It is a common misconception that symptoms of PTSD appear immediately after trauma. In fact, this fallacy could not be further from the truth.
Research to date tends to broadly state that symptoms will appear within 3 months of the trauma. Don’t confuse that as, “I will have all symptoms to meet PTSD within 3 months.” That is not what I’m saying, nor what current research discusses. The National Institute of Mental Health cites this exact data.
There is no single authoritative answer to when symptoms appear or how many will show up and when. The most common sentiment in the field is that a person may have one or more symptoms within 3 months. Think about it like this — you may lose sleep immediately, have bad dreams. That is one symptom, and it would be natural to experience insomnia and nightmares directly after experiencing trauma. That subsides, and then you may find that you isolate yourself a month later — another symptom. You may have a really hard week at work, then explode at someone. You’ve never done that before after a tough week, but it happened this once, some months after your traumatic event. This is another symptom.
All of the above are single, isolated symptoms of PTSD. You aren’t experiencing those symptoms simultaneously. You experience them as isolated, even seemingly dissonant, events. You may experience them simultaneously, yet they are still a mere three symptoms of many needed for a PTSD diagnosis. This is what most research points to in relation to having symptoms within the first 3 months after your traumatic exposure.
Having PTSD without experiencing the symptoms required to meet diagnosis is not all that different –on a much smaller scale — from how we experience viral infections. You may contract a virus from your child on a Sunday, incubate it for 5 days with no symptoms, and then experience the symptoms the following weekend. You carried the virus all week and were contagious, but how could you possibly know? Perhaps you felt a bit of a sore throat as the week wore on or had some sniffles, but it’s the right time of year to have seasonal allergies. It doesn’t mean you didn’t have a virus, just that you didn’t meet the telltale signs you would need to seek help and subsequently get treatment.
On a larger scale, how about sufferers of dementia? Many people with dementia experience a few symptoms, spread out, for months or even years before realizing there’s a real problem going on. They lose their balance or become disoriented every now and again. If they’re of a certain age, stumbling here and there or occasionally being forgetful doesn’t set off any alarm bells, the same way that being anxious or on guard following trauma is a perfectly non-pathological response to recently experiencing trauma. It often takes more time, and certainly requires more symptoms to be ticked off, before discovering you have a chronic problem, even if you do in fact already have the disease.
To further demonstrate the variability for when symptoms begin, MyPTSD has polled this exact question for 9+ years. Our member poll results, those who have answered, show that 31% experience symptoms in the first three months, with 49% taking longer than 12 months.
Our results demonstrate a much broader result set taken over 9+ years at the time of writing this article. If MyPTSD made a single statement, as the NIMH and other authoritative sources state, then our view would be that the majority of people take longer than 12 months to experience symptoms.
This view aligns with resilience data (also cited by NIMH) that the majority of people exposed to trauma do not develop PTSD, let alone symptoms that would be viewed as a mental health condition. PTSD from a single event is much rarer than PTSD from compounded traumatic events throughout life.
In short, the myth that PTSD appears directly following a traumatic event has little basis in reality. Sufferers can go years, even decades, without developing full blown PTSD. The best thing trauma survivors can do is to get help as quickly as possible and build a community around themselves of supportive, compassionate people who are both understanding and honest. This base of support will serve as a resiliency tool, and it can be invaluable in helping those who experience trauma return to a sense of normalcy. The honesty of others, coupled with compassion, can serve as a check against irrational and uncharacteristic behavior — an extra set of eyes to monitor the survivor for signs of a growing problem. Moreover, seeking a professional’s help following trauma has obvious and manifold benefits, whether to help mitigate developing symptoms with medications or simply serve as a guide to return to a stable, healthy lifestyle post-trauma.