Post traumatic stress disorder

What is PTSD?

If you have experienced, witnessed, or learned that someone close to you went through a deeply frightening, distressing, or life-threatening event, it is normal to feel upset, anxious, or distressed afterwards. However, if these feelings persist and begin to affect your daily life, it may be a sign of post-traumatic stress disorder (PTSD). PTSD is a mental health condition that can develop after a traumatic event and may cause symptoms such as distressing memories, flashbacks, nightmares, anxiety, or feeling constantly on edge, sometimes long after the danger has passed.

What are the symptoms of PTSD?

Symptoms are usually grouped into four areas and can affect everyone differently.

• Reliving the event through flashbacks, nightmares, or unwanted memories that feel like it's happening again
• Avoiding people, places or things that bring back memories of what happened, or avoiding talking about it altogether
• Difficulty remembering parts of the event, or ongoing negative thoughts about yourself, others or the world
• Feeling cut off from people, struggling to feel positive emotions, or losing interest in activities you once looked forward to
• Feeling constantly on edge or watchful for danger, known as hypervigilance
• Being easily startled, irritable, or having angry outbursts
• Trouble concentrating or sleeping
• Experiencing physical symptoms with no clear medical cause, such as headaches, stomach problems or unexplained aches and pains
• Feeling distressed or having physical reactions such as a racing heart, sweating or shaking when reminded of the event

You might notice symptoms straight away, or they may not appear for months or even years after the event. In children, PTSD can look different: they may re-enact the event through play, have nightmares, start wetting the bed again, or develop frequent tummy aches and headaches.

What causes PTSD, and who is at risk?

PTSD is caused by living through or witnessing or learning about a traumatic event, which could include serious accidents, physical or sexual assault, abuse, difficult childbirth, serious illness, nautral disasters, war, or a job that regularly exposes you to distressing situations, such as the emergency services or armed forces.

People that could be at risk include:

• A previous history of trauma, especially with little support at the time
• Experiencing repeated, prolonged or ongoing trauma, rather than a single event
• Being seriously injured, or witnessing harm, serious injury or death to someone else, during the event
• Mental health conditions that run in your family
• Existing anxiety, depression or other mental health conditions
• Living with ongoing stress, such as financial hardship or discrimination or relationship problems
• Not having support from other people after the traumatic event

Not everyone who experiences trauma develops PTSD. Roughly seven out of ten people worldwide will face a potentially traumatic event at some point, yet PTSD only takes hold in a minority of cases, rising sharply after events such as war or sexual violence. It affects more women than men. Early support and treatment from the people around you and trained professionals in the aftermath can help reduce the impact and symptoms and improve recovery.

Are there different types of PTSD?

While PTSD affects everyone differently, some recognisde forms include:

• PTSD with delayed expression: PTSD symptoms may not fully develop until months after the traumatic event, although some symptoms can appear earlier
• Dissociative PTSD: alongside the usual symptoms, you may feel disconnected from your own body or as though the world around you isn't real
• Preschool PTSD: seen in very young children, typically under six, who tend to show their distress through play or behaviour rather than being able to describe it
• Complex PTSD (CPTSD): develops after repeated or prolonged trauma, such as ongoing abuse, rather than a single event. It includes the usual symptoms of PTSD alongside longer-lasting difficulties managing emotions, seeing yourself positively, and maintaining relationships, and often needs more intensive, longer-term support to recover from

How is PTSD diagnosed?

There's no blood test or scan that diagnoses PTSD. The first step is usually a conversation with your GP about what you've been experiencing, who can arrange a referral to a specialist in mental health, such as a psychiatrist or a talking therapies service, if it's needed.

That specialist will explore your mood, behaviour, general health and family background, sometimes using structured questionnaires to build a fuller picture of what you're going through. A diagnosis generally requires symptoms to have continued for more than a month, to be seriously disrupting your daily life, and not to be better accounted for by something else, such as a medicine or another health condition.

How is PTSD treated?

Non-surgical treatment PTSD is a treatable conditions and with the right support, many people see a significant improvement in their symptoms.

Treatments can include:

• Trauma-focused cognitive behavioural therapy (CBT): Helps you understand and process the trauma while developing ways to manage distressing thoughts and feelings
• Eye movement desensitisation and reprocessing (EMDR): Uses guided eye movements while you recall the traumatic memory to help the brain process traumatic memories so they become less distressing over time
• Exposure-based therapy: supports you to gradually and safely revisit trauma-related memories, feelings or reminders that you may have been avoiding
• Medication: antidepressants, such as an SSRIs, may be recommended and other medicines may be used for specific symptoms, such as nightmares
• Group or family therapy: sharing experiences with others who understand, or working through the impact on your relationships to help improve communication and relationships

Complementary approaches such as mindfulness,relaxtion techniques, yoga or other wellbeing activities, usually alongside, rather than instead of, therapy or medicine can also be helpful.

When should I see a doctor?

• You think you may have symptoms of PTSD, especially if they've lasted more than a month
• Your symptoms are affecting your work, relationships, sleep or daily life
• You've had a PTSD diagnosis before, and your current treatment isn't helping
• You're using alcohol or drugs to cope, or finding it hard to manage day to day

When should I seek urgent help?

PTSD can sometimes lead to feelings of hopelessness, self harm or suicidal thoughts, so if things ever feel unbearable or are unable to keep yourself safe, seek help immediately. Contact your GP, call NHS 111, or speak to Samaritans free, any time, on 116 123. In an emergency, call 999.