How to Recognize PTSD

1. Agitation

Agitation is a feeling of anxiety or nervous excitement. Like many symptoms experienced after trauma, agitation exists on a spectrum. Words like restlessness, unease and tension usually describe mild agitation. Agitation can build to the point where we become short-tempered or constantly irritable. Untreated trauma can contribute to aggressive or harmful behavior toward ourselves or others.

2. Nervousness and Anxiety

It is normal to worry about stressful situations (such as a job interview) before they happen. But when we experience symptoms following exposure to trauma, these nervous feelings become so persistent and generalized that they disrupt daily life. Worries and anxious thoughts often show up physically. For example, when we have been exposed to trauma and experience anxiety, we may have a rapid heart rate, difficulty breathing, sweating and fatigue.

3. Problems with Concentration and Thinking

The body’s “fight or flight” response is activated when we experience trauma or a highly stressful event. When this response stays active long after the traumatic event, the body diverts resources and energy to sustaining it, which leads to physical and mental deficits in our cognitive systems, such as the ability to concentrate and think.

4. Memory Problems

After a traumatic experience, the fight-or-flight response can get “stuck” in overdrive, causing neural changes around the amygdala (also known as the brain’s “fear center”)³. The amygdala, together with the hippocampus and the prefrontal cortex, plays a role in the brain’s ability to process stress and memory. Memory loss can also occur as a defense mechanism.

5. Headaches

When the “fight or flight” response is activated, the body releases cortisol and adrenaline, two hormones that help it respond to a threat. These hormones affect the body’s nervous system and can sometimes cause headaches⁴. Headaches can have many other causes, but they can still be a symptom of PTSD, especially in combination with other symptoms.

6. Depression

Depression negatively affects how we think and feel about ourselves, and it can affect the way we behave. When we have been exposed to trauma and experience depression, we may feel sad, lose interest in activities we used to enjoy, feel guilty and worthless, and notice changes in our appetite. Depression can also cause increased fatigue and sleep disturbances: some of us may have trouble sleeping while others sleep too much. In the worst case, depression can lead to suicidal thoughts.

7. Suicidal Thoughts or Attempts

We can become so overwhelmed by our PTSD symptoms that we sometimes consider harming ourselves. When we experience trauma symptoms, we may also experience depression, panic attacks, anxiety and substance use, and we are at higher risk of suicide. In fact, people diagnosed with trauma symptoms are 9.8 times more likely to die by suicide⁵.

If you are experiencing suicidal feelings or thoughts right now, please contact ERAN , Israel’s national emotional first aid hotline, available around the clock at 1201.

We want you to know that you are not alone and that there is hope.

8. Mood Swings

Trauma triggers and other common experiences such as panic attacks and angry outbursts can cause sudden changes in mood. While bipolar disorder is a different condition, the mood swings that come with trauma exposure can sometimes be mistaken for bipolar disorder, and in some cases we may have both conditions. Working with a licensed psychiatrist is key to reaching the right diagnosis. For a referral to a professional, contact the Stella team.

9. Obsessive-Compulsive Tendencies

While a diagnosis of trauma symptoms and obsessive-compulsive disorder (OCD) are different conditions, after exposure to trauma we may behave in ways that look similar to OCD. For example, we might check the door locks several times before leaving the house, in response to the hypervigilance that can develop after trauma.

People with OCD and those diagnosed with trauma symptoms can both suffer from intrusive, disturbing thoughts. When we experience both conditions, we often feel a constant sense of dread and anxiety. These tendencies can be a sign of PTSD, especially if you have never had any form of OCD before.

10. Panic Attacks

Feelings of fear are common after exposure to trauma. Sometimes these attacks seem to come without warning or reason. At other times, they happen in response to a reminder of our trauma.

During a panic attack, we may feel as though we are losing control or are afraid of dying. Chest pain, a racing heart, trembling, hot flashes or chills, a choking sensation and other physical symptoms may also occur.

11. Paranoia

In response to traumatic or extremely stressful events, we can become paranoid. Our belief that we are not safe makes us operate in a state of high alert and suspicion toward others. We adopt this way of thinking to protect ourselves from harm or harassment.

12. Tremors

Tremors are linked to many common trauma symptoms, such as agitation, nervousness, anxiety, panic attacks and substance use. All of these are directly related to physical neural changes in the body after trauma.

13. Substance Use

When we experience symptoms after trauma, we may use drugs and alcohol to cope, since substances can temporarily reduce or numb the distressing emotions we are feeling.

14. Flashbacks

Flashbacks are a vivid reliving of partial or complete aspects of past traumatic events or stressors, as if they were happening in the present moment. When flashbacks happen, they can feel uncontrollable and frightening. Most flashbacks are visual, like watching a video of what happened. But in some cases, people relive other sensations of the trauma, such as sounds, smells, tastes, or a sense of physical pain or pressure. In addition, some people may re-experience the emotions they felt during the traumatic events. A flashback can last anywhere from a few seconds to several hours, and it is often accompanied by other physical symptoms such as sweating and a rapid heart rate.

15. Hyperarousal

Hyperarousal is common among people who have experienced trauma and stressors. It is characterized by heightened, ongoing alertness to potential threats, an adaptive response that initially serves as a way to protect yourself. People experiencing hyperarousal constantly scan their surroundings, expecting something bad to happen. They may be “on edge” and overreact to things or stimuli around them.

16. Nightmares

Trauma can show up as vivid dreams that often replay past traumatic events. People who have nightmares may feel intense fear, terror and helplessness, as if they are reliving the traumatic events. This can lead to sleep disturbances or make people afraid to go to sleep.

17. Sleep Disturbances

People may have difficulty falling asleep or staying asleep because of intrusive, distressing memories from the past that resurface during the night. Sleep can also be disrupted by frequent nightmares. As a result, people may develop sleep avoidance, leading to long-term sleep deprivation that can further worsen other PTSD symptoms. Beyond the memories and nightmares, hyperarousal and physiological symptoms can severely impair the ability to fall asleep and stay asleep. Disrupted sleep significantly affects mood and daytime functioning, causing difficulty concentrating, lower productivity, reduced quality of life, strain on close relationships and increased health risks.

18. Avoidance

Deliberately avoiding thoughts, feelings, or encounters with people, places and objects that are directly or indirectly associated with the traumatic experience.