Are You Recovering From Trauma, or Do You Have PTSD?

It’s common to experience emotional distress after a traumatic event like a car crash, the death of a loved one, or a natural disaster. And mental health symptoms that may occur post trauma could feel so intense you might wonder if you have post-traumatic stress disorder (PTSD).

But while most adults will experience a traumatic event at some point in their lives, only a fraction will develop PTSD as a result, according to the International Society for Traumatic Stress Studies (ISTSS).

People can also experience what clinicians and the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) call acute stress disorder (ASD) — PTSD and ASD are not mutually exclusive.

Understanding the mental health impacts of trauma can be tricky. So we asked experts to weigh in for more clarity.

How Does Trauma Affect Mental Health, in General?

Per the American Psychological Association (APA), when trauma — an emotional or physical response to a terrible event — occurs, it may generate symptoms that either improve or worsen, depending upon the individual and situation.

According to the National Institutes of Health, trauma responses may include, but aren’t limited to:

• Disassociation from the body or surroundings
• Exhaustion
• Confusion
• Difficulty remembering aspects of the traumatic event or the events that followed
• Anxiety, sadness, depression, or irritability
• Trouble concentrating
• Nightmares and sleep disturbances
• Numbness
• Physical injury

People respond differently to trauma, and it’s unclear why. But most usually follow one of four trajectories after a traumatic event, which may depend upon their past health history, the nature of the trauma, or both, says George Bonanno, PhD, a professor of clinical psychology at Columbia University in New York City, and author of The End of Trauma: How the New Science of Resilience Is Changing How We Think About PTSD. These paths include:

• Experiencing temporary symptoms right after a traumatic event, and then returning to baseline within a few weeks — the most common response, Dr. Bonanno says
• Showing PTSD-like symptoms following the traumatic event, but symptoms fade over time
• Having minimal symptoms immediately following the event, but developing symptoms later that gradually worsen
• Having symptoms shortly after a traumatic event that persist for months or years, which may indicate PTSD, Bonanno says

Following trauma, symptoms usually decrease or stop for most people after a handful of days or weeks, Bonanno says. For example, according to a past study published by Bonanno and others in the wake of 9/11, the authors found that about two-thirds of people who had experienced a traumatic event recovered without developing lasting symptoms.

That said, ASD may affect six to 33 percent of people, per the Cleveland Clinic, and PTSD may develop in 5 to 10 percent of people, the organization notes. Therefore, it’s important to promptly discuss any trauma you experience with your healthcare team to ensure you receive the best care for your needs.

What Does Acute Stress Feel Like?

Most of us are familiar with forms of stress, like acute stress. This happens from minor, everyday situations, like traffic jams, crowds, or an argument with a loved one, and comes in bursts, then fades after the circumstances resolve, per University of Central Florida Health.

In other words, “normal” levels of acute stress are proportionally related to a specific problem that lasts only as long as the problem itself.

What Does It Mean to Have Acute Stress Disorder?

When trauma happens, one’s acute-stress levels may become exacerbated. If symptoms worsen or are left untreated, it may develop into acute stress disorder, per the Cleveland Clinic.

ASD is a short-term mental health condition that can occur within the first month of experiencing a trauma. It presents symptoms like anxiety, fear, helplessness, disturbed sleep, flashbacks, and feeling numb or detached from your body, among others.

It’s treatable with talk therapy, though it’s difficult to assess how common ASD actually is, partially because some might not seek professional help right away, notes the Cleveland Clinic.

PTSD, on the other hand, is symptomatically similar to ASD, but lasts longer than four weeks.

What Does It Mean to Have PTSD?

A diagnosis of PTSD requires direct exposure to a traumatic event involving death, the threat of death, or physical or sexual assault, according to the ISTSS. Individuals with PTSD have symptoms that fall within four broad categories:

• Intrusive memories of the traumatic event, such as flashbacks and nightmares
• Hypervigilance, or feeling constantly on edge
• Dissociation, memory problems, and increased negative emotional states
• Avoidance of reminders of the event

People who experience trauma may feel these types of stress responses in the days and weeks following the event. However, in most people, these symptoms resolve in time. When symptoms persist for more than four weeks, clinicians begin to consider diagnostic criteria for PTSD, per the DSM-5.

It’s important to note, PTSD symptoms do not always start immediately following a traumatic event, says Gina Moffa, LCSW, a grief and trauma therapist with a private practice in New York City. For example, someone involved in a severe car accident may feel acute emotional distress, but over time, life returns to normal and they feel fine. Then, later on, they witness or experience a similar accident and memories of the first trauma come rushing back — only this time, the level of fear and anxiety becomes more amplified. This kind of experience is common in people with PTSD, Moffa says.

Repeated exposure to trauma — including traumatic events that may have occurred in childhood — is thought to be a key risk factor for developing PTSD, according to a review of 22 World Mental Health (WMH) surveys conducted by the World Health Organization (WHO).

How to Tell the Difference Between PTSD and Acute Stress Symptoms

The difference between trauma-induced ASD and PTSD can seem blurry.

Symptoms of ASD are essentially identical to PTSD, at least in the short term. But in individuals with PTSD, symptoms remain the same, or worsen, over a period of months or years, instead of gradually abating with time, notes the Cleveland Clinic. In other words, PTSD is a disorder of persistence, where the brain becomes stuck in a fear reaction and is unable to move on after a life-threatening event.

Sometimes, making a PTSD diagnosis can be relatively clear cut, says Andrew Rosen, PhD, founder and clinical director of the Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida. For example, Dr. Rosen recalls a 9/11 survivor who came to him for help years after the 2001 attacks. She had escaped the second tower before it collapsed and moved away from New York City, and yet for five years, her daily feelings of fear, anxiety, and grief increased to the point where she dreaded leaving her apartment. This patient, Rosen says, came to him with all the hallmark indicators of PTSD.

The general rule of thumb is that symptoms of acute stress should begin to subside within a short time: a handful of days or weeks, Moffa says. But, she notes that distinguishing PTSD from ASD, as well as other mental illnesses, can be tricky as the symptoms are unique to each individual. Further, it is unclear who will progress from ASD to PTSD, and those who develop PTSD are at higher risk of comorbid mental health conditions.

“It’s sometimes really unclear, so we have to do as much detective work as possible,” Moffa says, adding that she will consider factors such as whether a patient has a history of past trauma or mental health challenges, and what they are doing to cope when screening someone for possible PTSD. “There’s no real test to diagnose these things,” she says.

Whether a patient has been able to regain a sense of safety following a traumatic event is, to Moffa, a critical distinguishing factor of recovery. If someone has access to friends, family, or a support group that makes them feel safe to process what has happened, that person may be less likely to experience the lasting symptoms associated with PTSD, according to a recent theoretical review and past research.

On the other hand, excessive rumination may indicate that a person isn’t recovering, Moffa says. For example, when someone gets caught up worrying about what they could have done differently to prevent or avoid a trauma, it may point to PTSD, according to past research.

It’s also important to note, Rosen says, that traumatic experiences can lead to other mental health conditions that become comorbid with PTSD. For example, 1 in 10 New Yorkers showed symptoms of depression following the 9/11 attacks and the disorders studied rarely present in isolation, according to an article published in 2014’s Annual Review of Public Health.

Diagnosing Acute Stress Disorder and PTSD

Although ASD is recognized by the DSM-5, Richard Bryant, PhD, director of the Traumatic Stress Clinic and professor of psychology at University of New South Wales, in Sydney, Australia, says this is primarily because therapists may need to provide patients’ insurance companies with a diagnosis for billing purposes. Experiencing an acute stress reaction does not necessarily mean that an individual has or is developing PTSD, Dr. Bryant explains.

“PTSD traditionally will not be diagnosed in the first month, because a lot of people [who experience a trauma] have a stress response, and we don’t want to pathologize that because [it may not be] a disorder, but instead just a reaction to a terrible event,” Bryant says.

Along those lines, Rosen thinks it’s unhelpful for people to worry about which label best fits their experience — leave that concern to your doctor and mental healthcare providers, he says. Instead, the most critical thing to do is to seek psychological help after a trauma. “If you are suffering on any level, go talk to someone who can [provide a professional opinion].”

Tips to Cope With Trauma — and Potentially Prevent PTSD

If you’ve experienced a trauma, there are things you can do to promote recovery. Here are some tactics, recommended by experts:

Talk to a Healthcare Provider

Moffa encourages individuals who are struggling to cope with a traumatic experience to seek therapy, regardless of whether or not they think they have PTSD. Early intervention, she says, may help prevent the development of PTSD later in life. The APA offers a directory where you can search for certified psychologists by state to find a provider near you. Or, discuss your situation with your primary care doctor who can give you a referral.

Prioritize Your Self-Care Routine

In addition to healthcare approaches, using self-care strategies, like mindfulness exercises, deep breathing, and meditation, is critical for people who are experiencing stress related to terrifying life experiences, says Moffa. Incorporating these techniques into your recovery journey may provide mind-body support.

Get Plenty of Exercise

Physical exercise is also helpful for recovery following trauma, Rosen says. “By overusing the cognitive parts of the brian [following trauma], there is an increase of stress hormones and chemicals that, when they hit a certain amount, may result in entering fight or flight mode,” Rosen explains. “This may cause anxiety and panic attacks [among other symptoms], so we need to have a system to let it out — cardio is one way [to help mitigate this].”

Reach Out to Your Social Circle

Social support, Moffa says, is also key to trauma recovery. While it’s still unclear why some people develop PTSD and others do not, isolation is one risk factor that has consistently emerged from research. When people feel physically or emotionally isolated, they are much more likely to develop PTSD and other mental health conditions, per a systematic review. But connecting with family, friends, and loved ones may go a long way in helping to process and recover from trauma, Moffa says.

Join a Support Group

Trauma support groups can be beneficial for people who don’t have access to social support or a therapist, as well as for those who want to talk with others who’ve experienced similar traumas. Whether you join for group therapy online or in person, they may provide a venue for connection and healing, Moffa says.

MyPTSD, After Silence, Better Help, 7 Cups, and the U.S. Department for Veteran Affairs are just some of the many PTSD, trauma recovery, and mental health support groups available.

Be Mindful of Social Media Use

Social media may help people connect to others who understand and can validate their experiences, Moffa explains. However, she cautions that social media can also re-traumatize people by exposing them to additional images or videos of traumatic events. If you find yourself holding your breath or not blinking while you scroll through social media, Moffa says this is a good sign the content you are viewing is harmful rather than helpful.

Summary

It’s typical to feel afraid, anxious, helpless, and confused in the days and weeks after trauma. Most people experience short-term symptoms associated with an acute stress response, which usually subside in time.

While ASD and PTSD share nearly identical symptoms, they primarily differ in duration of symptoms. ASD is usually diagnosed by a heightened acute stress response within a month of the traumatic event, and is treatable with talk therapy. PTSD is diagnosed four weeks or more after a trauma, and involves experiencing life-threatening or traumatic events, among other symptom criteria. It is also treatable with psychotherapy.

PTSD may be more likely to occur when individuals experience other mental health challenges, repeated traumas, or social isolation. Early intervention may help prevent ASD or PTSD, and self-care practices like meditation and exercise may help reduce stress associated with traumatic events.

Note, it can be difficult for therapists to determine whether or not a patient has developed PTSD following trauma, so it's recommended to seek professional help from your doctor or mental healthcare provider if your day-to-day functioning and quality of life feels negatively impacted in any way.

If you or someone you know is struggling or in crisis, help is available. Call or text 988 or chat at 988lifeline.org.