Quick answer

What is post-traumatic stress disorder (ptsd)?

PTSD can develop after experiencing or witnessing traumatic events — serious accidents, assault, military combat, childbirth trauma, or disasters. Symptoms include re-experiencing (flashbacks, nightmares), avoidance, negative mood, and hypervigilance lasting over 4 weeks and affecting daily life. Trauma-focused CBT and EMDR are first-line NHS treatments. See a GP if symptoms persist after trauma — not weakness or delayed shock that always passes alone.

PTSD — when trauma stays in the body and mind

Post-traumatic stress disorder (PTSD) develops in some people after exposure to actual or threatened death, serious injury, or sexual violence — directly, witnessing, or learning it happened to close other.

Not weakness — normal fear circuitry fails to file memory as past event — triggers reactivate full fight-flight response.

Prevalence: ~50% experience trauma lifetime — ~20% of those develop PTSD — underdiagnosed.

Trauma examples

  • road traffic collision
  • assault, rape, domestic violence
  • childhood abuse
  • military combat
  • ** childbirth trauma**
  • natural disasters
  • ICU/near-death
  • sudden bereavement (contested in DSM — prolonged grief disorder separate)

Core symptom clusters

Re-experiencing

  • flashbacks — feels happening now
  • nightmares
  • intrusive thoughts/images
  • distress at reminders

Avoidance

  • people, places, conversations
  • emotional numbing

Cognition/mood

  • guilt, shame, blame
  • detachment, loss of interest
  • inability to remember parts of trauma
  • negative world view

Hyperarousal

  • sleep disturbance
  • irritable, angry outbursts
  • hypervigilance
  • exaggerated startle
  • concentration problems

Duration: >1 month for PTSD — <1 month — acute stress disorder.

Complex PTSD (cPTSD)

Repeated early interpersonal trauma:

  • affect dysregulation
  • negative self-concept
  • relationship difficulties
  • ICD-11 diagnosis — ** longer therapy**

Diagnosis

Clinical interview — PCL-5 questionnaire aids

Distinguish:

  • depression
  • GAD
  • substance misuse
  • TBI — overlap in veterans

Treatment — NICE recommended

Trauma-focused CBT

8–12 sessions typically:

  • psychoeducation
  • imaginal exposure — revisit memory safely
  • in vivo exposure — avoided situations
  • cognitive restructuring — guilt/distorted beliefs

EMDR

Structured protocol — bilateral eye movements/taps while processing trauma memory — equivalent efficacy to TF-CBT for many

Medication

SSRI — sertraline, paroxetine, fluoxetine — if therapy unavailable or comorbidity

Not benzodiazepines long term — impede processing, dependency

Prazosin — nightmares — off-label — mixed evidence

What does not help alone

  • generic counselling without trauma focus
  • ** alcohol** — worsens
  • avoidance forever — maintains

Single-session debriefing immediately after trauma — not recommended — may harm

Special groups

Military/veterans — Combat Stress, Op COURAGE

Emergency workers — Blue Light Together

Birth trauma — make birth better charities

Refugees/asylum — interpreter, culturally adapted therapy

Recovery

Many fully recover — therapy works

Stigma — “just get over it” — invalidating — professional help legitimate

Flashback now — grounding (5-4-3-2-1 senses) — therapy teaches skills

PTSD is treatable — trauma-focused therapy, not years of talking without structure, restores life after the unthinkable.

Common questions

What are the symptoms of PTSD?
Re-experiencing — flashbacks, nightmares, intrusive memories, physical reactions to reminders. Avoidance — places, people, thoughts related to trauma. Negative alterations — guilt, numbness, detachment, inability to feel positive. Hyperarousal — sleep problems, irritability, hypervigilance, exaggerated startle. Must last over 1 month for PTSD diagnosis.
How long after trauma can PTSD start?
Symptoms often begin within 3 months but can appear months or years later — delayed onset. Acute stress disorder — similar symptoms first month — may resolve or progress to PTSD. Early support after trauma does not always prevent PTSD but helps coping.
What is the best treatment for PTSD?
Trauma-focused cognitive behavioural therapy (TF-CBT) — gradually processing memory without retraumatisation. EMDR (eye movement desensitisation and reprocessing) — bilateral stimulation while recalling trauma — NICE approved. SSRIs (sertraline, paroxetine) if therapy waiting or comorbid depression — not first-line alone for most.
Is PTSD the same as anxiety?
PTSD is anxiety-related but specific — tied to traumatic memory re-experiencing and avoidance. Generalised anxiety lacks flashbacks to defined trauma. PTSD can coexist with depression, alcohol misuse — treat holistically.
Can PTSD be cured?
Many people recover fully with evidence-based therapy — memories remain but no longer dominate life. Some have residual symptoms manageable with skills learned in therapy. Complex PTSD from repeated trauma may need longer treatment — improvement still achievable.

Sources