A life threatening event. This includes a perceived-to-be life threatening event
1. Intrusive thoughts or memories of the event
2. Avoidance of people, places, or things associated with the event
3. Negative changes in mood and thinking, including feeling guilty, hopeless, or detached from others
4. Difficulty sleeping or concentrating
5. Irritability, recklessness, or hypervigilance.
Internal reminders of a traumatic event. These signs of trauma typically present as nightmares or flashbacks
Nightmares and flashbacks are the most common internal reminders of a traumatic event. Other reminders may include:
1. Intrusive thoughts or images that persist after the event has ended
2. Difficulty sleeping or concentration problems due to intrusive memories or thoughts
3. Avoidance behaviors, such as staying away from places or people that remind them of the trauma
4. Emotional numbing, which can manifest as a general sense of detachment from others or avoidant behavior in social situations
5. Increased anxiety and hypervigilance, often manifesting as difficulty relaxing, feeling jumpy, or being easily startled.
Avoidance of external reminders
For many individuals, avoidance is a way of coping with the overwhelming anxiety and distress that are triggered by reminders of the trauma. Avoidance can help reduce symptoms in the short-term, but it can also make symptoms worse in the long-term. When avoidance becomes excessive and interferes with daily functioning, it is referred to as “maladaptive avoidance”.
There are several different types of avoidance that may be seen in individuals with PTSD:
1. Physical Avoidance – This involves avoiding places or people that remind the individual of the trauma. For example, an individual who was involved in a car accident may avoid driving or being a passenger in a car. An individual who was sexually assaulted may avoid being alone or going to places where there are large groups of people.
2. Mental Avoidance – This involves avoiding thoughts, feelings, and memories associated with the trauma. Individuals may try to block out memories of the event by not thinking about it or talking about it. They may also avoid situations that might trigger these memories (such as watching television shows or movies that depict similar events). In some cases, individuals may dissociate from their surroundings when they are reminded of the trauma (this is known as “dissociative amnesia”). Dissociative amnesia refers to a period of time during which an individual can not remember important information about the traumatic event. +3 Emotional Avoidance – This involves numbing oneself emotionally so that they do not have to feel pain associated with memories of the trauma. Individuals may numbing themselves by using alcohol or drugs, withdrawing from friends and family members, engaging in risky behaviors such as gambling or promiscuous sex),or numbing themselves emotionally through self-injury such as cutting oneself .
Altered anxiety state
Avoidance behaviors:
PTSD sufferers may attempt to avoid anything that reminds them of the traumatic event. This can include places, people, thoughts, activities, and even emotions. The individual may go out of their way to avoid anything that trigger memories of the trauma.
Detachment and isolation:
Many individuals with PTSD feel detached from others and isolate themselves socially. They may feel like nobody understands what they’re going through and withdraw from family and friends. The individual may also avoid participating in activities they once enjoyed because they don’t feel like themselves anymore.
Hyperarousal: .
Changes in mood or thinking
It is not uncommon for people who have experienced a traumatic event to have changes in their mood or thinking. Some common examples include:
1. Feeling numb or disconnected from others.
2. Difficulty concentrating or feeling like your mind is “foggy.”
3. Increased irritability, anger, or aggression.
4. Feeling constantly on edge, hypervigilant, or jumpy.