Early post-trauma symptoms should largely disappear within days after the incident.
More severe symptoms take longer to gradually subside.

You’ll likely feel much better and possibly have recovered completely within four to six weeks (that is unless you continue to feel as if it all happened yesterday!)

During that time, the love and support of family and friends can significantly contribute to your recovery if you’re so fortunate to be surrounded by loved ones.

However, should you continue to suffer from severe anxiety symptoms, I highly recommend you access professional help as soon as possible.

Why?

Because it could be an early symptom of PTSD.

Also, if your symptoms don’t seem to subside within a few weeks, it’s definitely time to get professional help. The same counts if you’re experiencing residual symptoms no matter how long after the initial trauma.

The longer you wait to get help, the more you risk developing PTSD or other long-term psychological problems.

It matters not how long ago you were exposed to that trauma. Symptoms of PTSD can suddenly appear months or years later when you’re unexpectedly confronted with a trigger.

Post-traumatic stress disorder test to determine if you need help

If you were involved in or witnessed a traumatic event, your reaction will depend not only on what happened but also on the time scale.

If you’ve very recently been traumatised, there’s every hope that you’ll begin to feel better within 2 – 4 weeks, if not before. Whatever you’re feeling now is very likely to be absolutely normal.

About 4 – 6 weeks following the traumatic event, trauma counselling may be helpful if several of the following apply to you*:

14 signs and symptoms you need help

These are not symptoms of PTSD necessarily. They may, though, indicate that you’re at risk of developing significant mental health problems.

The more of the following questions you answer with a yes, the more urgent you need expert help, particularly if the traumatic event(s) happened more than a month ago.

1. You were already stressed before the event; perhaps there were already difficulties at home or work.
2. You’ve been traumatised before – in your personal or working life.
3. You felt your life was in danger – perhaps because of your job, an attack, a medical emergency or an accident.
4. You wish you’d done more – for instance, in a situation where many other people were involved, you may feel that you could have saved someone.
5. You wish you’d acted differently – for example, you may have thoughts like: if only you hadn’t done this or that, you wouldn’t have been there, or someone else wouldn’t have been there.
6. You feel ashamed about something
7. You continue to feel very angry, maybe think that someone is to blame for the event, and you can’t get rid of that thought.
8. You avoid being confronted with (aspects of) the event – you avoid thinking or talking about it, the people connected with it, or programmes about it and so on.
9. You have little accessible support – maybe you have friends and family, but you don’t perceive them as very supportive. Or perhaps you have few people you know, like and/or trust.
10. You feel stuck – can’t get on with your life. Even if the event happened ages ago, other people think you should have gotten over it. But to you, it seems it happened only yesterday.
11. You can barely cope with normal, day-to-day activities – they seem so mundane compared to what you’ve been through, or you just can’t concentrate on the job at hand. Maybe you feel you just don’t have the energy or are wholly ‘incapable’.
12. You’re drinking more alcohol than you would normally. Perhaps it’s helping you to get to sleep. Or maybe it helps to dampen the impact of the images, or at least slow down your constantly whirring thoughts (see signs and symptoms of alcohol addiction).
13. You smoke more – perhaps that’s how you’ve always dealt with stress, and now you need it more than ever. Maybe you’re taking (illegal) drugs and/or medicine to cope with all the above.
14. You’re suffering from acute stress symptoms – you may experience panic attacks and nightmares.

*Adapted from the Trauma Risk Management (TRiM) programme initially developed by British army mental health professionals Major Norman Jones, Capt. Peter Roberts OBE (Retired), and Prof. Neil Greenburg.

Both Major Norman Jones and Prof Neil Greenberg are at the forefront of research into trauma and TRiM at the King’s Centre for Military Health Research.

Finally – You are so much stronger than you think!

I want you to know that admitting to, accepting and being open about your emotional and mental wounds is a definite sign of strength!

I hope that this list of symptoms of PTSD has helped you understand a little better what’s happening to you.

Know that you can get through this!