• persistent worry about potential problems or negative outcomes and exaggerating potential consequences
• dwelling on negative thoughts or events, even when they are not directly present
• difficulty with concentration, memory, and decision making
• panic attacks, overwhelming rushes of intense mental and physical symptoms that come on very quickly, often without any obvious trigger, and last a few minutes.

• dizzying or painful headaches
• a racing heart or chest pains
• intense breathing or shortness of breath
• abdominal pains, stomachache or an upset stomach
• uncontrollable bodily trembling or shaking
• profuse sweating, even when cold
• fatigue or weakness
• tight muscles and muscle tension
• aching in one or more groups of muscle
• panic attacks, overwhelming rushes of intense mental and physical symptoms that come on very quickly, often without any obvious trigger, and last a few minutes.

• prolonged periods of sadness or low mood
• being uncharacteristically weepy or crying with little or no obvious cause
• an increase in the number and severity of mood swings or becoming uncharacteristically irritable
• a lack of enthusiasm for things that would normally bring pleasure
• seeming overly tired or having less energy than usual
• expressing feelings of extreme tiredness that are actually indicators of severe emotional exhaustion and a desire to escape emotional pain
• increasingly severe or frequent repetitive and compulsive behaviours
• self-harm or suicidal thoughts or urges.

• agoraphobia, the fear and avoidance of places or situations that might cause panic and feelings of being trapped or helpless
• amaxophobia, the fear of driving or riding in a vehicle such as a car, bus or plane
• erotophobia, which encompasses a broad range of anxieties and fears related to sex and physical intimacy
• gamophobia, the fear of commitment
• hoplophobia, the fear of weapons and in particular firearms
• mysophobia, the fear of germs and contamination
• somniphobia, an intense fear of sleep
• tokophobia, the fear of childbirth.

• being subjected to training using strong negative reinforcements such as hitting and spanking, or humiliation and ridiculing
• being seen as “won't do” rather than “can't do” and punished for unintended mistakes or labelled as inept, stupid, useless, etc
• regular or ongoing marginalisation, intimidation, and bullying.

• how well a person sleeps
• when they are able to sleep
• how well they function when awake.

• distressing dreams, nightmares or night terrors
• rumination, the repetitive and persistent thinking for more than a few idle minutes that unusually involves repeating a negative thought or trying to solve an evasive problem
• racing thoughts, confused and erratic thinking about multiple things at once
• intrusive thoughts, persistent unwanted, distressing and disturbing thoughts that often revolve around specific fears, themes, or concerns and can be graphically explicit or violent and upsetting
• earworms, songs or parts of songs that become stuck in your head and are difficult to dislodge.

• difficulty falling asleep and staying asleep
• unsatisfying sleep and trouble waking up in the morning or waking up fatigued and unrefreshed
• excessive daytime tiredness and difficulty focusing
• mood changes, particularly depression or being easily upset.

• you actions at the time of a traumatic event, both in the context of what you did and what you did not do
• whether you should have done something differently and if so how that might have changed the outcome
• the reasons that you think provide evidence of you being responsible
• the reasons that you think provide evidence of someone or something else being responsible
• whether and how much you will recover and what life will be like then
• whether you are losing control of yourself as a result of intrusive thoughts and memories.

• feeling as if your body or self is unreal or separate
• feeling like an observer who is experiencing yourself as if watching a movie or looking in from the outside
• feeling like a robot and having a sense of being controlled by an outside force or lacking control over your actions.

• feeling as if the world is unreal, dreamlike, or foggy
• familiar places seeming foreign or strange
• feeling physically disconnected from your surroundings and people
• objects seeming to be distorted, such as appearing larger, smaller, blurry, or flattened
• time feeling distorted by speeding up or slowing down
• sounds seeming muffled or unusually sharp
• vibrant colours appearing muted or washed out.

• a hypervigilant person might be wary of a crowded place, but a paranoid person might believe that most or all of the people in that place are somehow out to harm them or is plotting against them
• a hypervigilant person might be wary of people walking behind them, but a paranoid person might believe that those people were following them with malicious intent.

• blue-light sirens
• dogs barking
• electrical devices such as phone ringtones, washing machines, or vacuum cleaners
• running water
• walking on leaves or gravel.

• mouth, nose and throat sounds, particularly those produced by chewing or eating and drinking
• repetitive environmental sounds produced by other people or objects
• sounds produced by animals.

If a sound is linked to a harrowing experience it can cause a range of negative emotions including anxiety and somatic anxiety, disgust, extreme irritation, anger and rage or possibly trigger a flashback.

• regular and excessive alcohol intake outside socially acceptable occasions
• frequent use of drugs that are manufactured, obtained, or sold illegally and that may be impure or highly addictive
• misuse of prescription or over-the-counter drugs
• having unsafe sex.

• hair pulling
• forceful head shaking
• head banging on floors, walls or other surfaces
• face or head slapping
• eye gouging
• hand or arm biting
• bodily burning or cutting
• uncontrollable skin rubbing, picking, pinching, or scratching
• punching the self or hard objects
• swallowing sharp objects or drinking hazardous liquids.

• frequent dangerous driving
• embracing risks, especially those that could lead to bone fractures
• exercising excessively
• feeding and eating disorders, in particular bulimia nervosa, a serious and potentially life-threatening eating disorder where someone binge eats in one sitting, often in secret, then tries to purge their body of the food, usually by vomiting or misusing laxatives.

The theory of the “ideal victim” is seen as someone who is most easily recognised as legitimate because they conform to a set of assumed stereotypes, but this can lead to misunderstanding and exclusion.

• the victim seeing themselves as not worthy of recognition as such because they are the “wrong” gender, or physically or socially incompatible with the common image of what constitutes a victim
• occupational non-recognition, where the sufferer is not recognised as having valid claim to being a victim due to managerial and colleague expectations surrounding an assumed ability by individuals to cope with stressful situations within the remit of their profession
• institutional non-recognition, where formal systems such as education, healthcare, law enforcement and legal institutions fail to recognise or take the sufferer sufficiently seriously due to established or entrenched theories of victim status that do not allow for differences including
  • physical or intellectual abilities
  • gender, race or culture
  • nontypical victim behaviours
  • the impact of neurodiversity
  • chronic mental illness.
• societal non-recognition, when individuals or social groups refuse to recognise someone as being worthy of victim status for reasons including
  • an attitude that the lived experiences of suffering are exclusive to people from certain social classes or ethnic backgrounds
  • ignorance based on the sufferer being seen as ethnically, intellectually, physically, or socially inferior and therefore not to be considered as a person of relevance
  • inverted snobbery related to a sufferer's perceived success, greater wealth or higher social status.

• be overwhelming
• disproportionately escalate thoughts and emotional reactions relating to distressing events
• increase your anxiety or feelings of unease
• disrupt your concentration and awareness of their surroundings.

• thoughts jumping rapidly from one unrelated topic to another so leading to a constant stream of ideas and distractions
• an influx of creative ideas or potential projects that flood the mind all at once so making it harder to focus on a single task or idea
• intense problem-solving thoughts about things that may not need immediate attention
• getting lost in elaborate daydreams or fantasies.

• the negative aspect of thinking when in a calm or contemplative state by repeatedly replaying past actions, unresolved conflicts, or conversations, analysing what was done or said, then imagining different outcomes or responses
• the repetition of a particular thought, often in response to a trigger or stressor and potentially contributing to repetitive behaviours and routines.

• excessive worrying about tasks that need to be completed and potential negative outcomes, even if the task is neither imminent nor urgent
• focusing on the same thoughts repeatedly through boredom as a way to pass the time or distract themselves from their feelings or their current situation.

• dark thoughts that vividly imagine horrifying or violent events being inflicted on themselves, things they hold affection for, or things that are fragile and easily damaged
• intrusive sexual thoughts, fantasies and urges, potentially leading to above-average or unusual sexual behaviours and interests.

• negative thoughts about oneself, the world, or others that are not based in reality and can maintain fear or distress
• self-blame and guilt through taking responsibility for events or feeling a sense of personal wrongdoing
• threat-oriented patterns of thought and behaviour, developed through experience, that lead to a heightened sense of threat
• a sense of worthlessness or helplessness leading to a loss of confidence in the ability to function independently or effectively cope with difficult situations
• inflexible thoughts that prevent a person from processing events naturally and reduce their ability to manage their emotions.

• frequent negative moods and crying
• refusal to engage in social activities, including a lack of interest in maintaining existing friendships or making new friends
• the loss of friends due to unpredictable or unsocial behaviour
• aspects of intermittent explosive disorder, such as
  • long angry speeches or heated arguments
  • easily-provoked frustration and irritation
  • volatility and hair-trigger outbursts
  • threats or shows of aggression, including shoving, pushing, slapping, or physical fights
  • severe temper tantrums or meltdowns
  • obvious physical signs of heightened anxiety, such as shaking or chest tightness.
• struggles within the home environment
• developmental delays, including substandard academic performance and attendance.

• oppositional defiant disorder, or ODD, where a person might display behaviours such as
  • being prone to anger and short temperedness
  • often being argumentative with authority figures
  • being stubborn or noncompliant, often defying or refusing to comply with instructions
  • regularly annoying other people or getting easily annoyed with themselves
  • becoming resentful, spiteful or vindictive, and often blaming others for their mistakes.
• conduct problems and antisocial behaviour
• delinquent behaviour, such as deliberate fire setting, destruction of property, or theft
• displays of excessive physical aggression.

• an increased appreciation for life
• personal relationships growing stronger through a feeling of greater connectivity to other people
• an improving and greater sense of personal strength
• an increased awareness of new possibilities
• a move to a more positive view of personal experience and acceptance that the past cannot be changed
• uplifting spiritual or philosophical change.

• dizzying or painful headaches
• a racing heart or chest pains
• intense breathing or shortness of breath
• abdominal pains, stomachache or an upset stomach
• uncontrollable bodily trembling or shaking
• profuse sweating, even when cold
• fatigue or weakness
• tight muscles and muscle tension
• aching in one or more groups of muscle
• fear of losing control or dying.

• profound feelings of fatigue or exhaustion
• lethargy, tiredness and sleepiness
• bodily aches and pains and muscle soreness
• trembling and shaking
• brain fog
• pain in the chest region
• abdominal discomfort
• a persistent sense of discomfort or unease.

• the rumbling phase: the initial phase after the person's sense of calm and order has been interrupted by a trigger. They may start to display signs of rapidly increasing anxiety such as
  • pacing, twitching, shaking, rocking or becoming very still
  • if verbal, showing agitated speech patterns such as talking more quickly or more loudly than usual, or seeking reassurance through repetitive questioning.
• the rage phase: the person is totally emotionally overwhelmed and excess rage, panic or despair is released as a meltdown, example behaviours being
  • unrestrained crying, shouting or screaming
  • uncontrolled kicking, flapping or stomping about
  • repetitive movements or zoning out.
• the recovery phase: the person may be tired or sleepy, apologetic or embarrassed, deny or have no recollection of the meltdown.

Meltdowns are distinctly different from temper tantrums, which are brief episodes of largely deliberate extreme and unpleasant disruptive behaviour or emotional outbursts in response to frustration or anger.

• profound feelings of fatigue or exhaustion
• lethargy, tiredness and sleepiness
• headaches or brain fog
• bodily aches and pains and muscle soreness
• pain in the chest region
• gastrointestinal discomfort.
• a strong desire to isolate from others.

• exhaustion from the constant oppressive effect of PTSD-related distorted behaviours, emotions and sensory overload
• the challenges faced trying to re-navigate daily life and societal norms.

• increased prevalence of exhaustion, depression and a potentially increased risk of suicidal ideation or intent
• increased levels of anxiety and stress, including suffering from headaches, gastrointestinal problems or physical pain
• increasingly disrupted diet, rest and sleep patterns
• noticeably increased sensory sensitivity
• increased difficulty with concentration, memory or making choices
• becoming increasingly withdrawn and isolated, possibly to the point of physically shutting down
• an increase in both the number of meltdowns and the time needed to recover from them.

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