How to recognize PTSD and when to seek help

After shelling, the loss of a loved one, evacuation, or returning from the front line, a person may struggle to regain a sense of normality. Memories return in dreams, sudden noises trigger a startle response, and conversations with family become brief and tense.

Many people ask themselves: is this post-traumatic stress disorder (PTSD), or is it a normal response to extraordinary circumstances? It is important to understand which symptoms require attention, how PTSD differs from other stress reactions, and when to seek professional help.

Is it normal to feel unwell after a traumatic event?

Yes. After experiencing danger, loss, or another traumatic event, a person may experience intense emotional distress, anxiety, and exhaustion. According to the World Health Organization (WHO), approximately 70% of people experience potentially traumatic events during their lifetime, yet only a proportion of them develop PTSD.

In the first days and weeks after a traumatic experience, a person may experience various reactions, including:

• Sleep disturbances, frequent waking, and increased sensitivity to sounds.
• Intrusive thoughts about what happened and repeatedly reliving the event.
• Difficulty concentrating and carrying out everyday tasks.
• Irritability, tearfulness, or emotional detachment.
• Headaches, muscle tension, and stomach discomfort.

These are natural responses of the nervous system to a perceived threat. For many people, these symptoms gradually subside as their sense of safety returns. However, if symptoms persist, become more severe, or begin to significantly affect daily life, it is worth seeking professional help.

How is PTSD different from a normal stress response?

The main differences lie in how long the symptoms last and how significantly they interfere with daily life. According to the diagnostic criteria of the American Psychiatric Association, PTSD symptoms must persist for more than one month and cause significant distress or impairment in everyday functioning. Similar symptoms occurring within the first month after a traumatic event may indicate acute stress disorder.

It is also important to understand that PTSD does not always develop immediately. Symptoms may appear soon after a traumatic event or emerge many months or even years later. A person may cope with the consequences of combat experience, captivity, or the loss of a loved one for a long time before noticing that memories, anxiety, and sleep disturbances are beginning to significantly affect their life.

Exposure to war increases the risk of developing PTSD. According to the WHO, the prevalence of PTSD among people who have experienced armed conflict is estimated at approximately 15.3%. This highlights the importance of access to psychological and psychiatric support for people affected by war.

How to recognize PTSD: four groups of symptoms

Post-traumatic stress disorder can manifest in different ways. Some people experience intrusive memories and nightmares, while others avoid anything that reminds them of what happened or remain constantly on edge. Specialists identify four main groups of symptoms.

Re-experiencing the traumatic event

Intrusive memories that arise involuntarily, nightmares, and flashbacks in which it feels as though the event is happening all over again. The body may react as if it were facing danger in the present, with a racing heartbeat, sweating, or trembling.

Avoidance of reminders

A person avoids places, people, and conversations associated with the trauma. They may stop watching the news, avoid a particular route, or change the subject when someone asks what happened.

Changes in thoughts and mood

Persistent feelings of guilt or shame, or thoughts such as “It was my fault” or “The world is dangerous, and no one can be trusted.” Other symptoms may include losing interest in activities that once brought pleasure, feeling detached from loved ones, or having gaps in memory concerning details of the traumatic event.

Persistent hypervigilance

Being easily startled by sudden noises, disturbed sleep, outbursts of anger, difficulty concentrating, or engaging in risky behaviour. A person may sit in a café facing the door, constantly scanning their surroundings.

Having some of these symptoms does not necessarily mean that a person has PTSD. To make a diagnosis, a qualified professional assesses the overall pattern of symptoms, their duration, and their impact on everyday life.

Why PTSD cannot be diagnosed from a symptom checklist

Insomnia, irritability, memory gaps, anxiety, and difficulty concentrating are symptoms that many people may recognize in themselves. However, experiencing several of these symptoms does not automatically mean that a person has post-traumatic stress disorder.

Similar symptoms can occur as a result of chronic sleep deprivation, depression, anxiety disorders, alcohol use, and other health conditions. It is therefore important to assess the combination of symptoms, how long they have lasted, and how they affect everyday life.

A diagnosis is made by a qualified professional after evaluating the person's condition. If necessary, a doctor will also check whether the symptoms may be related to other medical conditions.

Online screening tests may help indicate whether professional assessment is advisable. However, if your experiences continue to affect your sleep, emotional well-being, or relationships with loved ones, consider speaking with a specialist even if an online test does not indicate a high risk of PTSD.

When should you seek help?

Consider seeking professional help if your experiences continue to affect your well-being, sleep, work, or relationships with loved ones. It is particularly important not to delay a consultation if you notice any of the following:

• Symptoms persist for more than a month, do not improve, or become more intense.
• Nightmares and fear of falling asleep mean you regularly sleep only three to four hours a night.
• You have started drinking alcohol more frequently or taking sedatives without medical advice to cope with emotional distress.
• Outbursts of anger and irritability are negatively affecting your relationships with your partner, children, or other loved ones.
• You can no longer work as you used to or find it difficult to leave the house.
• You avoid places, people, and situations that remind you of the traumatic experience, causing your social circle to gradually shrink.
• People close to you have noticed that you seem to have “become a different person.”

When is emergency help needed?

Seek immediate help if you or someone close to you:

• Is thinking about suicide, has made a plan, or is preparing to act on those thoughts.
• Is deliberately causing self-inflicted injuries.
• Poses a danger to others.
• Is in a state where they cannot distinguish reality or do not know where they are.

In Ukraine, call 103 for emergency medical assistance or 112 for the national emergency services number.

If there is no immediate threat to life but you need psychological support, you can contact these free, 24-hour helplines:

• 0 800 21 01 60 – the helpline of the international humanitarian organization People in Need.
• 0 800 33 20 29 – the crisis support line of the Ukrainian Veterans Fund, including support for veterans and their family members.

How to support a loved one with PTSD

Family members often feel helpless when someone withdraws or responds sharply to questions. In these situations, specialists recommend the following:

• Learn more about PTSD so you can understand that irritability and emotional detachment may be symptoms of the condition rather than a reflection of how the person feels about you.
• Let them know you are willing to listen, but do not pressure them to share details of what happened.
• Plan activities together that used to bring them pleasure, even simple ones such as going for a walk, having coffee, or fishing.
• Offer to help arrange a medical appointment and accompany them if they wish.
• Discuss what helps during difficult moments and develop a plan together. Identify dates, places, or sounds that are particularly challenging and agree on what may help in those situations.
• Look after your own well-being. An exhausted caregiver may struggle to support anyone else. You may also benefit from a psychology consultation.

Phrases such as “Pull yourself together,” “Other people have it worse,” or “You just need to forget about it” rarely help. They can intensify feelings of guilt and make the person feel misunderstood. Instead, help them understand that their experiences matter and that seeking professional help is not a sign of weakness.

If you notice concerning changes in a child, such as nightmares, bedwetting, or repeatedly acting out the traumatic event during play, seek support from a child psychologist.

Learn more about PTSD and how to help

Understanding post-traumatic stress disorder is important both for professionals who work with the consequences of traumatic experiences and for family members who want to better understand what a loved one is going through and how to support them. These topics are covered in the educational webinar “PTSD: Understanding and Support”.

The programme covers the mechanisms underlying PTSD, its clinical manifestations, contemporary approaches to symptom assessment, and evidence-based psychotherapeutic methods. Particular attention is given to the experience of war, working with military personnel, veterans, and civilians, as well as techniques for emotional stabilization and preventing retraumatization.

The webinar is intended for psychologists, psychotherapists, psychiatrists, doctors, social workers, rehabilitation specialists, and volunteers, as well as anyone who wants to develop a better understanding of PTSD and support people who have experienced traumatic events.

How is PTSD treated, and which specialist should you see?

Post-traumatic stress disorder is treatable. Psychotherapy is the mainstay of treatment, particularly trauma-focused cognitive behavioural therapy (TF-CBT) and eye movement desensitization and reprocessing (EMDR). When necessary, a doctor may also prescribe medication. The choice of treatment depends on the symptoms, their severity, and the individual's needs.

Depending on your situation, you may consult the following specialists:

• A psychiatrist assesses mental health, establishes a diagnosis, determines the treatment plan, and prescribes medication when necessary, including antidepressants.
• A psychologist with appropriate training can help you process the effects of a traumatic event using evidence-based psychotherapeutic approaches.
• A sleep medicine specialist can help assess and address sleep disturbances when insomnia and nightmares significantly affect your well-being.
• A general practitioner or family doctor can conduct an initial assessment, investigate possible physical causes of your symptoms, and refer you to an appropriate specialist if needed.

Do not take sleeping pills or tranquillizers without a doctor's prescription. Some medications can cause dependence or have unwanted side effects.Your physical health also deserves attention after nights disrupted by air-raid alerts. If you experience fluctuations in blood pressure after sleepless nights, read our cardiologist's advice on monitoring blood pressure after nights of air-raid alerts.

What can you do for yourself today?

While seeking appropriate support, try to maintain a regular daily routine, follow a consistent sleep schedule, stay physically active, and keep in touch with people you trust. Limiting alcohol is also important because it can worsen sleep and intensify emotional difficulties.

Simple breathing exercises and muscle relaxation can help reduce tension. These steps do not replace treatment, but they can provide additional support.

Seek help at Doctor Sam

If you recognize these symptoms in yourself or someone close to you, the specialists at Doctor Sam Medical Centre can help assess the situation and determine what kind of support may be beneficial. During a consultation, you can discuss your concerns, receive recommendations, and, if necessary, agree on a further treatment plan.

To book a consultation, call +380 97 312 92 91.

Our address: 1 Kiltseva Road, Respublika Park Shopping Mall, Kyiv, Ukraine