If we were to trust pop culture portrayals and online “experts,” we’d think post-traumatic stress disorder (PTSD) instantly manifests at the point of trauma. However, as with all aspects of our mental health, things are far more nuanced than this. Potentially traumatic events can happen to anyone at any time. How each person responds — consciously and unconsciously — is unique.
In fact, symptoms of PTSD may not emerge for months or years after a nightmarish experience — especially when it’s a matter of childhood trauma. We call this delayed-onset PTSD and it’s not rare. Some estimate that about one-fourth of PTSD cases are delayed.
What Is Delayed-Onset PTSD?
If PTSD symptoms arise six months or more after a potentially traumatic event, generally speaking, this would satisfy the criteria for delayed-onset PTSD. On the other end of that spectrum, there is no time limit. For example, signs of PTSD or C-PTSD can appear even decades after an incidence of childhood trauma. Ultimately, such distinctions are made with the support and observation of a trauma-informed therapist.
What Can Cause PTSD — Delayed or Otherwise?
- Neglect and abandonment
- Loss of a loved one via death, divorce, incarceration, etc.
- Physical illness or disability
- Living or serving in a war zone
- Being victimized by a natural disaster, crime, accident, or injury
- Emotional, physical, and sexual abuse (especially during childhood)
What Symptoms Would You and Your Therapist Be Looking For?
- Nightmares and flashbacks
- Unable to enjoy activities that once brought you happiness
- Self-isolation and social withdrawal
- Hyper-vigilance or startling easily
- Anger control issues
- Physical pain or other symptoms that emerge for no obvious reason
- Chronic feelings of shame and guilt
- Mood swings
- Emotional detachment and numbness
- Memory loss, especially related to the details of the trauma
- Avoiding any reminders of the traumatic event
- Self-harm
- Thoughts of death or suicide
Possible Causes of Delayed Onset PTSD
This question is more easily asked than answered and, of course, it’s important to remember that this can vary widely from person to person. That said, we currently have an accepted theory as to what might cause delayed-onset PTSD along with a couple of underlying reasons.
The Theory
It may not be that a trauma survivor displays no symptoms for months or years. The signs could just be subtle enough that a person isn’t alarmed and cannot justify a medical visit for them. Thus, the low-level symptoms could become normalized until things escalate — seemingly out of nowhere.
Two Underlying Reasons Why PTSD Might “Suddenly” Emerge
- Increased Stress: Some levels of stress are inevitable but a large or sudden increase could be the precise trigger to cause low-level PTSD to bubble up to the surface. The new stress doesn’t have to be related to the original traumatic event to serve as a powerful trigger.
- New Trauma: The introduction of fresh trauma into a survivor’s life could become a catalyst for the low-level symptoms from the past to transform into obvious, clear-cut PTSD.
Obviously, we need more research but the concepts above are a solid start when it comes to dissecting the mysteries of delayed-onset PTSD.
Getting Help for Delayed-Onset PTSD
Your memories and gut feelings can be very helpful in discerning the presence of something that needs professional attention. Beyond that, though, you don’t want to engage in self-diagnosis without input from a mental health practitioner. Someone with experience in treating trauma can help you identify causes, effects, and solutions.
A great start to never downplay symptoms that potentially point to a traumatic impact. Just because you’ve lived for months, years, or even decades without treatment doesn’t mean you should continue this pattern. Let’s connect and talk about what’s going on.