Post-traumatic stress disorder isn’t one-size-fits-all. It’s rarely identical from one person to the next. What some have likened to a continual replay of a traumatic event, others might experience as a continual emotional numbness. And then there are the ones who don’t realize they’re living with some kind of PTSD until months or even years after the event. That, after all, is the nature of traumatic stress disorder: It materializes differently in different people.
PTSD arises when an individual experiences or witnesses something profoundly disturbing, something that seems to pose a threat or that is overwhelming. A car accident. A sexual assault. A natural disaster. A serious injury. It might be anything. The thing is, when someone develops PTSD, their brain and body continue to react as though the threat is happening, even well after the threat itself is over.
And sometimes, it isn’t even one event. For some people, these traumatic events happen many times over many years. That leads us to one of the key features of PTSD that most non-veterans don’t talk about enough: the different types ptsd.
Let’s break them down.
1. Acute Stress Disorder (ASD)
First off, acute stress disorder is often confused with PTSD. It’s a bit like the body’s first response to trauma. The key difference? Time. ASD occurs during the first weeks after a traumatic event. You could have symptoms such as difficulty sleeping, increased anxiety, or avoidance symptoms, for example, you stay away from anything that reminds you of the trauma.
But if those symptoms last more than a month, that’s when we might start thinking in terms of post-traumatic stress disorder.
2. Classic PTSD
This is also the one that most people think of when they hear “PTSD.” The classic edition typically stems from a single traumatic event, say, a car accident or something similarly life-threatening, such as a near-death experience or a violent encounter.
PTSD symptoms here fall into a couple of categories:
Re-experiencing symptoms: flashbacks, bad dreams, or distressing memories can make you feel like you’re reliving the event.
Avoidance symptoms: avoiding places, people, or activities that could trigger the memory of trauma.
Arousal symptoms: feeling constantly on edge, angry outbursts, hypervigilance, or trouble concentrating.
Symptoms of mood: Negative thoughts, hopelessness, emotional numbness, or difficulty feeling good things.
They can cause a great deal of distress and disrupt life, work, school, or other responsibilities and relationships. And although the American Psychiatric Association provides guidelines, the subjective experience can be far messier.
3. Complex PTSD (C-PTSD)
Here is where it gets a little deeper.
Complex PTSD isn’t listed as a distinct diagnosis in the DSM-5 (the manual that mental health professionals use), but many experts believe it is separate from classic PTSD.
It’s something that usually occurs in individuals who have been exposed to chronic trauma, such as child abuse, domestic violence, and repeated neglect. It’s not so much about a one-time thing as a sustained sense of not being safe or having any power.
For those who suffer from complex PTSD, the hallmarks may look the same, but they run deeper, lack of trust in others, a profound, deep sense of shame or guilt, and difficulty in maintaining relationships, even going so far as self-destructive behavior that mimics, if not surpasses, self-medication.
And in some cases, even the source is hard to spot. When trauma is part of a person’s life for years, it becomes part of their identity.
4. Comorbid PTSD
PTSD rarely travels alone. People with PTSD often have difficulties with substance use, depression, anxiety, or physical health. Sometimes people self-medicate, turning to alcohol or drugs to numb the troubling memories or help them sleep. At other times, PTSD symptoms such as avoidance or feeling emotionally numb can exacerbate pre-existing mental health problems.
It’s a tangled web. But it’s important to acknowledge the overlap, because treating each element in isolation is likely to fall short; to be effective, treatment needs to be both based in reality and holistic.
5. Delayed-Onset PTSD
It’s not that unusual for a person to appear “fine” in the immediate aftermath of a traumatic event, only to be stricken with PTSD symptoms months, or even years later. It’s known as “delayed-onset PTSD,” and it may catch people completely by surprise.
Perhaps a new trauma should bring back old memories. Perhaps someone was too busy trying to survive to recognize the event at the time. Perhaps they just hadn’t known that they had been that directly affected.
Delayed PTSD is a reminder that time doesn’t always heal in a straight line. Occasionally, the symptoms arise when life has finally slowed down long enough for the mind to catch up.
Treatment Options For PTSD
One-size-mental-health doesn’t fit all for PTSD, but there are indeed effective treatments for PTSD, some of them are even highly so in clinical trials.
One of the best-known is cognitive processing therapy, which aims to help people reinterpret and change negative thoughts they associate with the trauma. And then there is talk therapy and group therapy, both of which can provide a powerful sense of social support and belonging.
For some, eye movement desensitization (known as EMDR) can dim the intensity of traumatic memories by reprogramming the brain’s storage of them.
Occasionally, drugs, especially selective serotonin reuptake inhibitors (SSRIs), can help alleviate symptoms of PTSD such as mood swings, depression, or insomnia.
Living With PTSD
PTSD is often invisible. Someone might seem to be chugging along just fine on the outside, going to work, having the little chats, showing up for their family. But inside, they could be battling reminders of trauma, experiencing disconnection from positive emotions, or facing symptoms of reactivity.
Some days are more difficult than others. Some nights feel endless. But so is acknowledging the pain.
Frankly, traumatic stress disorder PTSD isn’t always dramatic or evident. It’s the way someone jumps at a loud noise, avoids certain conversations, and loses their focus during routine activities. It is the weariness of always being vigilant, the fear of letting your guard down, the burden of negative thoughts that refuse to up and leave.
And yet, there is also strength in that fight. There’s resilience in anyone who is still standing after all they have been through. Healing may not be a straight line, nor ever feel “finished.” But peace, quiet peace, temporary peace, is still worth striving for.
