When someone witnesses or experiences a horrific event, they can be traumatized. If a particular set of symptoms is present for at least a month, that person ends up diagnosed with post-traumatic stress disorder (PTSD). At that point, the trauma survivor must seek treatment. But what happens if that particular set of symptoms doesn’t arise right away? What if symptoms don’t emerge for months or even years? This is typically called delayed-onset PTSD.

Delayed-onset PTSD may sound unusual and rare, but research suggests that as many as 25 percent of cases of PTSD are delayed-onset. Obviously, such a phenomenon must be explored.

What Is Delayed-Onset PTSD?

It’s generally accepted that PTSD is not delayed-onset until at least six months after the traumatic experience. Of course, there is no limit as to how long it takes for trauma symptoms to become identifiable. For the sake of clarity, here are the most common signs of PTSD (delayed or otherwise): 

• Intrusive thoughts, nightmares, and flashbacks

• Self-isolation and social withdrawal 

• Angry outbursts

• Unexplained physical pain and other symptoms 

• Losing interest in activities you once enjoyed 

• Hyper-vigilance 

• Mood swings 

• Memory loss

• Feelings of shame and guilt 

• Avoidance of anything that reminds you of the trauma 

• Emotional detachment

• Self-harm 

What Types of Events Can Cause Delayed-Onset PTSD?

It’s the same types of events that cause typical PTSD. Here are a few examples:

• Emotional, physical, and sexual abuse (especially during childhood)

• Neglect and abandonment

• Physical illness, injury, or disability 

• Living in a war zone

• Natural disasters

• Being targeted for or witness to a violent crime

• Death of a loved one

But Why is the Onset of PTSD Delayed?

This is the primary focus of ongoing research. A major trend is believed to be the intensification of already existing problems. In other words, a trauma survivor can experience mild PTSD symptoms but nothing extreme enough to cause them or their doctor too much concern. This is called sub-threshold PTSD. In fact, it’s extremely rare for delayed-onset PTSD to emerge without some low-level symptoms already in place. As to why those symptoms would worsen, here are two common factors: 

An Increase in Daily Stress 

Everyone has stress in their lives. It’s normal and unavoidable. But if you’re already struggling with sub-threshold PTSD, any increase in daily stress can trigger full-blown PTSD. The stress does not have to be related to past trauma. It can stem from more universal roots like financial issues, relationship strife, and so on.

Experiencing More Trauma 

A common example could involve a military veteran. During combat, they endured traumatic events but never felt anything more than sub-threshold PTSD. However, years later, in everyday life, they may suffer more trauma. Let’s say it’s a natural disaster. Suddenly, they are having nightmares about war-related events as the original PTSD symptoms become more severe.

Treatment For Delayed-Onset PTSD

For anyone who has lived through a traumatic event, a powerful first step is never to downplay what you feel. You don’t have to speak PTSD into existence, but you also don’t want to treat sub-threshold symptoms as unimportant. The earlier you connect with a therapist, the more likely you are to alleviate those symptoms before they can resurface later as delayed-onset PTSD. 

Keep in mind that you do not need an official PTSD diagnosis to benefit from treatments designed for PTSD. So, check yourself before you downplay or suppress distressing emotions and thought patterns. If they are left unaddressed, they will surface at some point — quite possibly, far worse than they are now.

To help clarify what you’re feeling and why, I invite you to reach out and make contact. Let’s talk soon about the situation and all your options. 

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