Typical reactions are an intense, unavoidable reliving
of the traumatic event in the form of images, film-like
scenes, or nightmares. The affected individual is unable
to control his or her memories. The attempt not to think
about the trauma again fails and leads to dysfunctional
avoidance behavior. This causes symptoms to become
prolonged and chronic.
PTSD symptoms can also include dissociative symptoms
(e.g. total or partial amnesia) and emotional
numbing. Manifestations of physical and psychological
unease, such as nervousness and sleep and concentration
disorders, occur as if the threat that occurred in
the past still continued to exist. Exaggerated startle
response, tension, outbursts of anger, and irritability are
also possible. Depending on the type of trauma, individuals
can experience deep despair and be tortured by
feelings of shame and guilt; this is sometimes associated
with self-harm. Distorted thinking can effect a
lasting change in the individual’s perception of the
world (“There’s danger lurking everywhere”), others
(“I can’t trust anyone”), and him/herself (“I’ll never get
over it”) (Box 2)