Post-traumatic stress: Read in the order of your interest
Before the diagnosis alone explains all of your current difficulties
Post-traumatic stress: Checking the duration of startle responses, nightmares, and avoidance
Post-traumatic stress is a state where re-experiencing the event, avoiding related scenes, and remaining constantly on alert hyperarousal, as well as changes in thoughts and mood, persist for more than a month and disrupt functioning. We do not force the disclosure of event details; instead, we first verify current safety, sleep, and situations that trigger the memories. While maintaining trauma-focused therapy and a safety plan, we reduce the burden of nightmares, startle responses, sleep loss, and physical tension. Immediate professional treatment is the priority for risks of self-harm or harm to others, safety issues due to dissociation, psychosis, severe alcohol use, or drug use.
Determine next steps
Post-traumatic stress: Symptoms to check now and the order of medical evaluation
We first verify current safety and professional treatment plans, then set concurrent goals to address sleep, heart rate, and digestive burdens remaining alongside post-traumatic stress disorder.
| Current Situation | Items to Check Together | Next action |
|---|---|---|
| First occurrence, cause is unclear | Physical illnesses, medications, changes in sleep | Start with necessary evaluations |
| Long-term repetition, reduction in daily activities | Avoided activities, recovery time, response to treatment | Integrated care plan |
| Physical burden remains during existing treatment | Sleep, heart rate, digestion, energy levels | Consultation on concurrent treatment goals |
| Symptoms that suddenly worsen or require immediate assistance | Immediate professional treatment is the priority for risks of self-harm or harm to others, safety issues due to dissociation, psychosis, severe alcohol use, or drug use. | Seek the relevant medical care immediately |
When to seek medical evaluation first
Do not wait; seek medical evaluation first for these symptoms
Even for familiar symptoms, if the following changes occur, prioritize the relevant medical evaluation over making inquiries.
- Immediate professional treatment is the priority for risks of self-harm or harm to others, safety issues due to dissociation, psychosis, severe alcohol use, or drug use.
- Thoughts of self-harm or harming others, or specific plans to do so
- Seizures, changes in consciousness, hallucinations, or impaired reality judgment
- Inability to eat or drink, or a state where it is difficult to maintain safety while driving or working
Rather than the name of the disease, we look at the patient's daily life
A state where sounds, smells, or places seem to trigger the event, causing startle responses, and where nightmares and avoidance shrink one's daily activities
Ensure current safety and continue trauma-focused professional treatment. Herbal medicine treatment is used concurrently with specific goals to reduce the burden of nightmares, hyperarousal, throbbing, digestion, and fatigue that make it difficult to sustain that treatment.
You can describe your current physical state and sleep without having to talk about the event
Without forcing detailed memories, we first verify nightmares, startle responses, avoidance, and the current safe environment.
Pattern identification of physical hyperarousal that disrupts professional treatment
We identify which of the following change during the same period: sleep, heart rate, sweating, gastrointestinal tension, or decreased energy.
Checking the capacity to maintain safety and professional treatment
We verify whether there are actual changes in falling back asleep after nightmares, daytime startle responses, eating habits, and participation in medical evaluation.
Treatment GoalsWhile maintaining trauma-focused therapy and a safety plan, we reduce the burden of nightmares, startle responses, sleep loss, and physical tension.
Consult about post-traumatic physical burden
Hyperarousal is a physical response, but a single illustration is not used to diagnose all causes.
The photos show daily scenarios where concerns regarding sleep, anxiety, mood, and medication appear, and the explanatory illustrations show a simplified process of excessive body tension and recording methods. These do not represent an individual's diagnosis or treatment results.If you have these experiences
A state where sounds, smells, or places seem to trigger the event, causing startle responses, and where nightmares and avoidance reduce one's daily activities
Some people experience startle responses as if sounds, smells, or places are bringing back the event, and their sleep and daily activities are restricted due to nightmares and avoidance. We do not force you to describe the event in detail and first verify your current safety.
For those who avoid sleep due to nightmares and startle responses to small sounds
Cases where sleep is avoided due to nightmares and startle responses to small sounds
For those whose daily range of activity has decreased by avoiding specific places, conversations, or relationships
Cases where the daily range of activity has decreased by avoiding specific places, conversations, or relationships
For those who wish to manage the burden on sleep, heart rate, and digestion while continuing trauma therapy
Cases where there is a desire to manage the burden on sleep, heart rate, and digestion while continuing trauma therapy
This is how we evaluate during medical evaluation
Post-traumatic stress: the current difficulties that remain behind the diagnosis
Post-traumatic stress is a condition where re-experiencing the event, avoiding related scenes, constant hyperarousal, and changes in thoughts and mood persist for more than a month and disrupt functioning. We do not force the patient to speak about the details of the event; instead, we first verify current safety, sleep, and situations that trigger the symptoms. While maintaining trauma-focused therapy and a safety plan, we lower the burden of nightmares, startle responses, sleep loss, and physical tension. Risk of self-harm or harm to others, safety issues due to dissociation, psychosis, severe alcohol or drug use prioritize immediate professional treatment.
You can explain your current physical state and sleep without having to talk about the event
Without forcing detailed memories, we first verify nightmares, startle responses, avoidance, and your current safe environment.
We perform pattern identification for physical hyperarousal that disrupts professional treatment
We identify which aspects change during the same period among sleep, heart rate, sweating, gastrointestinal tension, and decreased energy.
We verify the capacity to maintain safety and professional treatment
We check if there are actual changes in falling back asleep after nightmares, daytime startle responses, eating habits, and participation in medical evaluations.
Reasons why recovery may be slow
Post-traumatic stress: why it persists for a long time
We ensure current safety and continue trauma-focused professional therapy. Korean herbal medicine is used concurrently with specific goals to alleviate nightmares, hyperarousal, throbbing, digestion, and energy burdens that make it difficult to sustain that therapy.
Identify when the symptoms began
List the date the symptoms first appeared and any preceding changes in medication, illness, work, or relationships in chronological order.
Select the most challenging daily life scenarios
Choose one or two activities among sleep, commuting, travel, meals, or conversation that you have actually given up or been delayed in.
Verify recovery time
Record whether symptoms persist for several minutes, hours, or until the next day after they arise to quantify the burden of repetition.
The prescriber determines the reduction schedule, and the log is used as a reference for discussion to distinguish between rebound effects, withdrawal, and recurrence of original symptoms.
Tests and daily records
Where current treatment and lifestyle records meet
Please let us know about your current safety and changes in sleep and startle responses within the range of what you feel comfortable sharing.
First, we examine risks and other causes that must be checked
Immediate professional treatment is the priority for risks of self-harm or harm to others, safety issues due to dissociation, psychosis, severe alcohol use, or drug use.
Distinguishing between initial symptoms and long-lasting symptoms
Instead of the detailed contents of the event, nightmares, startle responses,Avoidance behaviorRecord when it occurred and the time it took for hyperarousal to subside.
Checking physical conditions that change together on the same day
Only the symptoms and patterns that repeatedly change together among chills/heat, sweating, appetite, bowel movements, dreams, and energy levels are reflected in the prescription.
Korean herbal medicine pattern identification for post-traumatic stress
Four changes observed in Korean herbal medicine treatment for post-traumatic stress
Rather than the details of the event, we observe the sequence of nightmares, hyperarousal, avoidance behavior, and their impact on sleep, heart rate, and digestion. While maintaining professional treatment, herbal medicine prescriptions are determined based on the remaining physical burden.
When you are startled by small sounds and your body is in a constant state of alertness
We look for startle responses, increased heart rate, alertness before falling asleep, and nightmares. We ask about triggering sounds, places, smells, and the scope of avoidance before asking for event details. We support the recovery of sleep and physical alertness responses within a range that does not compromise safety.
When suppressed tension spreads to anger, heat sensations, or headaches
We observe whether irritability, facial flushing, and neck/shoulder tension persist for a long time after recalling the event. We identify the timing of worsening hyperarousal alongside interpersonal conflicts and sleep deprivation. While continuing trauma treatment, we set Korean herbal medicine treatment goals to reduce physical overheating and sleep burden.
When appetite, sleep, and energy collapse together after enduring for a long time
We check if isolation increases after avoidance, and if appetite, concentration, and daytime activity decrease. We simultaneously check for anemia, thyroid issues, pain, medications, and worsening depression. While maintaining safety plans and professional treatment, we look for the recovery of daily rhythms and energy.
Changes to monitor during treatment
Returning to daily life before focusing on the number of symptoms
While maintaining trauma-focused therapy and a safety plan, we reduce the burden of nightmares, startle responses, sleep loss, and physical tension.
Without forcing detailed memories, we first confirm the presence of nightmares, startle responses, avoidance, and the current safety of the environment.
In the first consultation, these criteria serve as the current starting point. While maintaining trauma-focused therapy and a safety plan, we reduce the burden of nightmares, startle responses, sleep loss, and physical tension.
Current diagnosis, testing, and psychotherapy stage, and a complete medication list including prescription drugs, over-the-counter drugs, and supplements
Treatment priorities are adjusted by comparing changes over several days rather than a single good day. While maintaining trauma-focused therapy and a safety plan, we reduce the burden of nightmares, startle responses, sleep loss, and physical tension.
We identify which parts change during the same period among sleep, heart rate, sweating, gastrointestinal tension, and decreased energy.
The direction of the next medical evaluation is determined based on the lifestyle the patient wishes to resume. While maintaining trauma-focused therapy and a safety plan, we reduce the burden of nightmares, startle responses, sleep loss, and physical tension.
At the crossroads of sleep, tension, digestion, and energy
Four changes observed in Korean herbal medicine treatment for post-traumatic stress
Rather than the details of the event, we observe the sequence of nightmares, hyperarousal, avoidance behavior, and their impact on sleep, heart rate, and digestion. While maintaining professional treatment, herbal medicine prescriptions are determined based on the remaining physical burden.
Pattern identification (Byeonjeung) is not about assigning a constitution name to insomnia, anxiety, or depression. While maintaining the mental health diagnosis, psychotherapy, and the prescriber's medication plan, we select the axis that actually moves together among sleep, heart rate, digestion, body heat, and energy to adjust the priority of the Korean herbal medicine prescription.
When you are startled by small sounds and your body is in a constant state of alertness
- Changes to monitor in sleep and the body
- We observe startle responses, increased heart rate, alertness before falling asleep, and nightmares.
- Changes to monitor in the body
- We ask about triggering sounds, places, smells, and the range of avoidance before asking about the details of the event.
- Prescription priorities
- We support the recovery of sleep and physical alertness responses within a range that does not compromise safety.
When suppressed tension spreads to anger, heat sensations, or headaches
- Changes to monitor in sleep and the body
- We observe whether irritability, facial heat sensations, and neck and shoulder tension persist for a long time after recalling the event.
- Changes to monitor in the body
- We identify the timing of worsening interpersonal conflicts, sleep deprivation, and hyperarousal.
- Prescription priorities
- While continuing trauma treatment, we set Korean herbal medicine treatment goals to reduce physical overheating and sleep burden.
When appetite, sleep, and energy collapse together after enduring for a long time
- Changes to monitor in sleep and the body
- We observe whether isolation increases following avoidance, and if appetite, concentration, and daytime activity decrease.
- Changes to monitor in the body
- We simultaneously check for anemia, thyroid issues, pain, current medications, and the worsening of depression.
- Prescription priorities
- While maintaining a safety plan and professional treatment, we monitor the recovery of daily rhythms and energy.
When recovery is not possible due to vivid dreams and sweating every night
- Changes to monitor in sleep and the body
- We observe nightmares, early morning awakening, throbbing, dry mouth, and bodily sensitivity.
- Changes to monitor in the body
- We check for menstruation, menopause, weight changes, and long-term sleep loss.
- Prescription priorities
- Rather than the content of the dreams, we track the time it takes to stabilize after waking and the next day's functioning.
Order of prescription adjustment
- First, we examine risks and other causes that must be checked
Risk of self-harm or harm to others, safety issues due to dissociation, psychosis, severe alcohol use, or drug use require immediate professional treatment as a priority.
- Distinguish between initial symptoms and long-lasting symptoms
Instead of detailed accounts of the event, record when nightmares, startle responses, and avoidance behavior occurred, and the time it took for hyperarousal to subside.
- We check for changes in your physical condition that occur together on the same day.
Only the symptoms and patterns that repeatedly change together among chills/heat, sweating, appetite, bowel movements, dreams, and energy levels are reflected in the prescription.
- When adjusting for daily functioning and combination safety
We simultaneously check for recovery in commuting, mobility, sleep, and eating, as well as drowsiness, dizziness, gastrointestinal reactions, and changes in medications.
Why consider Korean herbal medicine treatment now?
- Cases where sleep is avoided due to nightmares and startle responses to small sounds
- Cases where the range of daily activities has decreased due to avoiding specific places, conversations, or relationships
- Cases where one wishes to manage the burden on sleep, heart rate, and digestion while continuing trauma treatment
What is evaluated in Korean herbal medicine treatment for this condition
- Without forcing detailed memories, we first confirm the presence of nightmares, startle responses, avoidance, and the current safety of the environment.
- Current diagnosis, test results, stage of psychotherapy, and a complete medication list including prescriptions, over-the-counter drugs, and supplements
- We identify which changes occur simultaneously among sleep, heart rate, sweating, gastrointestinal tension, and decreased energy.
We first check for current safety and situations requiring immediate help
Plans for self-harm, impaired reality testing, current violence or abuse, and sudden collapse of basic functioning are connected immediately to crisis or emergency support rather than symptom consultation.
Categorizing into re-experiencing, avoidance, and hyperarousal types
We observe whether flashbacks and nightmares predominate, whether there is avoidance of people, places, or conversations, or whether insomnia, hypervigilance, anger, and decreased concentration persist.
Record triggering scenes and your daily activity range
We track flashbacks, nightmares, avoidance scenes, vigilance, sleep, concentration, mood, functioning in work, outings, and relationships, as well as thoughts of self-harm.
Things to prepare before the consultationIf it is difficult to describe the details of the trauma, please prepare information on triggering sounds, smells, and places, as well as flashbacks, nightmares, avoidance, and changes in sleep, work, and relationships before the consultation to discuss the goals of Korean herbal medicine treatment.
Crisis intervention, CBT, ERP, trauma therapy, sleep studies, and the prescriber's dose reduction plan proceed in the necessary order. Korean herbal medicine treatment works alongside that plan to specifically target the remaining physical burdens, such as sleep, palpitations, digestion, and tension.
Consult on physical burden after traumaSleep and Mind Glossary
Additional information regarding post-traumatic stress
You can check the brief meaning first and then proceed to the detailed explanation.Frequently Asked Questions
Frequently Asked Questions about post-traumatic stress
Can I consult on post-traumatic symptoms even if it is hard to describe the event in detail?
Some people are startled as sounds, smells, or places seem to bring back the event, and their sleep and daily activity range decrease due to nightmares and avoidance. We do not force you to describe the event in detail and first verify your current safety. Without forcing detailed memories, we first check for nightmares, startle responses, avoidance, and your current safe environment.
Before a post-traumatic stress consultation, is it okay to record only current safety, sleep, and startle responses?
Before the consultation, we do not force detailed memories and first verify nightmares, startle responses, avoidance, and your current safe environment. Please organize the following in chronological order: current diagnosis, testing and psychotherapy stages, a complete medication list including prescriptions, over-the-counter drugs, and supplements, and which changes occur simultaneously among sleep, heart rate, sweating, gastrointestinal tension, and decreased energy. This helps in establishing the starting point for medical evaluation. We first verify the risk of self-harm, reality testing, and current safety, and maintain trauma-focused therapy. Korean herbal medicine treatment is limited to addressing accompanying burdens of nightmares, hyperarousal, heart rate, digestion, and energy.
When can Korean herbal medicine treatment be considered for post-traumatic stress?
Ensure current safety and continue professional trauma-focused therapy. Korean herbal medicine treatment is used concurrently with specific goals to address nightmares, hyperarousal, throbbing, digestion, and energy burdens that make it difficult to sustain that therapy.
What factors determine the Korean herbal medicine prescription for post-traumatic stress?
We identify which changes occur simultaneously among sleep, heart rate, sweating, gastrointestinal tension, and decreased energy. Without rushing for details of the event, we observe the sequence of nightmares, startle responses, avoidance, repetitive behaviors, sleep, heart rate, and digestion. While maintaining professional therapy, the Korean herbal medicine prescription is determined based on the remaining physical burden.
Can I receive this along with treatment from a psychiatry clinic?
Current safety and Post-Traumatic Stress Disorder Professional treatment is continued first. When combining this with herbal medicine treatment, one specific physical burden remaining in the body, such as nightmares, hyperarousal, throbbing, or digestion, is set as the initial goal.
Can I reduce my current medications while taking herbal medicine?
Do not reduce mental health medications currently being taken without consulting the prescribing medical staff. Record the date of any medication changes and changes in nightmares, startle response, anxiety, or sleep, and share the same information with each medical provider.
What changes would make other medical evaluations a priority over counseling?
Risk of self-harm or harm to others, safety issues due to dissociation, psychosis, severe alcohol use, or drug use require immediate professional treatment as a priority.
Evidence and Update Information
This content was compiled by Korean medicine doctor Choi Yeon-seung based on the official professional materials and disease-specific clinical data below, and was updated on 2026-08-26.
- NIMH: Post-Traumatic Stress DisorderSymptom clusters and treatment scope for re-experiencing, avoidance, arousal, and cognitive-mood changes
- NICE NG116: Post-traumatic stress disorderPTSD assessment, safety planning, and trauma-centered treatment principles
- NIMH: Obsessive-Compulsive DisorderObsessive thoughts, compulsive behaviors, and basic treatment pathways
- NIMH: Anxiety DisordersBasic explanations of generalized anxiety, panic, social anxiety, and difficulties experienced in daily life
- NIMH: DepressionEmotional, cognitive, and physical symptoms of depression and when to seek help
- VA/DoD 2025: Chronic Insomnia Disorder and Obstructive Sleep ApneaAssessment and treatment of chronic insomnia and sleep apnea, and the CBT-I priority principle
- NICE NG215: Medicines associated with dependence or withdrawal symptomsGradual reduction of benzodiazepines, Z-drugs, antidepressants, etc., and principles of individual pacing and continuous observation
- PubMed: Acupuncture for Anxiety, systematic review and meta-analysisA comprehensive review of acupuncture research for anxiety, including verification of research heterogeneity and application limits
- Royal College of Psychiatrists: Stopping antidepressantsDistinguishing antidepressant withdrawal symptoms from the recurrence of original symptoms, and reduction plans established with the prescriber