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Post-traumatic stress disorder (PTSD)

Post-traumatic stress disorder (PTSD) is caused by very stressful, frightening or distressing events. 

Someone with PTSD often relives the traumatic event through nightmares and flashbacks. 

They may experience feelings of isolation, irritability and guilt. They may also have problems sleeping, such as insomnia, and find concentrating difficult.

The symptoms of PTSD are often severe. They can have a big impact on your day-to-day life.

Developing symptoms

In most cases, the symptoms develop during the first month after a traumatic event. In a minority of cases, there may be a delay of months or even years before symptoms start to appear.

Some people with PTSD experience long periods when their symptoms are less noticeable. This is followed by periods where they get worse. Other people have constant, severe symptoms.

The specific symptoms of PTSD can vary among individuals.

Symptoms generally fall into 3 categories:

  • re-experiencing
  • avoidance and emotional numbing
  • hyperarousal (feeling 'on edge')


Re-experiencing is the most typical symptom of PTSD. This is when you involuntarily and clearly relive the traumatic event in the form of:

  • flashbacks
  • nightmares
  • repetitive and distressing images or sensations
  • physical sensations – such as pain, sweating, nausea or trembling

You may have constant negative thoughts about your experience. You may repeatedly ask yourself questions that prevents you from coming to terms with the event. For example, you may wonder why the event happened to you and if you could have done anything to stop it. This can lead to feelings of guilt or shame.

Avoidance and emotional numbing

Trying to avoid being reminded of the traumatic event is another key symptom of PTSD. This usually means avoiding certain people or places that remind you of the trauma. It could also mean that you avoid talking to anyone about your experience.

You may try to push memories of the event out of your mind, or distract yourself with work or hobbies.

You may also attempt to deal with your feelings by trying not to feel anything at all. This is emotionally numbing. This can lead to you becoming isolated and withdrawn. You may also give up pursuing activities you used to enjoy.

Hyperarousal (feeling 'on edge')

PTSD can make you feel very anxious and you may find it difficult to relax. You may be constantly aware of threats and easily startled. This state of mind is hyperarousal.

Hyperarousal often leads to:

  • irritability
  • angry outbursts
  • sleeping problems
  • difficulty concentrating

Other problems

PTSD also has a number of other problems, including:

  • other mental health problems – such as depression, anxiety or phobias
  • self-harming or destructive behaviour – such as drug misuse or alcohol misuse
  • other physical symptoms – such as headaches, dizziness, chest pains and stomach aches

PTSD sometimes leads to work-related problems and the breakdown of relationships.

Related topics




PTSD in children

PTSD can affect children as well as adults. Children with PTSD can have similar symptoms to adults. For example, having trouble sleeping and upsetting nightmares.

Like adults, children with PTSD may also lose interest in activities they used to enjoy. They may also have physical symptoms such as headaches and stomach aches.

There are some symptoms that are more specific to children with PTSD, such as:

  • bedwetting
  • being unusually anxious about being separated from a parent or other adult
  • re-enacting the traumatic event(s) through their play

When to seek medical advice

It's normal to experience upsetting and confusing thoughts after a traumatic event. But in most people, these improve naturally over a few weeks.

Talk to your GP if you or your child are still having problems about 4 weeks after the traumatic experience. You can also talk to them if the symptoms are particularly troublesome.

Your GP will want to discuss your symptoms in as much detail as possible. They'll ask if you've experienced a traumatic event in the recent or distant past. They'll want to find out if you've re-experienced the event through flashbacks or nightmares.

Your GP can refer you to mental health specialists, if they feel you'd benefit from treatment.

Content supplied by the NHS and adapted for Ireland by the HSE.

page last reviewed: 23/09/2018
next review due: 23/09/2021

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