Post-traumatic stress disorder (PTSD) is a psychiatric disorder that occurs after exposure to a life-threatening or physically harmful event. It is distinguished from a normal stress reaction by its persistence: symptoms last beyond a month and disrupt the daily functioning of the affected individual.
Mechanisms of traumatic memory and reconsolidation
PTSD is not simply an excess of stress. The central issue lies in how the brain stores and recalls the memory of the traumatic event. In an unaffected person, a distressing memory gradually integrates into autobiographical memory, loses its emotional intensity, and becomes a narrative of the past.
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In a person suffering from PTSD, this process fails. The memory remains fragmented, laden with raw emotions, and reactivates at the slightest associated sensory stimulus: a sound, a smell, an image. This is known as traumatic memory.
Recent research focuses on memory reconsolidation, which is the time window during which a reactivated memory becomes modifiable again. Understanding post-traumatic stress disorder also involves this neurobiological dimension, which opens therapeutic avenues beyond classical approaches.
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Causes of PTSD: risk factors before, during, and after trauma
Not all individuals exposed to a potentially traumatic event develop PTSD. According to the WHO, about 3.9% of the global population has suffered from this disorder at some point in their lives. The majority of those exposed recover naturally.
Several factors modulate the risk:
- Pre-existing factors include a history of trauma (especially in childhood), previous psychiatric disorders, and certain neurobiological predispositions related to stress regulation.
- Factors related to the event itself include: its severity, duration, the feeling of helplessness experienced, and the degree of perceived life threat. Combat, sexual assaults, natural disasters, and interpersonal violence are among the most common causes.
- Post-event factors play a decisive role. Social support (family, friends, community) after trauma reduces the risk of PTSD. Conversely, isolation, precariousness, or lack of care increases vulnerability.
PTSD affects women more than men, a gap that specialists partly attribute to the nature of the traumas experienced (sexual violence, domestic violence) and differences in the neurobiological response to stress.
Symptoms of post-traumatic stress: three categories to identify
The diagnosis of PTSD is based on the prolonged presence of symptoms grouped into three distinct categories. These manifestations must persist for more than a month and impair personal, social, or professional life.
Re-experiencing the trauma
The person involuntarily relives the event: flashbacks, recurrent nightmares, intense distress in response to reminders of the situation. These intrusive memories are not just unpleasant memories. They are accompanied by physiological reactions (increased heart rate, sweating, trembling) as if the danger were still present.
Avoidance and emotional numbing
The person actively avoids anything that reminds them of the trauma: places, people, conversations, thoughts. They may also exhibit emotional numbing, a loss of interest in previously enjoyed activities, or a feeling of detachment from loved ones.
Hypervigilance and reactivity
The nervous system remains in a state of constant alert. This manifests as sleep disturbances, marked irritability, difficulty concentrating, and exaggerated startle responses. This chronic neurovegetative activation exhausts the body and promotes physical complications (cardiovascular disorders, chronic pain).
Treatments for PTSD: trauma-focused therapy as the first line
Data consolidated in 2025 confirm that trauma-focused cognitive-behavioral therapies (TF-CBT) and EMDR remain the best-supported interventions. They show benefits for PTSD symptoms, as well as for the depression and anxiety that frequently accompany it.
TF-CBT involves gradually exposing the person to the traumatic memory in a safe setting to modify the associated dysfunctional thoughts and beliefs. EMDR uses bilateral stimulation (eye movements, tapping) during recall to facilitate the reprocessing of the memory.
A recurring debate concerns the so-called “phase-based” approaches for individuals who have experienced repeated or early trauma. These protocols include a stabilization phase before addressing the trauma. Meta-analyses from 2025, focusing on adults traumatized in childhood, show a weak effect of phase-based approaches compared to direct trauma therapy, with no significant difference in treatment completion rates.
Antidepressants (mainly selective serotonin reuptake inhibitors) are a complementary treatment, recommended when psychotherapy alone is insufficient or when access to specialized therapy is limited.
PTSD remains a disorder for which the timeliness of care matters. Rapid psychological support after the event does not always prevent the onset of the disorder, but seeking help as soon as symptoms persist beyond a few weeks improves prognosis. The most protective factor, even before any professional intervention, remains the support of those around the individual in the days and weeks following the trauma.