5 PTSD Physical Symptoms To Watch For

Post-traumatic stress disorder (PTSD) is a complex mental health condition that can affect several different aspects of an individual’s life. While many of the signs of PTSD impact a person’s mental and emotional well-being, this condition can also manifest as physical symptoms. Below is an overview of PTSD, its risk factors, and treatment options plus a closer look at five of the most common physical symptoms of this condition.

Understanding post-traumatic stress disorder and the mind-body connection

Post-traumatic stress disorder (PTSD) is a mental illness that can develop after an individual witnesses or experiences a traumatic event(s) such as a serious accident, natural disaster, or violence. Although it’s common in and often associated with members of the military who have been in combat zones, the disorder can affect anyone. 

PTSD is characterized by four key categories of symptoms:

• Re-experiencing the event or associated emotions (e.g., flashbacks, nightmares)
• Avoidance (e.g., avoiding experiences, locations, people, or even symbolic reminders that recall or are associated with the original event)
• Cognition/mood (e.g., memory issues, distorted thoughts)
• Hyperarousal/reactivity (e.g., irritability, being easily startled)

Often, it’s the hyperarousal/reactivity symptoms that lead to bodily effects. The underlying mechanism is that trauma can activate the body’s stress response, releasing stress hormones. PTSD is when this system remains on even when you’re not in danger, which can cause inflammation and other physical impacts. Plus, mental symptoms of PTSD (like flashbacks) can exacerbate physical symptoms (like muscle tension) because of the mind-body connection.

Risk factors and causes of PTSD

Researchers still don’t understand exactly what causes PTSD in adults and children, but they have identified several factors that may increase or decrease a person’s risk. For example, women may be more likely to experience PTSD than men—though this may be because women are likelier to experience certain traumatic situations like sexual assault. Some other factors that may affect a person’s risk of PTSD are below.

If you or a loved one is experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Support is available 24/7.

A history of trauma

Research suggests that having a history of trauma earlier in life—such as child abuse, especially sexual abuse—may increase a person’s risk of developing PTSD. The mechanisms of this process aren’t yet well-understood.

Biological factors

Researchers believe that genetics may play a role in a person’s likelihood of developing PTSD after experiencing trauma. Those with a family history of PTSD or other mental illnesses may be at higher risk. Scientists are exploring potential genetic biomarkers for PTSD, like lower levels of corticotropin-releasing factor.

Social and environmental influences

A person may be more likely to develop PTSD if they don’t have strong social support, like a close friend or access to a support group. They may also be more likely to develop PTSD if they have significant, ongoing environmental reasons to feel stressed, like unstable housing or financial insecurity.

PTSD vs. complex PTSD and co-occurring conditions

It can be helpful to note a second type of PTSD, known as complex post-traumatic stress disorder (C-PTSD). This condition can develop from repeated, ongoing trauma like war, poverty, or consistent abuse. C-PTSD involves similar symptoms to those seen with standard PTSD, but they tend to be more severe.

Also, it’s possible for a person to have co-occurring conditions that exist alongside their PTSD or C-PTSD. Other mental illnesses that commonly co-occur with PTSD or C-PTSD include:

• Anxiety disorders
• Depression
• Substance use disorder
• Borderline personality disorder

Emotional and behavioral PTSD symptoms to look out for

Many people may primarily associate PTSD with its cognitive, emotional, and mood symptoms. These stem from the way the mind reacts to a traumatic event. In addition to emotional numbness, distressing memories, and self-destructive behaviors, which are explored below, a person with PTSD may also experience emotional symptoms like:

• Difficulty concentrating
• Trouble remembering specific details of the traumatic event(s)
• Irritability and anger
• Increased fear and anxiety
• Mood swings
• Ongoing negative emotions
• Feeling detached or withdrawn from loved ones
• Lack of interest in activities once enjoyed
• Suicidal thoughts

Emotional numbness

Feeling emotionally numb is not uncommon after experiencing a traumatic event, as emotional numbness is thought to be the brain’s attempt to protect you. Alternatively, you may feel a strong sense of guilt for the traumatic event even if it wasn’t your fault.

Distressing memories and avoidance behaviors

Distressing memories of the traumatic event(s)—usually in the form of flashbacks or nightmares—are a hallmark symptom of PTSD. Triggers related to the trauma (like sounds, smells, people, or situations that remind you of the event) can make you feel like you’re back in that situation, which can cause the body to engage the stress response again. It’s one reason why avoiding talking about one’s trauma can be common in those with PTSD, since it can cause these re-experiencing symptoms.

Self-destructive behavior, such as substance use

Self-destructive behavior is a common response people with PTSD may have to their symptoms. They may use risky sexual behavior, substance use, reckless driving, or other potentially dangerous activities to numb or distract themselves.

Physical PTSD symptoms to look out for

Though the emotional symptoms may be more widely known, it’s not unusual for a person with PTSD to also experience physical effects. Five common types of physical PTSD symptoms include:

1. Sleep problems and chronic fatigue
2. Muscle tension, headaches, and chronic pain
3. Digestive issues and nausea, 
4. Heightened startle response and related physical anxiety symptoms
5. Sexual and reproductive health changes

1: Sleep problems and chronic fatigue

PTSD-related hyperarousal can make it hard to relax and rest. Re-experiencing the trauma through nightmares can also disrupt sleep or make a person fear sleeping. Whether you have difficulty falling asleep or staying asleep due to PTSD or not, a therapist may be able to help you address them through various mental health care techniques.

2: Muscle tension, headaches, and chronic pain

An estimated 25% of people who live with chronic pain also have PTSD, with some research suggesting that PTSD may actually exacerbate physical pain. This effect might occur because:

• The person develops chronic pain from an injury during the traumatic event, which is common in military members and first responders
• Emotional symptoms of PTSD can make self-care practices more difficult
• Anxiety (as a result of PTSD or an anxiety disorder) can cause persistent muscle tension

There may also be a link between PTSD and headaches or migraines. Some research suggests that headaches and PTSD may have “common genes and pathways” in the brain, which would mean that the two have some shared risk factors. 

3: Digestive issues

Research indicates that some people with PTSD also face gastrointestinal (GI) issues like irritable bowel syndrome (IBS), which can cause diarrhea, constipation, bloating, and cramping. In a study of a group of veterans with PTSD, researchers found that 36% of participants experienced stomach discomfort and 25% had symptoms of IBS specifically. 

This correlation may be due to the high levels of cortisol PTSD causes, which can upset the stomach. Or, in some people, it could be because PTSD symptoms make them turn to maladaptive coping mechanisms like smoking and alcohol consumption—which can cause GI issues as well. 

4: A heightened startle response

Hyperarousal is a category of PTSD symptoms that can also be considered a symptom itself. It refers to an increased sensitivity to stimuli, a heightened startle response, and/or hypervigilance, which can produce effects like a rapid heartbeat, jumpiness, and muscle tension. Hyperarousal can leave an individual feeling like they’re in a constant state of alert, which can be exhausting and may lead to or exacerbate other symptoms as well.

5: Sexual and reproductive health changes

Research suggests that experiences of trauma may even impact sexual and reproductive health—especially if the trauma involved sexual assault or abuse. PTSD symptoms may sometimes involve changes to overall sexual functioning, sexual satisfaction, and sexual desire, potentially including sexual pain and dysfunction.

When should you seek professional help for PTSD symptoms?

Symptoms of PTSD typically won’t go away without treatment from a professional. Understanding when to seek help so you can get treatment as soon as possible may help improve long-term outcomes.

Signs it may be time to seek support

While symptoms must last for more than a month in order for a PTSD diagnosis to be considered, you can seek professional help for them at any time. In fact, it’s usually recommended that you reach out for help as soon as you notice signs of mental health changes, which can look like:

• Insomnia
• Marked changes in behavior
• Unhealthy coping, such as using substances
• Nightmares or flashbacks about the traumatic event
• Avoiding reminders of the traumatic event

Who provides PTSD treatment?

You can receive PTSD talk therapy treatment from a mental health professional—like a licensed clinical social worker, therapist, or psychologist with experience providing trauma-informed care. If you’re looking for medication management, you’ll need to meet with a doctor or psychiatrist as well. 

Meeting with a therapist online through BetterHelp can be a convenient way to receive talk therapy for PTSD, though note that BetterHelp providers aren’t permitted to prescribe medication.

Crisis resources for urgent support

Finding a mental health professional who is experienced in working with trauma survivors is usually one of the most important aspects of seeking help if you’re experiencing PTSD symptoms. However, if you need immediate support, call a crisis lifeline or visit your nearest emergency room.

Evidence-based treatments for PTSD

The effects of this disorder can be severe, but PTSD is considered treatable, and many people who have experienced it go on to live stable, fulfilling lives. Treatments for PTSD typically consist of a combination of medication and psychotherapy. 

Effective psychotherapies for PTSD

Talk therapy is usually a core component of PTSD treatment. Two of several effective psychotherapies for this condition include:

• Prolonged exposure therapy, which helps the client gradually work up to facing the trauma-related memories they’ve been avoiding
• Cognitive processing therapy, which helps the client address distorted thoughts and beliefs about the traumatic event in order to reduce symptoms

Each person’s situation is different, but both of these and many other therapies for PTSD can often be delivered online.

Getting support through BetterHelp online therapy

Since therapy is the first-line treatment for this disorder, people experiencing signs of PTSD are encouraged to meet with a mental health care provider. They can offer you a safe place to process your emotions and develop healthy coping mechanisms for your symptoms. 

If you’d prefer to meet with someone in person, you can search for a provider in your local area. If you find virtual meetings with a therapist to be more comfortable or convenient for your needs or your schedule, you might consider online therapy through a platform like BetterHelp instead. 

A growing body of evidence indicates that, in many cases, online therapy may help alleviate PTSD symptoms just as effectively as traditional in-office care. For instance, a 2023 study suggests that online cognitive behavioral therapy (CBT) may produce similar benefits for those living with PTSD as in-person CBT. 

If you’re interested in trying online therapy to receive evidence-based care from a qualified provider, you might consider a virtual therapy platform like BetterHelp. Through BetterHelp, you can get matched with a licensed therapist who you can meet with via phone, video, and/or chat to receive trauma-informed care. The online format means you can receive accessible, convenient, professional help from anywhere you have an internet connection.