Symptoms may take several months (or years) to develop.
If you’re a veteran and you think you have post-traumatic stress disorder, or PTSD, a psychologist will ask you about the symptoms you’ve been experiencing. Your symptoms provide a big window into how the trauma of combat is affecting your life.
While PTSD may take years or even decades to appear, people who have experienced a traumatic event may notice some mood changes right away. “They can experience thinking about it often, having it be intruding into their dreams, increased reactivity, some negative mood,” says Amanda M. Spray, PhD, psychologist at NYU Langone Health.
Acute Stress Disorder vs. PTSD
Experiencing mood changes after a traumatic event is pretty common. When these changes are intense or dysfunctional, but last under a month, it’s called acute stress disorder.
“Acute stress disorder is between three days following the traumatic event and one month,” says Dr. Spray.
When these changes last longer than a month, it is no longer acute stress disorder. A doctor would then reassess the patient to see if they meet the criteria for PTSD.
“We consider these symptoms following a traumatic event to become PTSD when they start to interfere significantly with one's life,” says Dr. Spray.
Symptoms to Look For
You can group the symptoms of PTSD into four categories: re-experiencing, avoidance, negative cognitions, and reactivity.
- Re-experiencing means reliving the event. It refers to symptoms like flashbacks and nightmares of the event.
- Avoidance refers to avoiding triggers that might cause them to re-experience the traumatic event. For example, they might avoid places that remind them of the event, such as a fireworks show that reminds them of gunfire.
- Negative cognitions means negative mood changes. They might feel “like the world is no longer a safe place [or] that others are no longer trustworthy,” says Dr. Spray.
- Reactivity, or arousal, refers to being hypervigilant, easily startled, having difficulty sleeping, and being “on edge.”
“If someone thinks that they may have some symptoms of PTSD, or really any difficulty readjusting to the civilian world, I really encourage them to speak to a mental health provider who can then connect them to the type of care that they would most benefit from,” says Dr. Spray.
Amanda M. Spray, PhD, is a psychologist at NYU Langone Health in New York City and a clinical associate professor at the NYU Grossman School of Medicine.
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So initially, individuals who have been exposed
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to a trauma can experience certain symptoms
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following a traumatic event.
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They can experience thinking about it often,
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having it be intruding into their dreams,
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increased reactivity, some negative mood.
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That's sort of a pretty typical response
to trauma initially.
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If someone starts to experience many
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of these symptoms, together,
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for an extended period of time,
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that's when we get into diagnoses
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of acute stress disorder
and post-traumatic stress disorder.
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Acute stress disorder is between three days
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following the traumatic event and one month.
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We consider these symptoms
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following a traumatic event to become PTSD
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when they start to interfere significantly with one's life.
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So those symptoms fall into four main categories.
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The categories are re-experiencing,
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so the symptoms you often hear about with flashbacks,
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nightmares, re-experiencing the traumatic situation.
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For years, I would have dreams about Vietnam.
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I would have dreams about being in the trenches
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of World War I.
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Clearly I was never in any of those wars,
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but everything became wrapped up together
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in this one sort of like veteran experience
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in my brain that would play out at night.
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So avoidance occurs when someone
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is trying to not have those re-experiencing situations.
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They start to avoid people, places, things
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that remind them of the traumatic experience.
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Negative cognitions, or negative changes
in your mood,
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feeling like the world is no longer a safe place,
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that others are no longer trustworthy.
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And finally reactivity or arousal.
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So these are the symptoms you hear about,
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difficulty sleeping, being very jumpy.
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If we were to hear a loud noise,
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one might jump out of their chair
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like an exaggerated startled response,
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so that's what we see in the diagnosis of PTSD.
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If someone thinks that they may have
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some symptoms of PTSD or really any difficulty
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readjusting to the civilian world,
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I really encourage them to speak
to a mental health provider
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who can then connect them to the type of care
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that they would most benefit from.
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- Acute stress disorder. Washington, DC: U.S. Department of Veterans Affairs. (Accessed on July 15, 2020)
- Post-traumatic stress disorder. Washington, DC: American Psychological Association. (Accessed on July 15, 2020)
- Posttraumatic stress disorder in adults: epidemiology, pathophysiology, clinical manifestations, course, assessment, and diagnosis. Waltham, MA: UpToDate, 2020. (Accessed on July 15, 2020)