Post-Traumatic Stress Disorder (PTSD)

What is PTSD?

PTSD, or Post-Traumatic Stress Disorder, is a mental health condition that develops in some individuals after a shocking, scary, or dangerous event. Traumatic events can overwhelm the body and mind’s usual capacity to cope, leaving a residual pattern of intense fear responses, intrusive memories, and avoidance that persist long after the danger has passed.

It’s natural to feel afraid during and immediately after a traumatic situation. That short-term response prepares the body for survival—heightened alertness, rapid heartbeat, muscle tension. PTSD goes beyond this short-term alarm system. When the nervous system remains “stuck on high,” the individual may continue to feel threatened even in safe situations, impacting sleep, mood, concentration, relationships, and overall wellbeing.

People with PTSD may feel stressed or frightened even when they are not in danger. Daily routines—commuting to work, being in a crowd, hearing a loud noise—can activate memories or bodily sensations linked to the trauma. Without support, the person may withdraw, avoid reminders, or turn to unhelpful coping strategies that seem to work in the moment but keep symptoms going.

What Does PTSD Feel Like?

Living with PTSD can feel like being trapped in a constant state of fear and anxiety. Individuals might experience vivid flashbacks that make them feel as if the traumatic event is happening all over again, complete with images, smells, sounds, and bodily sensations. These episodes may arrive unexpectedly, triggered by something obvious (a news story, a location) or subtle (a particular tone of voice, a scent, a date on the calendar).

Nightmares and nocturnal panic attacks can disrupt sleep and leave people drained the next day. Even small, seemingly unrelated events can trigger surges of emotion or physical reactivity—racing heart, sweating, dizziness, trembling. It is common to feel detached, numb, or “not like myself,” alternating with sudden spikes of fear or anger. Many people describe being constantly on guard (hypervigilance), scanning for danger in ordinary spaces like supermarkets or public transport.

Over time, the effort to control or avoid memories can shrink a person’s world. They might stop seeing friends, abandon hobbies, or change routes to avoid reminders. While avoidance reduces distress short term, it limits life and prevents the brain from learning that the present is safer than the past.

Symptoms of PTSD

PTSD symptoms are intense and disturbing, typically grouped into four clusters. Below are the clusters and common examples, followed by a more detailed list of specific symptoms often associated with PTSD.

• Intrusive memories: recurrent, unwanted memories; flashbacks; nightmares; strong emotional or physical reactions to reminders.
• Avoidance: efforts to avoid thoughts, feelings, conversations, places, people, or activities that recall the trauma.
• Negative changes in thinking and mood: persistent negative beliefs about oneself or the world, distorted blame, persistent fear or shame, loss of interest, feeling detached, difficulty experiencing positive emotions.
• Changes in arousal and reactivity: being easily startled or frightened, feeling “on guard,” irritability or angry outbursts, risky or self-destructive behaviour, trouble sleeping, difficulty concentrating.

To provide a more complete picture, below are 17 specific symptoms often associated with PTSD (as depicted in the visual resource): Intrusive thoughts; nightmares; flashbacks; emotional distress after exposure to traumatic reminders; physical reactivity after exposure to traumatic reminders; avoiding thoughts or feelings related to the trauma; avoiding external reminders (people, places, activities); memory problems related to the trauma; negative thoughts about oneself or the world; distorted blame of oneself or others; persistent negative emotions (fear, anger, guilt); loss of interest in activities; feeling detached from others; difficulty experiencing positive emotions; irritability or aggressive behavior; risky or destructive behavior; hypervigilance and exaggerated startle response.

Difference Between Adjustment Disorder and PTSD

Adjustment disorder involves emotional or behavioral symptoms in response to a stressful event, but symptoms are typically less severe and shorter in duration than in PTSD. People with adjustment disorder usually experience distress linked to a clear stressor (e.g., job loss, breakup) and improve as circumstances stabilise or with short-term support. PTSD, in contrast, follows a traumatic event that involves actual or threatened death, serious injury, or sexual violence, and includes hallmark features such as intrusive re-experiencing and trauma-specific avoidance that persist for more than a month and interfere with functioning.

What Causes PTSD?

PTSD can be triggered by experiencing or witnessing life-threatening or deeply distressing events. While not everyone exposed to trauma develops PTSD, certain experiences carry higher risk, and repeated or prolonged trauma further increases vulnerability.

• Combat exposure: Military personnel and veterans may encounter life-threatening situations repeatedly, increasing risk.
• Physical or sexual assault: Survivors of violence or abuse can develop PTSD due to violation of safety and bodily autonomy.
• Accidents: Serious accidents (e.g., car crashes, industrial incidents) can be traumatic for victims and witnesses.
• Natural disasters: Earthquakes, floods, hurricanes, and other disasters can overwhelm coping resources.
• Childhood trauma: Prolonged abuse, neglect, or household violence can lead to PTSD or complex PTSD (C-PTSD), especially when supports are limited.

Additional risk factors include previous trauma, lack of social support, additional stressors (housing, finances), pre-existing mental health difficulties, and family history of mental health issues. Protective factors—such as supportive relationships, timely access to care, and coping skills—can lower the likelihood of developing post-traumatic stress disorder or reduce its impact.

Childhood PTSD — What It Is and Symptoms

Childhood PTSD occurs when a child experiences trauma and develops persistent symptoms that affect development, learning, and relationships. Traumatic experiences may include abuse, neglect, witnessing violence, serious accidents, medical procedures, or losing a loved one. Because children are still developing, trauma can interfere with the formation of a stable sense of self and safety in the world.

Symptoms of Childhood PTSD

• Behavioral changes: aggression or irritability; withdrawal from activities; regressive behaviours (e.g., bedwetting, clinginess).
• Emotional distress: anxiety, depression, guilt, shame, emotional numbness; frequent nightmares; separation fears.
• Cognitive difficulties: problems with concentration, memory, and learning; intrusive images that disrupt schoolwork.
• Physical symptoms: headaches, stomachaches, and other somatic complaints without a clear medical cause.

Children may re-enact aspects of the trauma in play, drawings, or stories. Caregivers and teachers play a crucial role in noticing changes, providing predictable routines, and linking families to trauma-informed support.

About Complex PTSD (C-PTSD)

Complex PTSD arises from prolonged or repeated trauma—often beginning in childhood—such as chronic abuse, captivity, or domestic violence. In addition to core PTSD symptoms, C-PTSD includes difficulties with emotional regulation, a persistent negative self-concept (e.g., shame, worthlessness), and chronic problems in relationships (mistrust, fear of intimacy, or repeated patterns of harm). People with C-PTSD often report feeling “stuck” in trauma dynamics even years later, especially when stresses or reminders accumulate.

Complex PTSD and Gender Dysphoria

Gender dysphoria refers to the distress experienced when an individual’s gender identity does not align with their assigned sex at birth. This mismatch can lead to significant emotional discomfort. While C-PTSD and gender dysphoria are distinct, they can interact in complex ways for some individuals.

Link Between C-PTSD and Gender Dysphoria

1. Impact of trauma: prolonged trauma, especially in formative years, can disrupt the development of a stable self-concept, including the capacity to explore and affirm gender identity safely.
2. Emotional dysregulation: both conditions involve intense distress; the chronic dysregulation seen in C-PTSD can intensify the discomfort associated with gender dysphoria.
3. Negative self-image: trauma-related shame or worthlessness can make it harder to accept and express one’s gender identity.
4. Relationship problems: difficulties with trust and boundaries can complicate efforts to find affirming communities and relationships.

With appropriate, affirming care, people can address trauma symptoms and pursue gender-affirming pathways that support safety, dignity, and wellbeing.

How Is PTSD Diagnosed and Treated?

PTSD is diagnosed by a qualified mental health professional through a comprehensive clinical evaluation, including discussion of symptoms, their duration, and the impact on daily life. Clinicians use the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria, which require exposure to a qualifying trauma and the presence of symptoms from the intrusion, avoidance, negative mood/cognition, and arousal/reactivity clusters for more than one month, causing significant distress or impairment.

Not everyone who experiences trauma develops PTSD, and some people improve over time with support from family and friends, stable routines, and self-care. However, many benefit from professional help to recover from severe and debilitating distress. Importantly, trauma is never the survivor’s fault, and effective treatments are available.

Evidence-Based Treatments

• Cognitive Behavioral Therapy (CBT): identifies and modifies trauma-linked beliefs (“I’m unsafe everywhere”) and reduces avoidance through gradual, supported exposure to reminders in a controlled way.
• Person-Centered Therapy: provides a non-judgmental, empathic environment that empowers clients to process experiences at their own pace.
• Eye Movement Desensitization and Reprocessing (EMDR): facilitates adaptive processing of traumatic memories, often reducing the vividness and emotional charge associated with them.
• Prolonged Exposure Therapy (PET): uses repeated, controlled exposure to trauma memories and safe reminders to reduce fear responses.
• Imagery Rescripting: helps individuals change the meaning or “ending” of traumatic images, reducing shame and helplessness.
• Guided Imagery: uses visualisation to reduce stress and increase a felt sense of safety.
• Acceptance and Commitment Therapy (ACT): builds psychological flexibility by allowing difficult thoughts and feelings while committing to valued actions.
• Medications: SSRIs (Selective Serotonin Reuptake Inhibitors) and SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors) may help with mood, anxiety, and sleep. Medication works best alongside psychotherapy.

Coping Strategies for Day-to-Day Life

While treatment addresses core drivers, practical skills help manage symptoms between sessions:

• Grounding and orientation: 5-4-3-2-1 sensory technique; naming colours and objects in the room; feet on floor, back against chair.
• Breath regulation: slow exhale practices (e.g., inhale 4, exhale 6) to shift the nervous system toward calm.
• Sleep hygiene: consistent wake time, wind-down routine, limiting late caffeine and screens; brief note-taking to park worries for the morning.
• Body-based practices: gentle stretching, yoga, or walking reduce muscle tension and improve mood.
• Mindfulness: noticing sensations and thoughts without judgment; returning attention to the present.
• Connection: trusted friends, peer support groups, faith or community organisations—connection counters isolation.
• Routine and structure: predictable daily rhythms provide a sense of safety and control.
• Limit substances: alcohol or drugs may worsen sleep and reactivity; seek safer coping alternatives.

How to Help Someone with PTSD

Supporting someone with PTSD requires patience, consistency, and empathy:

• Listen without judgment: allow them to share at their pace; avoid pushing for details.
• Validate: “What you’ve been through sounds really hard. I’m here.”
• Encourage professional help: offer to help find a therapist, accompany them, or remind them of appointments if they want support.
• Be patient: recovery takes time; setbacks are part of the process.
• Provide stability: predictable plans; clear, gentle communication; reduce surprise triggers where possible.
• Respect boundaries: ask for consent before hugs or touch; check in about what feels supportive.

Are You or a Loved One in Singapore Seeking Effective PTSD Treatment?

At Psychology Blossom Clinic, our therapists offer compassionate, personalised care grounded in evidence-based approaches. We work collaboratively to understand your goals, build safety and trust, and tailor a treatment plan that supports healing and resilience.

Our comprehensive PTSD treatment in Singapore integrates therapies such as CBT, EMDR, and ACT within a supportive environment. Whether trauma is recent or long-past, recovery is possible with the right support.

Don’t let PTSD continue to shape your life. Reach out today and take the first step toward a healthier, more fulfilling future. Our experienced PTSD therapists in Singapore can guide you with practical skills and sustained care.

Message: +65 8800 0554

Phone: +65 8686 8592

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FAQs

How to know if you have PTSD?

If you’ve experienced a traumatic event and struggle with the clusters described above—especially intrusive memories, avoidance, negative mood/cognition changes, and arousal symptoms for over a month—seek a professional evaluation.

How long does PTSD last?

Duration varies. Some recover within months; others experience symptoms for years. Early, trauma-informed intervention and strong supports improve outcomes.

What happens when PTSD is triggered?

Triggers can prompt flashbacks, panic, dissociation, or intense emotions. Grounding, breath work, and support reduce the intensity and help bring you back to the present.

What does a PTSD episode look like?

Episodes may include re-experiencing memories, feeling detached from reality, hyperarousal, and physical symptoms like sweating, shaking, or a racing heart.

What is the best medication for PTSD?

SSRIs and SNRIs are commonly used, but the best option varies. Work with a healthcare provider to personalise your plan; medication is often paired with psychotherapy.

We recommend This Video to those who wants to learn more about PTSD.

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