It’s easy to confuse post-traumatic stress (PTS) and post-traumatic stress disorder (PTSD). In addition to sharing similar names, there’s considerable overlap in symptoms between the two conditions. Both PTS and PTSD are associated with feeling fearful and/or nervous, avoiding the activity or place associated with the traumatic event, and nightmares. However, there are significant differences in symptom intensity, duration, and treatment.
PTS is a common, normal, and often adaptive response to experiencing a traumatic or stressful event. Common occurrences, like car accidents, can trigger PTS as well as more unusual events like military combat or kidnapping. Almost everyone who experiences a scary situation will show at least a few signs of post-traumatic stress. That’s because our brains are hard-wired to tell our bodies to tense our muscles, breathe faster, and pump more blood when we’re under intense stress. This is the “fight-or-flight” response that prepares your body to deal with a threat or challenge in the environment by pumping more blood and oxygen to your muscles, and it shuts down non-critical functions like digestion. This fight-or-flight response is a normal reflex during and sometimes even after a traumatic event, which is why PTS is considered a normal reaction and not a mental illness.
PTS Symptoms and Behaviors
If you’re experiencing post-traumatic stress, your heart may race, hands shake, you may sweat or feel afraid and nervous. After the stressful event, you might avoid or be leery of engaging in that activity again, you may have a bad dream about the event you just experienced, or you may feel nervous in a situation that reminds you of the unpleasant event. Although they can be momentarily intense, symptoms of PTS usually subside a few days after the event and won’t cause any prolonged meaningful interference with your life. One positive outcome of experiencing PTS may be that you behave more carefully in a potentially dangerous situation in the future.
Since post-traumatic stress is not a mental disorder, treatment is not required as the symptoms will likely improve or subside on their own within a month. However, you should talk to a healthcare provider if you feel troubled by your symptoms — if they’re interfering with your work, school, or relationships or if you’re engaging in reckless behavior such as drinking or using drugs to cope with symptoms.
Post-Traumatic Stress Disorder
PTSD is a clinically-diagnosed condition listed in the Diagnostic and Statistical Manual of Mental Disorders, the recognized authority on mental illness diagnoses. The fifth revision, released May 2013, includes the latest diagnostic criteria for post-traumatic stress disorder.
Anyone who has experienced or witnessed a situation that involves the possibility of death or serious injury, or who learns that a close family member or friend has experienced a traumatic event, can develop post-traumatic stress disorder, although most people don’t. It’s still not completely understood why some people who are exposed to traumatic situations develop PTSD while others don’t.
PTSD Symptoms and Behaviors
Common symptoms of post-traumatic stress disorder include reliving a traumatic event through nightmares, flashbacks, or constantly thinking about it. You might avoid situations or people that remind you of the event, have only negative thoughts or emotions, and constantly feel jittery, nervous, or “on edge.” Although some of these symptoms sound similar to PTS, the difference is the duration and intensity. Symptoms that continue for more than one month, are severe, and interfere with your daily functioning are characteristic of PTSD.
Behaviors that indicate professional intervention is needed may include drinking or smoking more than usual as attempts to reduce anxiety or anger, and aggressive driving. Service members who have experienced combat can be especially nervous driving under overpasses and past litter on the roadside — behavior learned in Iraq and Afghanistan where insurgents hide improvised explosive devices in garbage and use overpasses to shoot at vehicles. Other behaviors that indicate that help may be needed can include being wary of crowds, showing reluctance to go to movie theaters, crowded stores, or nightclubs, and avoiding news that addresses overseas combat or getting angry at the reports.
Certain medications and therapies are widely accepted by healthcare providers as effective treatments for post-traumatic stress disorder. Sertraline and Paroxetine are two medications the U.S. Food and Drug Administration approved for treatment. Trauma-focused psychotherapy techniques such as prolonged exposure therapy and cognitive processing therapy have also been proven to be effective and widely used.
Overall Key Points
- PTS symptoms are common after deployment and may improve or resolve within a month. PTSD symptoms are more severe, persistent, can interfere with daily functioning, and can last for more than a month.
- Most people with PTS do not develop PTSD. You can develop PTSD without first having PTS.
- PTS requires no medical intervention, unless symptoms are severe. However, you may benefit from psychological healthcare support to prevent symptoms from worsening.
- PTSD is a medically-diagnosed condition and should be treated by a clinician.
To learn more about PTSD:
- The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury has fact sheets, treatment information, and resources on psychological healthcare.
- The National Center for Telehealth and Technology develops smartphone apps, which include apps to help you track your mood and assist with PTSD treatment. The center also offers visitors an opportunity to learn how combat-related PSTD may be acquired, what it can be like to live with PTSD, and how to access care from its virtual PTSD learning experience.
- The National Center for PTSD under the Department of Veterans Affairs has information for veterans, service members, families, and providers.
Written exclusively for BrainLine Military by Dr. James Bender, Deployment Health Clinical Center.
Dr. James Bender is a former Army psychologist who deployed to Iraq as the brigade psychologist for the 1st Cavalry Division 4th Brigade Combat Team out of Fort Hood, Texas. In his current position, Dr. Bender is a subject matter expert for the PTSD Clinical Pathways Program, which is developing a pathway to treat PTSD that will be implemented across the Department of Defense.