PTSD - Symptoms, Causes, and Treatment Methods

PTSD - Symptoms, Causes, and Treatment Methods

Post-traumatic stress disorder (PTSD) is a mental health condition that can develop in people who have experienced or witnessed an event threatening their life, health, or safety. A car accident, assault, physical or sexual violence, natural disaster, sudden death of a loved one, combat experiences - these are just some of the situations that can lead to PTSD. Not every person who has experienced trauma will develop this disorder, but in those who do, it can fundamentally change daily functioning. In this article, we discuss PTSD symptoms, its causes, risk factors, and the most effective treatment methods currently available.

How Is PTSD Different from a Normal Stress Response?

After a traumatic event, the natural reaction is shock, fear, sleep difficulties, and tension. In most people, these symptoms gradually subside within a few days or weeks - the body processes the experience on its own and returns to balance. We speak of PTSD when symptoms do not subside after at least one month from the event, and often intensify over time. In some individuals, symptoms appear only after several months or even years after the trauma - this is known as delayed-onset PTSD.

This distinction is important because not every person who has experienced something difficult has PTSD. A natural stress response after trauma is normal and expected. The problem begins when the brain is unable to naturally process the experience and the nervous system remains in threat mode permanently.

According to epidemiological studies, PTSD affects approximately 3.5-6% of the general population over a lifetime. Among individuals directly exposed to trauma, this percentage is significantly higher - reaching up to 30-40% among sexual violence survivors and 15-20% among combat veterans. In Poland, it is estimated that approximately 10% of the population may experience PTSD during their lifetime, but most cases remain undiagnosed.

Four Symptom Clusters of PTSD

The current diagnostic classification (DSM-5) identifies four main symptom clusters of PTSD. To make a diagnosis, symptoms must be present in each of the four categories, persist for at least one month, and cause significant distress or functional impairment.

1. Intrusion - Recurrent Re-experiencing of Trauma

This is the most characteristic symptom of PTSD. The person experiences recurring, unwanted memories of the traumatic event that appear involuntarily - they cannot simply "stop thinking about it." These may include:

• Flashbacks - the feeling that the trauma is happening again, here and now, with the full intensity of emotions and bodily sensations. During a flashback, the person may lose contact with reality and behave as if the threat were real
• Nightmares related to the event - often so realistic that the person wakes up screaming, in a sweat, with a pounding heart
• Intense psychological distress when encountering reminders of the trauma - a sound, smell, place, anniversary, or even a song from that period can trigger a wave of emotions
• Physiological bodily reactions to reminders - rapid pulse, sweating, trembling, nausea, a sensation of tightness in the chest

Intrusions are particularly exhausting because the person has no control over them. They appear involuntarily - at work, during a conversation with loved ones, while driving. Over time, the person begins to live in constant tension, anticipating the next flashback.

2. Avoidance

A person with PTSD actively avoids everything that might remind them of the traumatic event. This is a natural defense strategy - if memories cause pain, it is logical that we try to avoid them. The problem is that avoidance maintains the disorder - it does not allow the brain to process the experience:

• Avoiding thoughts, feelings, and conversations related to the trauma - the person may change the subject every time a conversation approaches the difficult topic
• Avoiding places, people, and activities that trigger memories - e.g., a person after a car accident avoids driving, a person after an assault avoids a particular street
• Sometimes avoidance is so extensive that the person shuts themselves at home and drastically restricts their life - quitting work, stopping socializing, avoiding all new situations
• Emotional numbing - some people cope with trauma by "switching off" emotions, which makes them appear cold and distant

3. Negative Changes in Thinking and Mood

Trauma changes the way a person perceives themselves, other people, and the world. These changes are often the most destructive in the long run, as they permeate every aspect of daily life:

• Beliefs such as "the world is completely dangerous," "no one can be trusted," "I am broken," "it was my fault"
• Persistent feelings of guilt or shame - often disproportionate to the situation, e.g., a victim of violence blaming themselves for what happened
• Loss of interest in previous activities - things that once brought joy now seem empty and meaningless
• A feeling of being cut off from other people - even among loved ones, the person feels alone, as if there were invisible glass between them and the world
• Inability to experience positive emotions - emotional numbness, absence of joy, lack of hope for the future
• Dissociative amnesia - inability to recall important aspects of the traumatic event

4. Hyperarousal

The nervous system of a person with PTSD remains in a constant state of readiness for threat - as if a fire alarm had been triggered and no one could turn it off:

• Difficulty falling asleep or staying asleep - the brain cannot "switch off" for the night
• Irritability and anger outbursts - emotional reactions disproportionate to the situation
• Concentration problems - because part of attention is constantly engaged in monitoring for threats
• Hypervigilance - constantly scanning the environment for threats, sitting with one's back to the wall in a restaurant, checking emergency exits
• Exaggerated startle response - e.g., jumping violently at a loud sound or a door slamming
• Self-destructive behaviors - reckless driving, alcohol abuse, self-harm

What Causes PTSD?

Not every person who experiences trauma will develop PTSD. It is estimated that about 60-80% of people experience at least one traumatic event in their lifetime, but PTSD will develop in only 5-10% of them. Risk factors include:

• Intensity and duration of trauma - longer and more intense events are associated with higher risk
• Previous traumatic experiences - especially from childhood, which sensitize the nervous system
• Lack of social support after the event - isolation after trauma is one of the strongest predictors of PTSD
• Co-occurring mental health disorders - depression, anxiety disorders
• Biological predisposition - differences in activity of the amygdala and prefrontal cortex
• Feeling of helplessness during the event - the less sense of control, the higher the risk
• Peritraumatic dissociation - derealization or emotional detachment during the event

The type of trauma matters. Interpersonal trauma - meaning deliberate action by another person, such as violence, abuse, or assault - is associated with a higher risk of PTSD than "impersonal" traumas such as natural disasters or accidents. The most difficult to process are traumas in which the perpetrator is a close person - a parent, partner, or caregiver.

Complex PTSD - When Trauma Repeats

Alongside "classic" PTSD, modern psychiatry also recognizes Complex PTSD (C-PTSD), introduced into the ICD-11 classification by the World Health Organization. C-PTSD occurs in response to repeated, prolonged trauma - especially in childhood. Domestic violence, chronic emotional neglect, years of abuse - these are experiences that not only leave a traumatic imprint but shape the entire personality and way of functioning in relationships.

In addition to symptoms typical of PTSD, individuals with C-PTSD experience difficulties in emotion regulation (anger outbursts, chronic emptiness, self-harm), identity disturbances and low self-worth (a deep conviction of one's own worthlessness), and chronic problems in interpersonal relationships (difficulty trusting, repeating destructive relational patterns). We write more about childhood trauma and its impact on adult life in our article on childhood trauma.

How Is PTSD Diagnosed?

PTSD diagnosis is primarily based on a clinical interview conducted by a psychologist or psychiatrist. The specialist asks about the circumstances of the traumatic event, symptoms, their duration, and their impact on daily functioning. There are also standardized diagnostic tools, such as the PCL-5 questionnaire (PTSD Checklist) or the structured CAPS-5 interview (Clinician-Administered PTSD Scale), which help in the precise assessment of symptom severity.

It is important to differentiate PTSD from other disorders that may have similar symptoms - generalized anxiety disorder, depression, adjustment disorders, borderline personality disorder, or dissociative disorders. Therefore, diagnosis should be conducted by a specialist with experience in trauma work.

PTSD Treatment Methods

PTSD is a disorder that responds well to treatment - especially when recognized and addressed early enough. International guidelines agree that trauma-focused psychotherapy is the treatment of first choice. The main methods with proven effectiveness are:

EMDR Therapy - recommended by the WHO as a first-line treatment for PTSD. It uses bilateral stimulation (eye movements, tapping) to process frozen traumatic memories. It is particularly effective for single-event traumas. Research shows that as few as 3-6 EMDR sessions can significantly reduce PTSD symptoms after a single traumatic event. You can read more about this method in our article on EMDR therapy.

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) - helps identify and change negative beliefs resulting from trauma. It includes psychoeducation, relaxation techniques, processing of the traumatic memory, and relapse prevention. A typical course is 12-16 sessions.

Exposure Therapy - gradual, controlled confrontation with the memories and situations that the person avoids. The goal is to reduce fear through habituation. The patient learns that contact with the memory is not dangerous and that fear gradually decreases.

Somatic Therapy - an approach that incorporates the body into the trauma healing process. It is particularly useful when trauma is "stored" in the body in the form of chronic tension, pain, or physiological reactions. You can read more about this method in our article on somatic therapy.

Pharmacotherapy - SSRI medications (sertraline, paroxetine) are recommended as first-line pharmacotherapy for PTSD. They are prescribed by a psychiatrist and are often used concurrently with psychotherapy. Medications do not treat PTSD on their own, but they can alleviate symptoms (insomnia, anxiety, depression), which facilitates engaging in therapeutic work.

Prognosis - Can PTSD Be Cured?

Yes - the vast majority of people with PTSD can recover with appropriate treatment. Research shows that approximately 50-60% of patients respond to trauma-focused therapy, and many of them achieve full symptom remission. The earlier treatment begins, the better the prognosis.

It is important not to treat PTSD as a "life sentence." It is a disorder, not a permanent personality trait. A brain that has learned to respond with threat can also learn safety - but it needs appropriate support to do so.

When to Seek Help?

If symptoms persist for more than a month after a traumatic experience and affect daily life - that is the time to consult a specialist. You do not have to wait until things are "bad enough." The earlier treatment begins, the better the prognosis.

It is particularly important to seek help when suicidal or self-harming thoughts appear, when you reach for alcohol or psychoactive substances as a way to cope with symptoms, when you isolate yourself from loved ones and lose the ability to fulfill daily responsibilities, or when symptoms begin to affect your work, relationship, or relationships with your children.

If someone close to you says that you have "changed" after some event - take that into account. Often people with PTSD are the last ones to notice the change in themselves.

Help at Sztuka Harmonii Psychological Center

At Sztuka Harmonii Psychological Center in Gdansk, we work with individuals after traumatic experiences. Malgorzata Kozlowska, MA, a psychologist and psychotraumatologist with an EMDR certificate, provides therapy for both classic PTSD and complex PTSD. She uses the EMDR method and other psychotraumatological approaches, selecting the method according to the individual needs of the patient. Aleksandra Ostrowska, MA, also a psychotraumatologist, specializes in crisis intervention and long-term work with trauma survivors. They collaborate with Anna Lewicka, MA, who provides long-term individual psychotherapy for individuals with a history of trauma.

The first step is a psychotraumatological consultation, during which a specialist will assess your situation, provide a preliminary diagnostic evaluation, and propose a treatment plan tailored to your needs. The consultation lasts 50 minutes and takes place in an atmosphere of complete safety and confidentiality.

Call 732 059 980 or schedule an appointment through our website. We see patients at four offices in Gdansk and Gdynia. Online consultation is also available. You do not have to cope with this alone - professional help can be the beginning of a journey toward regaining your balance.