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Natural Recovery vs. PTSD

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What happens after a trauma?

People are affected by traumas—defined as events involving actual or threatened death or sexual violence—in different ways.1

  • Some people never experience any major problems. This is known as resistance.1
  • Many people have symptoms similar to posttraumatic stress disorder in the weeks after a trauma. For most of those people, those symptoms will then go away on their own. This is known as natural recovery or resilience.1
  • Other people experience symptoms that do not go away on their own. Posttraumatic stress disorder (PTSD) is one potential outcome when this happens.1

Most people do not have long-term problems after a trauma.

In fact, many people who develop PTSD after a trauma will find that it resolves fairly quickly. The graph below shows the percent of people who have PTSD at different time points in the year after a trauma. This graph shows that:

  • Most people do not have PTSD one year after a trauma, regardless of the type of trauma.
  • After sexual assault, natural recovery or resilience is most common.
  • After traumas other than sexual assault, many people will experience resistance.

What helps people recover naturally?

We know much more about what makes someone likely to develop PTSD than we do about what makes someone likely to recover naturally. For example, people who cope by avoiding and people who experience certain kinds of traumas or have mental health conditions already may be at greater risk for PTSD. However, the following factors are thought to contribute to natural recovery:5,6

  • Social support, including:
    • Believing that other people care about you and will be there if you need them7,8
    • Being able to talk about the trauma and your reactions to it with supportive people9
    • Having supporters who avoid reacting in unhelpful ways when told about the trauma10
  • Getting back to one’s life, including:
    • Returning to your routine, such as going to work or school, doing chores and maintaining a sleep schedule11
    • Not avoiding reminders of the trauma11
    • Staying connected to friends and other important people12
  • Making meaning of what happened, including:13
    • Finding helpful and realistic ways to fit the trauma into the way you think about yourself other people and the world
    • Noticing unhelpful thoughts that get in the way of making meaning, such as self-blame, and finding more helpful thoughts
    • Looking for examples of ways that you did your best or coped well

Is there anything else that I can do to help me recover?

Even though many people recover naturally, some people will need treatment to address symptoms of PTSD. Most people will show improvement when they receive one of the treatments that have been shown to work for PTSD. You can learn about the treatments that work for PTSD on the National Center for PTSD website. The website also has a tool you can use to see which may be the best fit for you.

If you are already seeing a therapist or decide to see a therapist in the future, you can show them this fact sheet so that they can learn about the resources that ISTSS offers for therapists that work with trauma survivors. This includes:

  • ISTSS has developed clinical practice guidelines to support prevention and early intervention for PTSD. For more information see our Posttraumatic Stress Disorder Prevention and Treatment Guidelines Fact Sheets for Adults and Children.
  • Effective Treatments for PTSD, Third Edition provides a comprehensive review of the clinical research literature and PTSD practice guidelines in order to assist clinicians who provide prevention and treatment interventions for children, adolescents and adults with or at risk of developing PTSD.

References

  1. Layne, C. M., Warren, J. S., Watson, P. J., & Shalev, A. Y. (2007). Risk, vulnerability, resistance, and resilience: Toward an integrative conceptualization of posttraumatic adaptation. In M. J. Friedman, T. M. Keane, & P. A. Resnick (Eds.), Handbook of PTSD: Science and practice (pp. 497–520). New York: Guilford.
  2. Dworkin, E. R., Jaffe, A. E., Bedard-Gilligan, M., &  Fitzpatrick, S. (2020). PTSD in the year following sexual assault: A meta-analysis of prospective studies. Unpublished data.
  3. Hiller, R. M., Meiser-Stedman, R., Fearon, P., Lobo, S. McKinnon, A., Fraser, A., & Halligan, S. L. (2016). Changes in the prevalence and symptom severity of child post-traumatic stress disorder in the year following trauma—a meta-analytic study. Journal of Child Psychology and Psychiatry, 57(8), 884-898.
  4. Santiago, P. N., Ursano, R. J., Gray, C. L., Pynoos, R. S., Spiegel, D., Lewis-Fernandez, R., ... & Fullerton, C. S. (2013). A systematic review of PTSD prevalence and trajectories in DSM-5 defined trauma exposed populations: intentional and non-intentional traumatic events. PloS One8(4), e59236.
  5. Burton, M. S., Cooper, A. A., Feeny, N. C., & Zoellner, L. A. (2015). The enhancement of natural resilience in trauma interventions. Journal of Contemporary Psychotherapy45(4), 193-204.
  6. Feeny, N. C., & Zoellner, L. A. (2014). Conclusion: Risk and resilience following trauma exposure. In L. A. Zoellner, N. C. Feeny, L. A. (Eds.), Facilitating resilience and recovery following trauma, (pp. 325–334). New York: Guilford Press. 
  7. Brewin, C. R., Andrews, B., & Valentine, J. D. (2000). Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. Journal of Consulting and Clinical Psychology, 68(5), 748–766.
  8. Ozer, E. J., Best, S. R., Lipsey, T. L., & Weiss, D. S. (2003). Predictors of posttraumatic stress disorder and symptoms in adults: A meta-analysis. Psychological Bulletin, 129(1), 52–73.
  9. Belsher, B. E., Ruzek, J. I., Bongar, B., & Cordova, M. J. (2012). Social constraints, posttraumatic cognitions, and posttraumatic stress disorder in treatment-seeking trauma survivors: Evidence for a social-cognitive processing model. Psychological Trauma: Theory, Research, Practice, and Policy4(4), 386-391.
  10. Dworkin, E. R., Brill, C. D., & Ullman, S. E. (2019). Social reactions to disclosure of interpersonal violence and psychopathology: A systematic review and meta-analysis. Clinical psychology review72, 101750.
  11. Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M., & Strosahl, K. (1996). Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology64(6), 1152-1168.
  12. Shallcross, S. L., Arbisi, P. A., Polusny, M. A., Kramer, M. D., & Erbes, C. R. (2016). Social causation versus social erosion: Comparisons of causal models for relations between support and PTSD symptoms. Journal of Traumatic Stress29(2), 167-175.
  13. Park, C. L. (2010). Making sense of the meaning literature: An integrative review of meaning making and its effects on adjustment to stressful life events. Psychological Bulletin, 136(2), 257–301.