PTSD symptoms

What are the symptoms of PTSD?

PTSD symptoms are complaints that arise after a traumatic experience, in which your nervous system remains in a state of heightened alertness. These reactions are not ‘crazy’, but a comprehensible reaction of your body to a profound experience.

It may be that after a traumatic experience, you experience mostly nightmares and feelings of anxiety, or rather a heightened sensitivity and a constant feeling of being chased. Or all of the above at the same time. Not one person is like that. PTSD It is the same. There is a wide variation in the symptoms you may experience, how long you suffer from them, and the extent to which you suffer from them.

People with post-traumatic stress disorder can therefore differ greatly from each other, but they have in common that they experience four core symptoms of PTSD in different forms and to varying degrees.

Core symptoms of PTSD

1. Re-experiencing (intrusions): the feeling that it is happening again

Intrusions are sudden emerging thoughts, sounds, or images that often evoke intense fear and seem very realistic. People with PTSD often experience intrusions in the form of recurring and intrusive memories of a traumatic experience.

Several forms of intrusion can be distinguished:

• Re-experiences: Refers to experiencing intense and vivid memories of a traumatic experience. These can be images, sounds, smells, or sensations that occur at unexpected moments.
• Flashbacks: Refers to a specific form of re-experiencing where someone loses contact with the here and now and completely becomes immersed in the moment of a past traumatic event. This often leads to intense fear, panic, and the feeling that the trauma is happening again.
• Nightmares: refers to frightening and disturbing dreams. Nightmares associated with PTSD often involve a traumatic event and can be so realistic that someone feels as if the event is happening again.

Re-experiencing events, flashbacks, and nightmares can be very overwhelming and are accompanied by the same stress and emotions experienced during the original situation. They can also cause intense physical reactions, such as increased heart rate, sweating, trembling, and a feeling of unreality or dissociation.

These ‘intrusive’ symptoms can vary in frequency and intensity. Some people with PTSD only experience them occasionally, while others have to deal with them daily.

2. Prevention: try to avoid overwhelming

In PTSD, conscious and unconscious avoidance of situations and things that remind one of the traumatic event and evoke a lot of fear often plays a large role. This can include avoiding specific situations, places, activities, emotions, types of people, smells, and sounds.

In principle, anything that is associated (triggered) with a traumatic event can become a source of fear and overwhelm, and therefore is avoided. This is also known as triggers They can be very specific things that are directly related to a traumatic event, for example a particular location or specific sound, but they can also be things that resemble this or indirectly evoke a memory of the event.

Although avoidance has an important function: trying to avoid overwhelm and flashbacks, in the long run it often has a major negative impact on people's daily lives, and anxiety increases rather than decreases.

Avoidance can also lead to more and more things becoming frightening, and therefore being avoided. This can lead to people becoming socially isolated, not daring to leave their doors, and feeling increasingly less part of society.

3. Negative feelings and thoughts: gloom, fear, and guilt

An important aspect of PTSD are negative feelings and thoughts, which have started or worsened after experiencing a traumatic event. This is also described as ‘negative changes in mood and cognition’.

People with PTSD may feel depressed, empty, and hopeless. They may feel guilty or ashamed about what happened, and blame themselves. They may also have difficulty concentrating, and experience problems with attention and memory.

Negative feelings and thoughts can manifest themselves in various ways:

• Negative thoughts: about yourself, the other person and/or the world around you. This can also be about negative expectations and beliefs, and having a distorted image of yourself, the other person and/or the world.
• Negative feelings: such as gloom, guilt, shame, anger, hopelessness and worthlessness.
• Self-accusation: Many people with PTSD blame themselves for what happened and struggle with feelings of guilt, even when they are absolutely not to blame.
• Memory and concentration problems: Problems with attention, concentration, and memory are common. People may also have difficulty remembering aspects of the traumatic event.
• Loss of interest: in things that someone used to enjoy, such as activities, social contacts, and hobbies.
• No longer feeling positive emotions: Instead, many people experience emptiness or a flat feeling.
• Distance from others: PTSD can lead to a sense of isolation from others, and/or the active withdrawal of others. This can lead to feelings of isolation and difficulty in establishing or maintaining social contact.

4. Hyperarousal: constantly being on and feeling tense

A final core symptom of PTSD is also known as hyperarousal It refers to an elevated state of tension and alertness. Just like the negative emotions and thoughts, the symptoms of hyperarousal also arise or worsen after experiencing a traumatic event.

Many people with PTSD recognize the feeling of being constantly ‘on,’ unable to relax, always on guard. This is an expression of hyperarousal: being too tense.

Hyperarousal can manifest itself in various ways:

• Irritability: Becoming quickly irritated, angry, or frustrated. Minor irritations can lead to intense emotional reactions, including outbursts of anger.
• Hypervigilance: Also known as increased alertness or hyper-alertness. Many people with PTSD are constantly on guard and alert for signs of danger. This makes concentrating and relaxing difficult.
• Excessive panic reactions: Shocking at sudden sounds, movements, situations, or triggers that evoke memories of the trauma. These shock reactions are more intense than what is considered ‘normal’.
• Concentration problems: Due to constant internal turmoil and hyper-alertness to signals from the environment, focusing and directing your attention to a single task is difficult.
• Sleep problems: In order to be able to sleep, a certain degree of relaxation is required. Increased alertness, tension, and constant negative thoughts or memories often lead to sleep problems.
• Careless behavior: making impulsive and reckless decisions, such as dangerous driving behaviour, risky activities, or unwise financial choices. This behavior can stem from a sense of numbness, or as a distraction from intense and unpleasant emotions and thoughts.
• Self-destructive behavior: To (temporarily) escape from emotional pain, re-experiencing or constant tension and anxiety, people sometimes seek relief in the form of self-destructive behavior. This can, for example, involve self-harm, drug and alcohol use, or risky sexual behavior.

These complaints are related to How your nervous system reacts after a traumatic experience. Your body remains, as it were, in a state of readiness, as if there is still danger.

Dissociative symptoms

Some people with PTSD also experience dissociation. This can feel like you’re detached from yourself or your surroundings, or like everything becomes unreal. Dissociation is mainly used as a symptom of Complex PTSD Although people with ‘classic’ PTSD can also experience dissociative symptoms.

Dissociation is the opposite of association: it involves temporarily disconnecting the consciousness, so that sensory perceptions (what you see, feel, hear, taste, smell) are not experienced as well or at all. It can arise in response to overwhelming experience, intense stress, or triggers related to trauma.

Dissociation often leads to a sense of alienation, towards oneself, one's surroundings, and/or what one experiences. People who are dissociated, for example, do not feel any pain for a moment, or do not consciously experience what is actually happening.

Dissociation can range from mild moments of ‘not quite being there’ to being completely disconnected and unable to move. Furthermore, dissociative symptoms vary in frequency: some people experience them several times a day, others only occasionally.

Physical complaints

Although physical complaints are not officially described as symptoms of PTSD, they do occur quite often. These physical complaints are often a direct result of experiencing prolonged and intense stress.

Common physical complaints associated with PTSD:

• Headache
• Gastrointestinal complaints
• Heart palpitations
• Breathing problems
• Dizziness
• Muscle and joint pain
• Reduced defenses: Chronic stress can weaken the immune system, making you more vulnerable to diseases and infections