Trauma is more common than many people realize, and it can result from a wide range of distressing experiences — whether it’s an accident, a natural disaster, physical or sexual abuse, exposure to violence, medical emergencies, or the sudden loss of someone close. It can also stem from long-held events, like growing up in an unsafe or neglectful household. In some cases, this exposure to trauma can lead to a condition known as delayed stress disorder.
Many of us might count ourselves among the 70% of adults -223.4 million people, according to the National Council for Behavioral Health — who have experienced one of these types of traumatic events at least once in our lifetimes. Commonly, trauma may dissipate after a short period, and you may cope well and return to the routines and responsibilities of daily life. Trauma disorder often develops when symptoms continue to linger for an extended period.
Then there are times when the psychological and physical effects of deep emotional trauma, equally as severe, aren’t readily apparent. They don’t emerge right away — in fact, they may not surface for months or even years, often without a tangible or obvious trigger. What’s known as delayed stress disorder can catch one by surprise, prompted by traumatic memories once thought past.
What Is Delayed Stress Disorder?
Delayed stress syndrome is when the onset of trauma symptoms emerges after a significant time — typically at least six months since a traumatic event.
“While the majority of people who develop PTSD (post-traumatic stress disorder) do so within the first week or month following the traumatic encounter, a significant minority of people with PTSD present delayed expression of the disorder,” states a 2022 study on delayed PTSD.
Rather than causing prompt reactions to trauma, some people are unable to process their emotions over a traumatic event in the immediate aftermath of a traumatic incident. This can become distressing for someone suffering from a delayed trauma response, who may have been confident they had moved beyond their traumatic experience but now, caught off guard by unresolved trauma that’s begun to resurface.
Delayed Stress Disorder vs PTSD
There’s a close relationship between delayed stress disorder and PTSD; one reason why delayed stress syndrome is sometimes called delayed post-traumatic stress disorder.
Studies show that most people who experience trauma will not, in fact, develop PTSD; nearly six out of every 100 people (6% of the entire population) will develop PTSD at some point. According to the U.S. Department of Veterans Affairs, women are more likely to experience PTSD than men due to the nature of traumatic instances they may experience (such as sexual violence and assault). Still, veterans exposed to wartime combat are more likely to have PTSD than their civilian counterparts.
One of the key differences between delayed stress disorder and PTSD lies in their timing. According to the Mayo Clinic, standard PTSD symptoms generally begin within three months of a traumatic event. Although it’s not uncommon for PTSD triggered years later to occur, delayed stress syndrome or delayed PTSD always takes longer to become active.
And because both conditions involve similar symptoms — intrusive memories, nightmares, emotional numbness, and hypervigilance (being easily startled) — delayed PTSD may sometimes be more difficult to recognize or differentiate from another cause due to the delay between the traumatic event and the present.
Why Trauma Can Remain for Years
The way we react to overwhelming trauma is a type of survival mechanism, the brain’s way of making us remember experiences that are fearful or scary so we can avoid similar situations in the future.
“When we feel stressed or threatened, our bodies release hormones called cortisol and adrenaline. This is the body’s way of preparing to respond to danger, and we have no control over it,” says website Mind.org.
But that’s in the case of a more immediate stress response. What about a delayed stress reaction? Research shows that several neurobiological factors may explain the delay. Our minds are like vaults where memories are securely stored away — and traumatic memories are not easily erased. Often, your mind protects you by compartmentalizing these memories, only to have them resurface later as a delayed trauma response.
“The capacity of (trauma and) PTSD to occur with delayed onset may result from the interaction of an array of underlying neurobiological mechanisms,” notes the 2022 study.
Apart from neurological reasons, other factors can begin to explain trauma becoming PTSD triggered later:
- Increased life stress: Going through difficult situations like divorce, job changes, health problems or financial struggles can make old trauma symptoms emerge — even when they’re unrelated.
- New traumatic experiences: Going through another difficult event can trigger reactions to earlier trauma, like experiencing a car accident or medical emergency after a family member or loved one lost their life in a similar event years ago. Your ability to cope with past events becomes compromised when faced with this new trauma.
- Gradual worsening of existing symptoms: Many people already have mild trauma responses that just weren’t severe enough to be diagnosed as PTSD or a trauma disorder. These symptoms can gradually become more intense over time. It’s been noted as common in older people who may develop delayed PTSD originating from a traumatic experience they had when younger.
“If we experience trauma, our body’s reactions can continue long after the trauma is over,” says Mind.org. “For example, when we’re in a situation that reminds us of the trauma. This might affect how we think, feel and behave, especially if recovering from the trauma has been difficult.”
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What Are the Signs and Symptoms of Delayed Stress Disorder?
The hallmark signs of delayed stress disorder mirror those found in standard PTSD and other trauma disorders and can include:
- Intrusive flashbacks and nightmares causing unintentional reliving of the trauma
- Hypervigilance/heightened startle response, on edge from noises or unexpected touch
- Mood swings ranging from mild irritability to emotional outbursts
- Isolating oneself from people, places or situations that remind you of the trauma
- Increased distrust of others or feeling betrayed
- Physical symptoms like fatigue, headaches or gastrointestinal distress
- Symptoms consistent with depression (i.e., losing interest in activities you once loved)
- Intense anxiety or occurrence of panic attacks — potential precursors to panic disorder
- Increased risk of substance abuse
- Emotional dysregulation, with a tendency to self-blame or feel guilty or shameful over a traumatic incident you feel could have been prevented
However, the difference is that with a delayed trauma response, these symptoms may materialize months or years after a serious traumatic event, often triggered by a reminder — however minor or small — that may remind you of that original trauma, even if a conscious connection or link isn’t made.
How Does Delayed Stress Disorder Affect Daily Life?
Consider the above list of delayed stress syndrome symptoms and think about how pervasive and disruptive they can become in day-to-day life — especially when they seem to conjure from a deeply buried place without warning.
“Many trauma survivors experience symptoms that … limit their ability to function normally (e.g., regulate emotional states, maintain steady and rewarding social and family relationships, function competently at a job, maintain a steady pattern of abstinence in recovery),” notes a 2014 publication on trauma.
An unexpected return of traumatic memories long forgotten until now can begin to invade each of these facets of functional life and lead to the onset of other co-occurring issues, like depression. Studies show that more than 50% of people with depression have also been exposed to some form of traumatic experiences during their childhood.
“It is likely that individuals who exhibit both depressive and dissociative symptoms would have experienced more traumatic events, especially childhood betrayal trauma,” notes a study from the March 2025 Journal of Psychiatric Research.
Perhaps worse yet, when someone suffers from any undiagnosed condition, delayed stress disorder included, you may feel ashamed for not “getting over it,” especially if you or others around you don’t understand how trauma works.
Footprints to Recovery Mental Health provides outpatient treatment programs in New Jersey.
Treating Delayed Stress Disorder and Other Trauma Disorders
Delayed stress disorder can emerge without warning from past trauma that has been suppressed or buried in one’s psyche. Thankfully, talk therapy and holistic approaches can work together to process and release what’s been stored, sometimes for years.
Evidence-Based Psychotherapy
EMDR
Eye Movement Desensitization and Reprocessing (EMDR) is a type of therapy effective in ameliorating distress connected to trauma. EMDR was founded in the adaptive information processing mode and was developed by psychologist Francine Shapiro. In EMDR therapy, you’ll be asked to recall an upsetting experience while using your eyes to follow back-and-forth movements or sounds — called bilateral stimulation. Shapiro discovered that this process slowly makes it easier to reprocess and desensitize oneself to trauma and make it easier to heal from past trauma.
Brainspotting
Like EMDR, brainspotting is an approach that identifies certain eye positions (called “brainspots”) that are connected to deep-held, pent-up trauma in the brain. Brainspotting therapy involves very little talking, however. You’ll use your eyes to follow the slow movements of a pointer held by your therapist while processing emotional experiences as they locate the brainspot — technically a hotspot, a point where you’ll be asked to confirm when your thoughts, emotions and even physical sensations feel the most intense. It’s a particularly beneficial process when one’s trauma is initially difficult to articulate.
Cognitive-Behavioral Therapy
CBT, for short, Cognitive-Behavioral Therapy, works to reconcile how negative thoughts (your cognition) influence your emotions and actions (your behavior). It’s an evidence-based psychotherapy that works to help you identify, challenge, and replace distorted thought patterns related to past trauma (like negative thinking, diminishing positive thoughts, or expecting the worst) with more positive thoughts. By developing new tools through CBT to question these beliefs and reframe your mental narrative, you can begin to resolve your delayed stress response and PTSD triggered years later, alleviate your symptoms, and, most importantly, learn new coping mechanisms.
Holistic Treatment for Delayed Stress Disorder
Expressive Arts Therapy
Holistic translates to “whole,” and holistic therapy is an alternative form of treatment designed to heal your mind, body, and spirit — each of which can be affected by delayed stress disorder. Expressive art therapy is just one avenue, encouraging you to explore the emotions linked to trauma through everything from painting to music or writing. You don’t need to have experience in any of these activities for expressive arts therapy to be effective; the abstract nature of expressing trauma in ways that might be difficult through words can lead you to discover new talents you can keep pursuing after treatment is finished.
Meditation and Mindfulness
A delayed trauma response prevents you from remaining in the present. Triggered traumatic memories keep one focused on their past experiences, unable to keep you moving forward in the here and now. However, through mindfulness meditation, we must remain mindful of and grounded in the present moment (the only moment we have control over). Meditation helps you become skillful in observing the thoughts and sensations that arise from traumatic memories without judging or being overwhelmed by them. As a popular and effective holistic therapy, it truly is a practice of mind over matter.
Diet and Exercise
Trauma is not only rooted in the mind — your physical well-being plays as much of a role in overcoming delayed stress disorder and delayed PTSD. “Engagement in preventative physical health behaviors, such as having a nutritious diet and adequate exercise, has also been shown to yield beneficial downstream effects for physical health and functioning in those with PTSD,” notes a 2021 study. Physical exercise helps boost the endorphins that can help regulate and counteract stress hormones that contribute to stress-related depression, and a healthy diet supports brain health. Sound advice for anyone, not only if you’ve suffered from trauma, it’s part of the nutritional counseling offered at Footprints to Recovery.
Experiential Therapies
Engaging in experiential therapy is the perfect hand-in-hand treatment with meditation and mindfulness because it keeps you engaged and connected in the moment. Participating in equine therapy and outdoor adventure therapy are opportunities to stay in the present moment, regulate emotions, and practice interpersonal skills in real time —the chance to interact, care for, and bond with a gentle service horse, practice teamwork, and engage in physical activities to offset the adverse effects of trauma. And as a complement to traditional therapy, it can set you on the path to recovery with confidence and stability.
Finding Professional Help for Trauma
Delayed stress syndrome and delayed post-traumatic stress disorder can come without warning, making it imperative to seek help for it if the effects of past trauma have begun to affect you. Statistics show that only half of people with severe PTSD report receiving any treatment, with a small percentage receiving specialized mental health care — but there doesn’t need to be a delay in finding help.
Footprints to Recovery’s outpatient facility meets the needs of anyone struggling with a trauma disorder. Our staff is compassionate and experienced in all the different types of therapies and modalities we’ve covered in this article. Signing up for treatment means you’ll have the guidance of a case manager to keep you on point with your treatment plan, which is always tailored for your needs. And as you progress through treatment, the knowledge you gain can help you take the steps necessary to avoid triggers and cope when symptoms may arise.
We can help you if you’re seeking to regain control of your mental health and well-being. For questions on outpatient treatment, cost, insurance coverage, and more, don’t hesitate to contact our admission specialists, available 24/7.
References:
- https://www.thenationalcouncil.org/wp-content/uploads/2022/08/Trauma-infographic.pdf
- https://www.nsvrc.org/blogs/exploring-conversation-trauma-blog-series/why-do-we-have-trauma#:~:text=Trauma%20occurs%20because%20of%20the,it%20doesn’t%20happen%20again.
- https://pubmed.ncbi.nlm.nih.gov/11982541/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC8783158/
- https://www.ptsd.va.gov/understand/common/common_adults.asp
- https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967
- https://www.verywellmind.com/delayed-onset-ptsd-meaning-and-reasons-2797636
- https://www.ncbi.nlm.nih.gov/books/NBK207191/
- https://www.sciencedirect.com/science/article/pii/S0022395625001049#:~:text=Given%20that%20over%2050%25%20of,and%20dissociative%20symptoms%20would%20have
- https://www.emdr.com/what-is-emdr/
- https://health.clevelandclinic.org/brainspotting-therapy-and-how-it-works
- https://www.apa.org/ptsd-guideline/treatments/cognitive-behavioral-therapy
- https://pmc.ncbi.nlm.nih.gov/articles/PMC8049465/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC6034513/#:~:text=Only%20half%20of%20those%20with,receive%20specialty%20mental%20health%20care.
