After a car crash, an assault, a hurricane or a sudden loss, most people feel shaken for a while. The National Institute of Mental Health (NIMH) says it is natural to feel afraid during and after a traumatic situation. For many, the jumpiness, the bad dreams and the replaying settle down over the following weeks. For some, they hang on, or they arrive after life seemed to be back to normal.
When symptoms usually start
NIMH says PTSD symptoms usually begin within 3 months of the event but sometimes emerge later. The American Psychiatric Association (APA) adds that symptoms may appear later and can persist for months and sometimes years. A gap between the event and the symptoms does not rule PTSD out.
You also do not have to be the person who was in danger. NIMH notes that learning a relative or close friend went through a trauma can sometimes cause PTSD.
Four kinds of symptoms
PTSD is diagnosed by a qualified clinician using the DSM-5-TR, which names it posttraumatic stress disorder. In plain words, NIMH sorts the symptoms into four groups:
- Reliving it: flashbacks that can bring a racing heart or sweating, memories or dreams that keep returning, and distressing thoughts.
- Steering clear: staying away from places, events or objects that bring the experience back, or pushing away thoughts and feelings about it.
- Feeling on alert: startling easily, feeling tense or on guard, trouble concentrating or sleeping, irritability or angry outbursts, and risky or reckless behavior.
- Changes in thinking and mood: trouble remembering key parts of the event, harsh beliefs about yourself or the world, too much blame aimed at yourself or others, lasting fear, anger, guilt or shame, lost interest in activities, feeling cut off from people, and difficulty feeling happy.
NIMH explains that an adult diagnosis calls for at least one reliving symptom and one avoidance symptom, plus at least two from each of the other groups, lasting longer than a month and serious enough to get in the way of daily life.
How long it can last
The course differs from one person to the next. NIMH says some people improve within 6 months, while others have symptoms that last a year or longer. If symptoms are wearing you down, you do not have to wait them out.
What raises the risk, and what helps protect
NIMH lists factors that make PTSD more likely, including earlier trauma, especially in childhood; being hurt, or seeing someone hurt or killed; feeling intense fear or helplessness; having little support afterward; added stress such as losing a loved one, a job or a home; and a personal or family history of mental illness.
On the other side, NIMH links resilience to seeking out and accepting support from others, having a coping strategy, and feeling okay about how you acted during the event.
Need to Talk to Someone?
In-person in West Ashley or telehealth statewide across South Carolina.
Signs it is time for an evaluation
- Symptoms have lasted more than a month
- You are avoiding work, driving, people or places you used to handle
- Sleep, temper or concentration problems are affecting your job or your family
- Someone close to you has noticed a change and is worried
What treatment can involve
NIMH names psychotherapy, medication or both as the main treatments, and describes talk therapy approaches including cognitive behavioral therapy, exposure therapy and cognitive restructuring. The APA also lists cognitive processing therapy, prolonged exposure therapy and eye movement desensitization and reprocessing (EMDR). Medication when indicated is decided jointly with the patient.
Between visits, NIMH suggests keeping regular routines, setting realistic goals, staying in touch with people you trust, easing stress with exercise or mindfulness, and avoiding alcohol and drugs. It also says to expect symptoms to improve gradually, not immediately.
Care at Hope Behavioral Medicine
We see adults for PTSD in person in West Ashley and by secure video anywhere in South Carolina. Our counseling uses cognitive behavioral therapy, acceptance and commitment therapy and trauma-informed care, and your provider can coordinate a referral when a specialized approach is a better fit. Request an appointment.
Sources: NIMH, Post-Traumatic Stress Disorder (revised 2023); American Psychiatric Association, What is Posttraumatic Stress Disorder (PTSD)? (reviewed March 2025); American Psychiatric Association, DSM-5-TR (posttraumatic stress disorder).
This article is general information, not medical advice, and does not create a patient–provider relationship. Every situation is different, so see a provider who can evaluate yours and develop a plan of care. Any medication discussed here may not be right for you: the right choice depends on your diagnoses, other health conditions and current medicines, so take medication only as directed by the provider managing your care. If you are ever in doubt about an emergency, call 911 or go to the nearest emergency room.
Frequently Asked Questions
It can. NIMH says PTSD symptoms usually begin within 3 months but sometimes emerge later, and the American Psychiatric Association notes they may appear later and last for months or even years.
Longer than a month, and serious enough to interfere with daily life, according to NIMH. A qualified clinician makes the diagnosis using the DSM-5-TR.
Sometimes. NIMH says learning that a relative or close friend experienced trauma can cause PTSD.
Yes. Hope Behavioral Medicine sees adults by secure video anywhere in South Carolina and in person at our West Ashley office.