Post-traumatic stress disorder (PTSD) is one of the most painful and complex mental health conditions to live through and treat. There are many kinds of trauma, each requiring different strategies for healing. Although every person’s experience with trauma is unique, in general, there are five stages a person goes through on their path to recovery. In this article, I explain what PTSD is and what each stage consists of for a person experiencing trauma.

What Is PTSD and How Does It Affect Daily Life?

Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after experiencing or witnessing a traumatic event. Trauma can be defined as an event or experience that causes a person to feel intense fear, helplessness, or horror. 

PTSD is a complex condition that affects those who have experienced: 

• Military combat
• Sexual assault or abuse
• Physical assault or violence
• Natural disasters 
• Witnessing a death or injury
• Car accident

PTSD is specifically related to trauma. It involves a response to extreme stress. PTSD symptoms can vary. They typically fall into four categories, must last more than a month and significantly impact daily functioning:

• Intrusive thoughts: Flashbacks or nightmares which can be triggered by reminders of traumatic events
• Avoidance behaviors: Avoiding people, places or things that remind a person of a traumatic event
• Negative mood: Feelings of guilt, shame or depression
• Hyperarousal: Feelings of irritability, anger, or hypervigilance; being startled

PTSD is not just a psychological condition; it also has physiological and biological components. In response to a traumatic event, the body releases stress hormones such as cortisol and adrenaline. These hormones help the body respond to stress in the short term. Over time, they can cause damage to the body and brain.

PTSD can severely disrupt a person’s life, causing issues such as:

• Headaches, stomachaches and difficulty sleeping
• Severe anxiety
• Depression
• Substance abuse
• Difficulties in maintaining relationships and employment

Trauma can affect a person’s beliefs about the future, with loss of hope, limited expectations about life, fear that life will end abruptly or early, or anticipation that normal life events won’t occur [1].

Stages of PTSD

There are several models of stages for reactions to a traumatic event and ensuing PTSD with four stages [2] for disaster and mass violence and five stages, as follows:

Stage 1: Impact/Emergency

• Immediately after a traumatic event occurs, the person may be in a state of shock as they attempt to process what happened to them. 
• People may feel overwhelmed, numb, powerless, guilty, afraid, nervous or ashamed. 
• Their brain and body go on high alert (hypervigilant) as they become hyper-aware of their surroundings
• Typically lasts a few hours but may continue for weeks. 

Stage 2: Denial/Numbing

• Some people don’t experience this stage.
• Others feel emotionally numb after the event.
• They may be in denial about what happened or downplay the severity of it.
• To protect themselves from the stress and anxiety caused by the trauma, they may avoid thinking about it or talking about it.
• Our brains naturally block traumatic experiences to protect us from more pain.
• However, denial doesn’t help long-term healing. A trauma informed talk therapist can help process the experience in a safe, comfortable space. 

Stage 3: Rescue

• Once the initial shock has worn off, the person begins to accept what happened to them and starts to process the event.
• This doesn’t mean the person moves on from what happened, they simply begin to confront, understand and comprehend the event and their trauma.
• They may ruminate a lot, trying to make sense of it.
• They may begin to acknowledge the event by visiting the site where it happened, writing about it, or sharing with others.
• They may look for support groups to talk with other people who experienced similar traumatic events.
• As the survivor reflects on what happened to them, a range of emotions emerge. It’s common to have feelings of shock and denial as well as confusion, despair, anger, depression, stress, hopelessness and guilt

Stage 4: Short Term Recovery/Intermediate

• The person has established a renewed sense of safety and may look at the traumatic event in a different light.
• The person starts to regain their life back as it was before the traumatic event.
• They may leave the hospital (if hospitalized), acknowledge they need help and go back to work or school.
• Now they face new challenges and may start to experience physical symptoms such as anxiety, flashbacks or sleep disturbances.
• They may find loving support and care from some family or friends.
• Or they may be let down, receiving little or no support, either because others don’t know about the event or the person with PTSD hides how much they are struggling

Stage 5:  Long-term Recovery

• At some point the person needs to find a way to move on from their traumatic experience.
• Starting to accept that their life has changed, they may begin to mourn their previous life.
• If  they experience a triggering event, they may regress to a previous stage and then return to the long-term recovery stage.
• This stage may last the longest. In fact they may spend their whole life learning to live with and manage the traumatic experience. 
• They may accept the benefit of professional help.
• With time and acceptance of the event they may recover.
• Some may gain renewed hope and a sense of control over their lives.

How Long Does PTSD Last?

Recovery from PTSD is a journey and for many, a lifelong process. There is no “average” time to recover as it varies with each individual. For some, it may be weeks or months. For others, it is a years-long journey.

Recovery Timeline

As there is no set timeline for recovery from PTSD, the best way to judge this is by progressing through the stages.

Corner Canyon Can Help

Treatment is available in Utah. Are you or a loved one looking for a compassionate space to heal from trauma and mental health issues? Our licensed professional therapists and counselors can provide compassionate help. Reach out to our Admissions team now at Corner Canyon Health Centers. We’re in a peaceful setting bordered by the beautiful Wasatch Mountains.

Sources

[1] Center for Substance Abuse Treatment (US). Trauma-Informed Care in Behavioral Health Services. Substance Abuse and Mental Health Services Administration (US); 2014. (Treatment Improvement Protocol (TIP) Series, No. 57.) Chapter 3, Understanding the Impact of Trauma. 
[2] Phases of Traumatic Stress Reactions Following Disaster and Mass Violence. PTSD: National Center for PTSD. US Department of Veterans Affairs.