How To Identify The Stages Of PTSD And Seek Help

For many people who have experienced or witnessed a life-threatening or deeply distressing event, post-traumatic stress disorder (PTSD) can have an immense impact on their daily lives. People who have experienced trauma may start to relive the event through flashbacks and nightmares. They might be constantly on edge and actively avoid anything that reminds them of the trauma.

Healing from PTSD, like healing from a physical injury, often follows a pattern of specific stages. The stages of PTSD can differ in how long they last and how severe they are, and they often include initial shock, denial, vivid flashbacks, and recovery. Working through these stages is a part of managing and overcoming PTSD. 

The stages of PTSD can often be identified in various ways. Recognizing these stages may help empower individuals to find the support they need to cope with the challenges that come with PTSD. 

What is post-traumatic stress disorder (PTSD)?

Post-traumatic stress disorder is a mental illness that can develop after an individual has been exposed to one or more traumatic events. This disorder may develop with a variety of mental and physical symptoms, including recurring memories of the event, mood changes, and intense emotional responses.

The causes and risk factors of PTSD

The causes of PTSD can be complex, and whether an individual will experience this condition may depend on various psychological, social, and genetic factors. Traumatic events that increase the risk of PTSD could involve combat exposure, physical abuse, natural disasters, and even severe accidents.

A person’s stress reactions can be influenced by their past experiences, their support system, and their natural ability to cope. Some potential causes and risk factors for PTSD include:

• Being exposed to combat or military conflict
• Experiencing or witnessing acts of violence or severe injury
• Being involved in a serious accident
• Surviving a natural disaster, such as a hurricane or earthquake
• Surviving personal assaults, including sexual assault or robbery
• Having a history of mental health conditions
• Lacking support after a traumatic event

A mental healthcare provider may evaluate potential triggers and causes of PTSD when making a diagnosis. Early diagnosis and intervention may be key to an adequate recovery.

The five stages of PTSD

Many experts believe that PTSD progresses in distinct phases, which survivors of trauma pass through as they recover. One common framework involves five stages—the impact stage, denial stage, repetitive stage, short-term recovery stage, and long-term recovery stage. The following are descriptions of each of these five stages.   

Stage 1: The emergency or impact stage

The emergency stage of PTSD typically unfolds immediately after an individual experiences a traumatic event. It's usually marked by an array of intense reactions as the person lives with the immediate effects of the trauma. 

During this phase, it's common for individuals to experience a variety of symptoms, such as confusion, fear, hopelessness, and physical disturbances like insomnia or a racing heartbeat. Identifying this stage typically involves observing the acute distress that dominates a person's emotional and physical state. Their responses to daily life and routines can be significantly impaired.

Stage 2: The numbing or denial stage

During the numbing stage of PTSD, individuals may experience a significant reduction in their emotional responsiveness. They might seem detached from their feelings or appear unresponsive. This happens as a way to protect themselves from the full effects of the traumatic event they experienced. It's common for them to experience difficulty remembering details of the trauma or lose interest in things they used to enjoy.

Common symptoms in this stage may include:

• Avoidance: Actively avoiding places, people, or activities that are reminders of the trauma.
• Memory problems: Trouble remembering important aspects of the traumatic event.
• Detachment: Emotional numbness or disconnection from others.
• Reduced interest: A noticeable disinterest in activities of daily life.

Stage 3: The intrusive or repetitive stage

Stage 3 of PTSD, often referred to as the intrusive or repetitive stage, marks a period in which individuals experience involuntary and distressing memories of the traumatic event. During this phase, a person may have vivid flashbacks or nightmares that make it seem as though they were reliving the trauma. This stage is also recognized as the rescue stage, a time when the process of coming to terms with the traumatic experience begins.

Symptoms that commonly arise in this stage include:

• Persistent remembering or "re-experiencing" the event through intrusive thoughts.
• Distressing dreams related to the trauma.
• Physical reactions to reminders of the traumatic event, such as sweating or increased heart rate.
• Emotional distress after exposure to reminders of the experience.

Stage 4: The short-term recovery stage

In the short-term recovery phase of PTSD, individuals may begin to process the traumatic experience. This stage can be a time of transition when people start to piece their lives back together.

Key aspects of this stage often include a reduced intensity of PTSD symptoms and a gradual return to daily activities. Individuals may notice fewer intrusive memories and begin to develop coping skills that facilitate personal growth after trauma. Emotional responses shift from being overwhelmed to actively seeking a sense of normalcy.

In this stage, commonly known as the intermediate phase, it can be helpful to identify progress by noticing how responses to reminders of the trauma become easier to manage. Emotional control at this point may involve a blend of lingering distress and increasing stability. Some individuals may still have occasional symptoms like flashbacks or anxiety, but they typically occur less often and with less intensity.

Stage 5: The long-term recovery stage

In the long-term recovery stage of PTSD, which some may call the integration and maintenance stage, individuals may begin to reclaim control over their lives. They typically gain a better understanding of their trauma and its effects, which may allow them to develop strategies to handle symptoms well. This period is characterized by adjustment and blending as individuals learn to coexist with their experiences without letting them take over.

This stage can be identified when a person's PTSD symptoms become less intense and more manageable. Common symptoms may include occasional flashbacks or nightmares and mild arousal or reactivity to triggers related to the trauma.

 The affected person may start to:

• Engage in normal activities with more confidence and less anxiety.
• Display stable emotional responses.
• Report fewer instances of reliving the trauma.

The symptoms may persist at lower levels as individuals in this stage harness coping skills that help them engage with daily life more fully. They may continue to work on their recovery through therapy or support groups while maintaining the gains they've achieved. This stage is about moving forward with a renewed sense of resilience and an understanding that, while the past cannot be changed, a person’s approach to the present and future can evolve.

Duration of PTSD stages

Traumatic events can leave a lasting impact, and the PTSD recovery time can vary widely among individuals. These stages are not rigid and may not occur in a linear fashion.

The initial impact of trauma can be unpredictable; some individuals may experience symptoms immediately, while for others, they may emerge days, weeks, or even months later. The denial phase can similarly fluctuate in length, often depending on personal resilience and support systems. 

During the intrusion stage, individuals may have recurring flashbacks or nightmares, which can persist for varying periods before they begin working through the phase. Here, individuals actively process the traumatic event, which can take months or years. Finally, the long-term reconstruction phase involves rebuilding one's life and can last indefinitely as coping strategies and psychological healing continue to evolve.

Treatment for PTSD

Various PTSD treatment options are available, including psychological therapies and medication. The treatment plan generally depends on the individual’s specific needs and symptoms.

The following are some psychological treatments for PTSD:

• Cognitive behavioral therapy (CBT): This therapy involves working with a counselor in a structured way for a limited number of sessions. CBT often helps individuals understand and change the thought patterns that lead to stressful emotions.
• Exposure therapy: In this therapy, individuals face and control their fear by being exposed to the trauma they experienced in a safe and controlled way.
• Eye movement desensitization and reprocessing (EMDR): EMDR involves following the therapist’s hand movements (or sounds) while recalling the traumatic event, which can reduce the distress from the memory over time. 

Medication

Medication can also play a role in treatment:

• Selective serotonin reuptake inhibitors (SSRIs): Medicines like sertraline or paroxetine may help to alleviate the symptoms of PTSD.
• Serotonin-norepinephrine reuptake inhibitors (SNRIs): A medication like venlafaxine is another option that may be prescribed.

When seeking treatment, it's important for an individual to consult with a healthcare provider who can tailor the approach to their particular situation. One form of treatment may not work for everyone, and the process of finding the right combination of therapies can take some time.

Experiencing difficulties with PTSD?

Speak with a mental health expert

Finding mental health care for PTSD

Therapists and counselors are trained to help individuals process their trauma. They might use various evidence-based treatments to help manage the symptoms of PTSD. 

The efficacy of online therapy for post-traumatic stress disorder

Studies show that online therapy can effectively address numerous mental health conditions, including PTSD. The convenience of online therapy often contributes to its success. Online therapy allows individuals to connect with licensed therapists regardless of their geographic location.

Learning how to identify the stages of PTSD with an online mental health provider

Online therapy platforms like BetterHelp match users with licensed therapists based on their unique needs. These professionals are experienced in managing PTSD and can offer personalized support through a structured healing process.