Trauma During Adulthood

What is a traumatic event?

Traumatic events involve either 1) actual or possible death or serious injury or 2) sexual violence. Most adults have lived through at least one traumatic event and many have experienced more than one event. Trauma can also be chronic, meaning that similar events happen many times over a long period of time.

There any many different types of traumatic events, but here are some examples:

• Sexual or physical abuse or assault
• Serious vehicle accidents
• Combat or war zone exposure
• Serious medical events
• Seeing death or dead bodies, including while at work
• Unexpected death of a loved one
• Natural disasters
• Arson or house fires
• Torture
• Domestic violence
• Witnessing or experiencing violence, such as a homicide or suicide
• Terrorism or mass violence

What are common responses following a traumatic event?

Professionals have found three different paths that adults can follow after trauma:

• Some people never experience any major problems. This is known as resistance. Resistance is very common after traumas that do not involve sexual assault or abuse.
• Many people have symptoms similar to posttraumatic stress disorder (PTSD) 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. This path is very common among people who experience sexual assault.
• Other people experience problems that do not go away on their own. Posttraumatic stress disorder (PTSD) is one potential outcome when this happens. PTSD is described in detail in the next section.

What is Posttraumatic Stress Disorder (PTSD)?

PTSD is a mental health condition that may be diagnosed by a professional when someone has experienced a traumatic event and is having particular types of problems as a result. The major types of symptoms experienced by people with PTSD include:

• Re-experiencing symptoms, including:
  • Flashbacks or intrusive thoughts about the traumatic event
  • Intense physical or emotional reactions to reminders of the event
  • Nightmares
• Avoidance symptoms, including:
  • Avoiding thinking or talking about the trauma
  • Avoiding people, places, activities or sensations that remind you of the trauma
• Negative changes in your thinking and emotions, including:
  • Feeling more down, depressed, angry or anxious
  • Finding it hard or impossible to feel happy
  • Feeling shameful or guilty
  • Feeling distant from other people
  • Losing interest in things you used to enjoy
  • Being unable to remember important parts of the trauma
  • Having more negative thoughts about yourself, other people and the world
• Hyperarousal or emotional/physical reactivity, including:
  • Being always on guard and/or easily startled
  • Having trouble concentrating
  • Being quick to anger and aggression
  • Doing things that are risky (e.g., impulsive sex, binge drinking)
  • Having trouble sleeping

What is Complex Posttraumatic Stress Disorder (C-PTSD)?

C-PTSD is a mental health condition that also may be diagnosed by a professional when someone has experienced a traumatic event. C-PTSD shares many symptoms in common with PTSD, including re-experiencing, avoidance, and hyperarousal, as described above. However, C-PTSD also includes

• Problems in emotion regulation, like having difficulty managing ones feelings
• Problems in self-image, like feeling completely different from other people and/or having a negative self-view
• Interpersonal problems, including having trouble trusting others 

What are risk factors for PTSD or C-PTSD following trauma?

Risk factors for PTSD can be present before, during or after a trauma.

• Risk factors BEFORE a trauma include:
  • A history of other mental health conditions, including PTSD
  • A history of other traumas
  • A family history of mental disorders
• Risk factors DURING a trauma include:
  • Experiencing certain types of trauma, like sexual assault or unexpected death of a loved one
  • Experiencing a more severe trauma
  • Believing that your life is in danger during the trauma
  • Experiencing more physical injury or specific types of injury, such as head injury or loss of consciousness
  • Dissociating during the trauma
• Risk factors AFTER a trauma include:
  • Having less social support or more negative social interactions
  • Having more life stress
  • Avoidance coping

What helps people recover naturally after trauma?

We know much more about what makes someone likely to develop PTSD than we do about what makes someone likely to recover naturally. However, the following factors are thought to contribute to natural recovery:

• Social support, including:
  • Believing that other people care about you and will be there if you need them
  • Being able to talk about the trauma and your reactions to it with supportive people
  • Having supporters who avoid reacting in unhelpful ways when told about the trauma
• Getting back to one’s life, including:
  • Returning to your routine, such as going to work or school, doing chores and maintaining a sleep schedule
  • Not avoiding safe reminders of the trauma
  • Staying connected to friends and other important people
• Making meaning of what happened, including:
  • 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

How can someone decide if they need professional help?

Many times, people are able to recover from traumatic events on their own and with the help of their support systems. Sometimes, professional help is needed to recover.

If symptoms do not go away within one month following a traumatic event, a visit to a mental health professional or primary care physician is recommended. There are also mobile apps, like PTSD Coach, that can be helpful in monitoring your symptoms and preparing for this visit.

If treatment is needed, what are the options?

Even though many people recover naturally, some people do need treatment. Most benefit quickly when they get 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 is the best fit for you. There are options for people who prefer talk therapy and for people who prefer medication. Know that no single treatment is effective for everyone and it might take time to find the right fit—but don’t give up!

The field of mental health is constantly changing and new treatments are being developed. To make sure you or someone else gets the best treatment, we recommend learning about these evidence-based treatments before your visit so that you can ask the provider which they offer.

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 have been created for therapists that work with trauma survivors. This includes:

• ISTSS’ PTSD Prevention and Treatment Guidelines, which were released in 2019 and describe the state of the evidence on ways to prevent and treat PTSD. You can visit this resource here.

How can I find someone to help me?

Professional organizations like ISTSS often have directories of mental health professionals who can help. Don’t give up if you don’t find a provider in your area! You can also search the internet, call your doctor or insurance company, or ask other people you know if you don’t find someone right away. Just be sure to ask them if they are experienced in helping people who have experienced trauma and whether they offer the treatment you have decided on. See ISTSS’ directory of mental health professionals.

Where can I get more resources?

For more information, visit the Public Resources page of ISTSS’ website. There, you will find links to many of our public education products, briefing papers and affiliated resources.