Monch told MTV Hive that PTSD is “more mental, emotional and personal” because it came out of the depths of a period of depression. He also gave the internal and external factors that helped him create the album. “I was working on the title track, which took me to a point in between Internal Affairs and Desire, where I was heavily depressed. Through the waiting period, the industry period, and going through a lot emotionally. Then there was the physical [problem] with asthma. It was the worst. So I started off with that title track and my manager was like, ‘Yo, let’s really dive into that state and how you got to where you are now, and how this follows what people go through to get back to a so-called ‘normal’ situation’.”

The concept album follows a veteran through combat experience, his return home, relationship dissolution, drug addiction, painful depression, and, finally, a triumphant but realistically rendered decision to keep living and struggling.