Post-traumatic stress disorder (PTSD)Why do some traumatic events stay present in the mind and body, and can you recover from them?

13What is post-traumatic stress disorder?

Post-traumatic stress disorder (PTSD) is a psychological condition that arises after exposure to an event that is life-threatening or extremely terrifying, or after witnessing such an event happen to someone else. The mind remains “stuck” at the moment of danger, recalling it against the person's will, and the body treats the safe present as if it were still in the middle of the event.

It is entirely normal to feel fear, sadness, tension and trouble sleeping in the days and weeks after a traumatic event. This is an expected human response, and in most people it gradually settles. But when the response lasts more than a month, grows stronger instead of fading, and begins to disrupt work, relationships and sleep, doctors speak of post-traumatic stress disorder.

In the International Classification of Diseases (ICD-11) the disorder has the code 6B40 and falls within the group of “disorders specifically associated with stress,” alongside another condition, “complex post-traumatic stress disorder” (6B41). The American DSM-5 places it among “trauma- and stressor-related disorders.” In both, the diagnosis requires a traumatic event that came before the symptoms.

14What counts as a traumatic event?

Not every painful situation is “trauma” in the medical sense. What is meant here is an event involving a real threat to life or safety or a risk of serious injury, whether it happened to the person themselves, they witnessed it, or they learned that it violently or suddenly happened to someone close to them. Examples include:

Emergency doctors, paramedics, firefighters and journalists in conflict zones are also exposed to this kind of event through their work, because they repeatedly face difficult scenes. The details of why some people are affected and others are not are on the causes page.

15How common is post-traumatic stress disorder?

These figures come from the World Health Organization and carry two important messages: first, trauma is a very common human experience, and second, most people who go through it do not develop the disorder. The organization also notes that about 40% of people with the disorder recover within a year without intervention, while in others it continues for years if untreated.

Women are affected more than men; in the United States, for example, statistics estimate lifetime prevalence at about 8% of women versus 4% of men, partly related to the different kinds of trauma each is exposed to. We have no reliable published Egyptian figures to rely on here.

16What does it feel like from the inside?

Many people with the disorder describe their life after the trauma as having “split into a before and an after.” They may smell a scent or hear an ordinary sound and find their heart pounding and their body stiffening as if the danger were returning. They may stay away from certain roads, places or conversations without explaining why, and feel distant from loved ones, as if there were glass between them.

“I knew I was safe, but my body didn't believe it.” (A phrase repeated by many people who have been through the experience, not a quotation from a specific patient.)

This contradiction between what the mind knows and what the body feels is the core of the disorder. That is why phrases like “forget it” or “be strong” do not help; what is happening is tied to how memory is stored and how the brain's alarm system responds, not to willpower.

17What happens in the brain after trauma?

During danger the amygdala (the alarm center) activates and releases stress hormones that prepare the body to flee or fight. After the danger has passed, this response should settle, and the event should be stored in memory as “the past, which is over.”

In post-traumatic stress disorder the alarm system stays highly sensitive, the regulating regions at the front of the brain become less able to calm it, and the memory is not filed in a clear time order. So it returns as vivid sensory fragments: images, sounds and bodily sensations, rather than as a story from the past. The reassuring news is that the brain is flexible, and trauma-focused psychological therapy helps reprocess the memory until it loses its charge.

18Acute reaction, post-traumatic stress disorder or complex trauma?

There is no separate page for the types, so here we summarize the main differences doctors use:

Psychiatry also recognizes that symptoms can be delayed, appearing months or even years after the event, sometimes when facing new stress or an occasion that recalls the trauma.

19How does it differ from anxiety, depression and normal grief?

• Generalized anxiety: anxiety that moves between different subjects in life, whereas post-traumatic fear is tied to a specific event and its reminders. See generalized anxiety disorder.
• Panic attacks: they come suddenly and may have no clear trigger, whereas here they are often set off by a reminder of the event. See panic attacks.
• Depression: it shares loss of pleasure and withdrawal with the disorder, and the two often occur together, but depression does not necessarily include intrusive memories or heightened alertness. See depression.
• Grief for a loved one: normal grief centers on longing for the person, but when the death is violent or sudden, images of the moment of death itself may take hold, and this needs assessment.

20Common myths and the facts

21When should you see a psychiatrist?

• More than a month has passed since the event and the symptoms have not eased or have grown.
• Sleep is disturbed most nights by nightmares or heightened alertness.
• You have started to avoid work, study, going out, or important people in your life.
• You turn to alcohol, sedatives or any substance to forget or to sleep.
• You feel anger or emotional numbness that harms your relationships.
• Thoughts of death or self-harm have appeared, and here help is urgent.

A psychiatrist or a therapist trained in trauma assesses the condition and distinguishes between a normal reaction, the disorder, and any accompanying depression or addiction. You are not asked to tell all the details of the event in the first session; you set the pace.

22Can you recover from post-traumatic stress disorder?

Yes, and recovery is the rule, not the exception. The World Health Organization states that trauma-focused psychological therapies, such as trauma-focused cognitive behavioral therapy and eye movement desensitization and reprocessing (EMDR), are the proven first choice. Many people improve even many years after the event; it is never too late to ask for help.

23How can the family support a person who has been through trauma?

• Provide safety and calm first, and keep a simple daily routine that restores a sense of control.
• Listen if they want to talk, do not pressure them to tell details, and do not question them about what happened.
• Avoid blame such as “why did you go there?” and minimizing such as “be thankful it wasn't worse.”
• Notice changes in sleep, mood and substance use without suffocating monitoring.
• Gently encourage them to seek specialist help, and offer to go with them to the first appointment.
• Look after yourself too; supporting a traumatized person is exhausting, and the family has every right to ask for support.

24Post-traumatic stress disorder guide: everything you need to know

We have gathered everything about post-traumatic stress disorder into 5 pages, each answering one question in detail. Choose what you are looking for: