It's usually when we can't 'function'. For me it's ongoing. To answer NotDepressed, I do go back and forth between denial and acceptance. I mean, who wants to admit to something that seems to have more power over you than you do?? That's my source for denial. But also, as others have said, it's a fork in the road moment; initially for me, it was knowing something was terribly wrong and deal with it or die.
Now it's knowing my quality of life is seriously skewed. It could be better, and I want it to be better, but again, sometimes I feel like a puppet, and someone else has control of my emotional strings. I want that control back. It is a struggle. So we fight, maybe for the first time, especially if we couldn't fight against the original trauma.