Learn about PTSD

What is PTSD?

Posttraumatic Stress Disorder (PTSD) is caused by witnessing, experiencing, or learning about someone close to you who experienced traumatic events (such as actual or threatened death, serious injury, or sexual violence).

The good news: PTSD is treatable.

PTSD includes 4 types of symptoms:

1. Re-experiencing or reliving the trauma, such as:
   • Disturbing memories or nightmares
   • Feeling or acting like the trauma is happening again (flashbacks)
   • Becoming very upset when reminded of the trauma
2. Persistent avoidance such as:
   • Avoiding memories or thoughts about the trauma
   • Avoiding places, people or conversations that remind you of the trauma
3. Negative thoughts and moods
   • Feeling detached or isolating from others
   • Negative beliefs (such as “I'm a bad person”, “I can't trust anyone”, “The world is dangerous”)
   • Self-blame for the trauma
   • Persistent negative emotions such as fear, anger, guilt, or shame
   • Trouble feeling positive emotions like happiness and love
   • Lack of interest or participation in pleasurable/important activities
4. More on-edge and reactive, such as:
   • Feeling on guard
   • Being irritable or angry
   • Trouble sleeping
   • Startling easily
   • Problems concentrating
   • Being reckless or self-destructive

These symptoms last for a month or more and are bothersome, and/or lead to problems in social or family life, work, and school.

PTSD can also include “dissociation,” in which people feel like they are detached from themselves or as if the world around seems unreal, distant, or distorted.

In Canada, you may hear the term “operational stress injury,” or OSI, which is used to describe any persistent psychological difficulty resulting from operational duties performed by a Canadian Armed Forces or a Royal Canadian Mounted Police member. Operational stress injury describes a broad range of problems that usually results in impairment in functioning, including PTSD and other diagnosed medical conditions such as anxiety and depression, as well as a range of less severe conditions.

How does PTSD develop?

After trauma, it's normal to be in shock, have painful memories, and be upset by reminders. Trauma can also change how people think about themselves, others, and the world leading to more extreme ideas like “nowhere is safe,” or “no one can be trusted.”

For most, these reactions will lessen over time. But for some, these reactions continue and can be severe enough to disturb everyday life.

How common is PTSD?

Although most people feel much better within a month or two after a trauma, some people do develop PTSD or other problems like depression or substance use problems.

Did you know?

• About 9.2% of Canadians will have PTSD in their lifetime.
• Women develop PTSD more often than men.
• Certain types of trauma, such as those related to combat and rape, can cause higher rates.

Who develops PTSD?

Virtually anyone can develop PTSD; it is not a sign of weakness. However, there are some factors that make it more likely.

Risk factors before a trauma:

• being female
• having experienced a prior trauma
• having been abused as a child
• having a pre-existing mental health problem
• having a family history of mental illness

Risk factors during a trauma:

• believing you will die
• feeling detached from yourself or your surroundings
• feeling completely helpless
• having a panic attack
• being seriously injured

Risk factors after a trauma:

• lack of social support
• additional life stresses (such as job loss, divorce)

How long does PTSD last?

PTSD symptoms usually appear soon after trauma. For most people, these symptoms go away on their own in the first few weeks and months after that. For some people, the symptoms can last for many years, especially if they do not seek help.

PTSD symptoms can worsen during times of stress or when people are reminded of what happened by trauma triggers (such as reminders, anniversary of trauma). How long PTSD lasts also depends on whether effective treatment is received.

Problems related to PTSD

Some other problems are more common for people with PTSD. These include:

• depression
• panic attacks
• alcohol and substance use problems
• problems in relationships, work, school, or other important activities
• physical symptoms (pain, headaches, digestive problems)
• increased risk of medical problems

Did you know?

• More than half of men with PTSD have alcohol problems.
• Nearly half of women with PTSD also suffer from depression.

PTSD treatment

PTSD is treated with talk therapy or medication, or a combination of these. Among the most effective treatments for PTSD are exposure-based cognitive-behavioral therapies (CBT). These treatments involve exploring how the trauma has negatively affected one's thinking and helping survivors think in more balanced ways about what happened and what it might mean.

Treatment may also include having the trauma survivor spend time safely, and with support, with the painful trauma memories and reminders that they've been avoiding, seeing that they can survive them and be ok. Individuals are also taught coping skills to more effectively deal with stress and manage PTSD symptoms, much like the skills taught in the PTSD Coach Canada Application.

For more information about treatment, including where to find it, read the Understanding PTSD treatment page.

Do I have PTSD?

Only a trained mental health professional can determine if you have PTSD. However, there are self-tests, including the one in the PTSD Coach Canada Application, which can help you decide if your symptoms require a more thorough evaluation from a mental health professional. If you think you have PTSD, talk with your doctor or schedule an evaluation with a mental health professional. Also, remember that some people may develop other problems like depression or substance use disorder after a trauma.

If your trauma was less than a month or two ago and you are not in too much distress or having problems functioning in everyday life, then you may want to see if your symptoms get better on their own. Using the tools in the PTSD Coach Canada Application can help you cope when you feel distressed.

If you still don't feel well after one or two months, seek professional help.

I have PTSD. How can the PTSD Coach Canada Application help me?

If you've been diagnosed with PTSD, the tools in the PTSD Coach Canada Application may help you manage your symptoms. However, it is not meant to be a replacement for professional care. If you are currently in treatment for PTSD, you should talk with your provider about using PTSD Coach Canada as part of your work together.

Remember: effective treatment for PTSD is available! You don't have to live with your symptoms forever.

I'm embarrassed to have PTSD

If people with PTSD see it as a sign of weakness or damage, they may feel ashamed or secretive about it. This may be especially true if the person has angry outbursts, flashbacks or other symptoms of PTSD when in public.

Embarrassment and shame can lead trauma survivors to withdraw or keep quiet about their problems. But this can backfire and leave them isolated and unsupported.

Remember: PTSD is a normal response to abnormal circumstances.

Social isolation

It's common for people with PTSD to isolate themselves. You may feel overwhelmed or unsafe in groups, quick to anger, misunderstood, or just uninterested in being around people. However, isolation can lead to loneliness, depression, and anxiety.

The PTSD Coach Canada Application offers some suggestions and strategies to help you cope with feeling disconnected from people, and start to reconnect with loved ones and friends.

Sleep problems: Nightmares

If you have upsetting nightmares that interrupt your sleep, here are some tips:

• On waking up, turn the light on, take a few deep breaths, and notice the sights, sounds and smells around you.
• Pay attention to the differences between the nightmare and the current moment, and let those differences calm and reassure you.
• Distract yourself for 5 to 10 minutes after you wake up with a book or some music; try getting up and spending time in a different room.
• When you try falling asleep again, think about pleasant things and avoid thoughts of the nightmare.
• Avoid sleep deprivation. Keep a consistent sleep schedule and exercise regularly to help reduce your nightmare frequency.
• Be cautious about your use of alcohol, caffeine, and nicotine, which can disrupt sleep.

Sleep problems: Insomnia

If you lie awake in bed for more than 15-20 minutes without falling asleep, try the following:

• Get up and do something boring, like reading an instruction manual.
• Only return to bed when you become sleepy.
• Keep the lights low and do not use your computer or watch TV.
• Have some water, warm milk, or herbal tea.
• Have a light, low-sugar snack if you are hungry.
• Read something soothing or listen to relaxing music.
• When you return to bed, take slow, deep breaths for about 10 minutes.
• Calm your thoughts with prayer, meditation, or “counting sheep”.
• If it’s hard to share a bed with your partner, consider sleeping separately sometimes.

What do I do if I get triggered?

Try the RID tool:

• Relax
• Identify
• Decide

First, do something to help yourself Relax (such as take some deep breaths, get a drink of water, or remind yourself “I can handle this.”)

Second, identify what the trigger is (such as a car backfiring, being in a crowd). Then identify how now is different from then (such as you are not in a war zone, you have more control now).

Third, decide what to do. For example, if being in a crowd upset you, recognize that this crowd is not hostile: maybe you’re celebrating. You can decide to stay in the crowd and see that you are safe now.

What is dissociation?

Dissociation is the sense of detachment from physical and emotional experiences, sensations, memories or one's immediate surroundings. Dissociation can range from mild to intense. It often happens without the person's intent, so it can be confusing and upsetting.

Examples: observing yourself/your body from an outside perspective (such as above, across the room), sounds or sights seeming far away or distorted, losing sense of time, or physical or emotional numbing.

I am avoiding things

People with PTSD often find themselves avoiding things that remind them of the trauma they experienced. While it may feel like a relief in the short run to avoid painful reminders, when you end up avoiding things that you need to deal with, isolating yourself, or noticing that your life has gotten a lot smaller, it can mean that avoiding isn’t really working.

You can find tools and strategies for calming yourself in the face of reminders, and for surviving and even thriving when you do things you’ve been avoiding in the Manage Symptoms section of the PTSD Coach Canada Application.

I don't trust people

Many people who have been through a trauma feel mistrustful, but it’s not helpful to make that assumption about everyone all the time.

Practice asking yourself questions like:

• Is that true all the time? What percent of the time are people untrustworthy?
• Can I think of a time when someone came through for me?
• Who are 3 people I know who I can trust at least a little?
• What can I trust them with?

I can't control my temper

This can be really scary and frustrating for many trauma survivors, especially Veterans and Active Duty military personnel who have been in places where being angry or aggressive was seen as beneficial. You can learn to control your behavior when you are upset with the help of this app and/or with in-person therapy. Check out some of the coping tools for anger in the Manage Symptoms section of the PTSD Coach Canada Application.

I'm always on edge

Feeling edgy, vigilant, or constantly alert to danger is a common experience for many people with PTSD. Relaxation exercises and mindfulness practices can help soothe your nervous system. These exercises are available in the Manage Symptoms section of the PTSD Coach Canada Application.

I feel sad all the time

Feeling sad, down, heavy or blue most of the time for more than 2 weeks can be a sign of depression. If you are concerned that you may be depressed, talk with your health care provider or reach out to a mental health professional for support. If you are a Canadian Armed Forces (CAF) member, a Military or a Royal Canadian Mounted Police (RCMP) Veteran, you can also call the Canadian Armed Forces Member Assistance Program (CFMAP) and Veterans Affairs Canada (VAC) Assistance Service 24-hour toll-free line at 1-800-268-7708 or 1-800-567-5803 (TDD).

If you are a Canadian Armed Forces (CAF) member, you can contact Canadian Forces Health Services, or visit the “You’re Not Alone” website.  

If you are a Veteran, you can also contact Veterans Affairs Canada by at 1-866-522-2122 or 1-833-921-0071 (TDD).