Posttraumatic Stress Disorder: Definition and Symptoms

Approximately 7%-8% of the US population will develop post-traumatic stress disorder (PTSD) during their lifetime. Post-traumatic stress disorder (PTSD) is a complex, multifaceted trauma- and stressor-related disorder, according to the Diagnostic and Statistical Manual for Mental Disorders 5, Text Revision (DSM-5-TR). Anyone who has experienced or witnessed a traumatic event may develop PTSD and suffer from its distressing effects for years to come. The diagnostic criteria for PTSD were expanded and updated in the DSM-5-TR. This change included the addition of ‘vicarious trauma,’ meaning one only has to witness a trauma – not necessarily be part of it – to be at risk for PTSD.

Symptoms of PTSD

Symptoms of PTSD vary from person to person, but some of the more common, symptoms include nightmares, hypervigilance, and a heightened or exaggerated startle response. There are four clusters of PTSD symptoms:

Re-experiencing symptoms: Flashbacks, physical or emotional reactions when reminded of the traumatic event
Avoidance symptoms: Avoiding anything that reminds them of the event
Negative changes: Mood swings, irritability, withdrawal from loved ones
Hyperarousal symptoms: Heightened startle response, hypervigilance

These intrusive symptoms must be present for a period of at least one month and cause significant distress. Because PTSD is a biopsychosocial condition, it can affect multiple facets of an individual’s well-being, including arousal, cognition, and mood.

Because of these distressing symptoms, many people who have PTSD experience a loss of interest in activities they once enjoyed, or that might trigger a memory of the traumatic event. It is common for those with PTSD to experience difficulties in sleep and concentration. Irritability, feelings of guilt, and frequent re-living of the traumatic event are all typical experiences that infringe upon a person’s life and well-being when they have PTSD.

Startle Responses

Issues in arousal are common with PTSD. The startle response, “an extreme response to an intense stimulus,” is the body’s physical reaction to fear. With PTSD and other anxiety disorders, this response is often heightened, meaning a more pronounced response is elicited to a stimulus that likely would not affect other people the same way. People with PTSD may always feel “on guard,” or hypervigilant, and have a heightened startle response. Often, observers may note an exaggerated startle response or “jumpiness” as another potential indicator of PTSD.

Those who have PTSD may not exhibit the same symptoms all of the time. Some may come and go, while others may be more persistent. It is essential to take all signs seriously and understand that while certain situations may not seem anxiety-provoking to the general public, they may elicit a severe startle response from someone with PTSD. People living with PTSD are often mindful of these ‘triggers,’ especially after seeking treatment.

Support is critical for addressing and managing post-traumatic stress disorder. Those with PTSD may essentially be re-living their trauma over and over again, robbing them of enjoying everyday life. Through thorough assessment, mental health professionals can identify the signs of PTSD and begin the treatment process to improve patients’ well-being and quality of life.

To learn more about the symptoms, etiology, and effects of post-traumatic stress disorder, view this Symptom Media video case study.

Written by Jessica Dzubak, MSN, RN

American Psychiatric Association (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed, text revision). American Psychiatric Publishing, Inc. https://doi.org/10.1176/appi.books.9780890425596.

Fetcho, J.R. & McLean, D.L. (2009). Startle response. Encyclopedia of neuroscience as cited in Science Direct. Retrieved from https://www.sciencedirect.com/topics/medicine-and-dentistry/startle-response#:~:text=Increased%20startle%20responses%20are%20excessive,of%20disorders%2C%20including%20hereditary%20hyperekplexia.

U.S. Department of Veterans Affairs. (n.d.) PTSD: National Center for PTSD.https://www.ptsd.va.gov/understand/common/common_adults.asp

Jessica Dzubak, MSN, RN, is the Director of Nursing Practice for the Ohio Nurses Association. She is also a freelance writer specializing in the healthcare industry. She enjoys her two dogs, which add commentary to her articles by laying their heads across the keyboard while she’s writing.