Delayed-Onset PTSD Symptoms


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To be diagnosed with post-traumatic stress disorder (PTSD), you have to experience a specific set of symptoms for at least one month following exposure to a traumatic event, but in some cases, people may experience delayed-onset PTSD.

Delayed-onset PTSD is not frequently diagnosed, and there is not a great deal of research on this type. However, its occurrence has been observed and studied in some research, and it appears that almost a quarter of PTSD cases may be delayed onset. This research has produced some theories on what delayed-onset PTSD is and why it occurs.

What Is Delayed-Onset PTSD?

Delayed-onset PTSD describes a situation where a person does not develop a PTSD diagnosis until at least six months after a traumatic event.

In some cases, the delayed onset of PTSD can be even longer. For example, some people may not begin to experience symptoms consistent with a PTSD diagnosis until years after the experience of a traumatic event.

Delayed-onset PTSD of this type has mostly been observed among the elderly, who may develop PTSD stemming from a traumatic event that occurred when they were much younger.


The jury is still out with regard to why delayed-onset PTSD may occur. However, there is a small body of research that sheds some light on this condition.

It appears that people who may be most at risk are those who are experiencing some symptoms of PTSD, but not enough to meet criteria for a PTSD diagnosis (referred to as subthreshold PTSD) after a traumatic event. The development of delayed-onset PTSD in the absence of any previous PTSD symptoms is very rare, and most cases of delayed-onset PTSD seem to reflect a worsening or re-occurrence of symptoms.

Research also shows that the occurrence of additional life stressors or traumatic events may increase the likelihood that someone would develop a PTSD diagnosis in response to a prior traumatic event.

The experience of additional trauma may tax one's ability to cope with a previous traumatic event, increasing the likelihood that existing subthreshold PTSD symptoms become more severe.

For example, one study of World War II veterans found that many had a worsening of their PTSD symptoms or the development of delayed-onset PTSD much later in life. Almost half the veterans indicated that the worsening of their symptoms was triggered by major life changes, such as losing a job or a family member.


After a traumatic event, many people may begin to experience some symptoms of PTSD. For most, these symptoms may naturally lessen over time. However, for some, symptoms may persist.

Even though symptoms may not be severe enough to meet criteria for a PTSD diagnosis, they can still interfere with your life. In addition, if they are not adequately addressed, they could increase your risk for delayed-onset PTSD.

It is very important to take steps early on to cope with your PTSD symptoms. There are a number of effective, healthy coping strategies.

Most importantly, you want to be careful not to rely on coping strategies that are focused on the avoidance or suppression of PTSD symptoms, such as substance use. These strategies may help you initially escape your symptoms, but in the long run, they only cause your symptoms to persist and generally get worse.

In addition, if you notice that you are continuing to experience symptoms from a traumatic event that happened some time ago, it may be worthwhile to talk to a mental health professional. You don't need a diagnosis of PTSD to benefit from PTSD treatments.

A Word From Verywell

Even if you don't meet the criteria for PTSD, PTSD-focused therapy may help resolve your symptoms, as well as provide you with some additional support and better coping strategies for future life stressors. If you are looking for treatment providers in your area, there are a number of helpful websites that can assist you in locating the right therapist for your needs.

9 Sources
Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Smid GE, Mooren TT, Van der Mast RC, Gersons BP, Kleber RJ. Delayed posttraumatic stress disorder: systematic review, meta-analysis, and meta-regression analysis of prospective studies. J Clin Psychiatry. 2009;70(11):1572-82. doi:10.4088/JCP.08r04484

  2. Frueh BC, Grubaugh AL, Yeager DE, Magruder KM. Delayed-onset post-traumatic stress disorder among war veterans in primary care clinics. Br J Psychiatry. 2009;194(6):515-20. doi:10.1192/bjp.bp.108.054700

  3. Chopra MP. PTSD in late life: special issues. Psychiatric Times. 2018;35(3).

  4. Horesh D, Solomon Z, Zerach G, Ein-Dor T. Delayed-onset PTSD among war veterans: the role of life events throughout the life cycle. Soc Psychiatry Psychiatr Epidemiol. 2011;46(9):863-70. doi:10.1007/s00127-010-0255-6

  5. Herrmann N, Eryavec G. Delayed onset post-traumatic stress disorder in World War II veterans. Can J Psychiatry. 1994;39(7):439-41. doi:10.1177/070674379403900710

  6. National Institute of Mental Health. US Department of Health and Human Services. Post-traumatic stress disorder.

  7. PTSD: National Center for PTSD. US Department of Veterans Affairs. PTSD and problems with alcohol use.

  8. National Alliance on Mental Illness. Finding a mental health professional.

  9. Watkins LE, Sprang KR, Rothbaum BO. Treating PTSD: A Review of Evidence-Based Psychotherapy Interventions. Front Behav Neurosci. 2018;12:258. doi:10.3389/fnbeh.2018.00258

Additional Reading
  • Andrews, B., Brewin, C.R., Philpott, R., & Stewart, L. (2007). Delayed-Onset Posttraumatic Stress Dsorder: A Systematic Review of the Evidence. American Journal of Psychiatry, 164, 1319-1326.

  • Andrews, B., Brewin, C.R., Stewart, L., Philpott, R., & Hejdenberg, J. (2009). Comparison of Immediate-Onset and Delayed-Onset Posttraumatic Stress Disorder in Military Veterans. Journal of Abnormal Psychology, 118, 767-777.

  • Hepp, U., Moergeli H., Buchi S., Bruchhaus-Steinert H., Kraemer B., Sensky T., & Schnyder U. (2008). Post-Traumatic Stress Disorder in Serious Accidental Injury: 3-Year Follow-Up Study. British Journal of Psychiatry, 192, 376-383.

  • Horesh, D., Solomon, Z., Zerach, G., & Ein-Dor, T. (2010). Delayed-Onset PTSD Among War Veterans: The Role of Life Events Throughout the Life Cycle. Social Psychiatry and Psychiatric Epidemiology, 46, 863-870.

  • Smid, G.E., Mooren, T.T., van der Mast, R.C., Gersons, B.P., & Kleber, R.J. (2009).Delayed Posttraumatic Stress Disorder: Systematic Review, Meta-Analysis, and Meta-Regression Analysis of Prospective Studies. Journal of Clinical Psychiatry, 70, 1572-1582.

By Matthew Tull, PhD
Matthew Tull, PhD is a professor of psychology at the University of Toledo, specializing in post-traumatic stress disorder.