Post-traumatic stress disorderThis section has information about the symptoms and causes of post-traumatic stress disorder (PTSD). It explains who might develop PTSD and the treatment options. It is for anyone affected by trauma or PTSD and their family, friends and carers. Show
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Overview
Need more advice?If you need more advice or information you can contact our Advice and Information Service. AboutWhat is post-traumatic stress disorder (PTSD)?Post-traumatic stress disorder (PTSD) is a mental illness. You can develop it after experiencing something that you find traumatic. This can include seeing or hearing about something traumatic. The symptoms of PTSD can start immediately or after a delay of weeks or months. They usually start within 6 months of the traumatic event. There can be lots of different symptoms. See the next section for more information. Not everyone who has been through a trauma will develop PTSD. Many people will have some trauma symptoms for a while. They are a normal reaction to a traumatic experience. Some people slowly come to terms with what has happened. Their stress symptoms can start to disappear after a few weeks or so. But some people’s symptoms last longer and they can develop PTSD. Treatment can help you to recover fully from PTSD or manage the symptoms better. See further down this page for more information. Some people may deal with symptoms for many years. This can sometimes develop into a personality change for a small number of people. You can find more information about 'Stress – How to cope' by clicking here. How common is PTSD?The NHS say that PTSD is estimated to affect about 1 in every 3 people who have a traumatic experience. But it's not clear exactly why some people develop the condition and others don’t. What is complex PTSD?The main symptoms of PTSD and complex PTSD are the same. Complex PTSD is sometimes known as c-PTSD, or CPTSD. If you have complex PTSD, you may have extra symptoms such as:
You’re more likely to develop complex PTSD if your trauma has been an ongoing event. Or series of different traumatic events. The trauma might be very threatening or frightening. Most commonly from a trauma which you weren’t able to escape from such as:
CausesWhat causes PTSD?You can develop PTSD after experiencing something that you find traumatic. This can include seeing or hearing about something traumatic. It can be caused by experiencing witnessing or hearing about single, repeated, or multiple events such as:
But it could be caused by other things too. The important thing is how you individually experience the event or events. Traumatic events might affect our belief that life is fair, reasonable safe, and that we are secure. But not everyone who experiences trauma will develop PTSD. The risk of developing PTSD depends on how the experience affects you. PTSD is more likely to develop if the traumatic event:
If you have experienced depression or anxiety now or in the past, you are at a higher risk of developing PTSD. You can find more information about:
What things might help protect you from developing PTSD?Things that may help to prevent the development of PTSD after a trauma include:
These factors won’t always protect someone from developing PTSD. But they can help in some cases. SymptomsWhat are the symptoms of PTSD?The main symptoms and behaviours associated with PTSD and complex PTSD include:
Other symptoms and behaviours associated with PTSD and complex PTSD include:
You can find more information about ‘Dissociation and dissociative identity disorder’ by clicking here. How can I get help if I have symptoms of PTSD?You can get help from:
You can also try self-help techniques. How can the NHS help me?If you have symptoms that are causing you a lot of distress or are affecting your daily life, you can see your GP. Your GP should carry out an initial assessment using screening tools to decide what care you need. Your assessment should include information about:
Your GP will be able to talk to you about treatment options and coping strategies. You're likely to be offered treatment if you've had symptoms of PTSD for more than 4 weeks or your symptoms are severe. You can choose whether to have treatment and decide about the options your GP offers you. If you’re unsure of anything, like the benefits of treatment, then ask your GP. For more information about how PTSD is treated see the next section below. The section explains how you can refer yourself for NHS talking therapy. GPs can offer you treatment and advice for symptoms of mental illness, including PTSD. But only a psychiatrist can properly diagnose PTSD. Your GP will only refer you to a psychiatrist in an NHS specialist mental health team if your condition is severe. Including if your GP thinks you’re experiencing complex PTSD. A psychiatrist will diagnose PTSD through a more in-depth mental health assessment. They use the following manuals to help to diagnose you:
You can find out more information about ‘NHS mental health teams’ by clicking here. Where can I get help if I’m having a mental health crisis?If you are in crisis means that your mental health is very bad, so you might need urgent support and treatment. If you need urgent help, you can do the following.
How can social services help me?If you need support to look after yourself then you have the right to a needs assessment from social services. For example, you may need support so that you can:
You can find more information about ‘Social care assessment – Under the Care Act 2014’ by clicking here. What other help is available?How can charities help me? Some charities may have other services available, such as employment support or isolation prevention services. You can look on our website www.rethink.org to see if we have any support groups or services in your area. Click on ‘Help in your area’ at the top of the webpage. Contact details charities who might be able to help are in the Useful contacts section at the bottom of this page. Self-help You can find more information about:
TreatmentHow is PTSD treated?PTSD is mainly treated with talking therapies, medication or a mixture of both. What are NICE guidelines?NICE stands for National Institute for Health and Care Excellence. They make recommendation to the NHS about what treatment should be offered to patients for the condition they’re living with. NICE have made the following recommendations to treat PTSD. You might have clinical symptoms of PTSD and have experienced 1 or more traumatic events in the past month. NICE say you should be offered the following treatment options as prevention of, or treatment for PTSD:
You can usually refer yourself for NHS talking therapy. You can also have private talking therapy if you can afford to. You can find more information about ‘Talking therapies’ by clicking here. What is active monitoring?Active monitoring or ‘watchful waiting’ may be suggested if you have mild symptoms of PTSD. Or the trauma has happened within the last 4 weeks. This means that your symptoms should be monitored, and you should have a follow up appointment in 1 month. Active monitoring is used because 2 in every 3 people who experience a trauma will recover without treatment. What is trauma-focused cognitive behavioural therapy (CBT)?CBT helps you deal with your symptoms by making changes to how you think and act. Your therapy should help manage symptoms and reaction to trauma and help you deal with related emotions. Sometimes CBT can be aimed at specific symptoms of PTSD such as sleep problems or anger. What is cognitive processing therapy (CPT)?CPT is focused on helping people who are ‘stuck’ in their thoughts about a trauma. It is based on the idea that PTSD symptoms happen because of conflict between pre-trauma and post-trauma beliefs. These conflicts are called ‘stuck points’. And are addressed through activities such as writing about the traumatic event. What is narrative exposure therapy (NET)?NET can help to reduce distress resulting from complex or multiple traumatic experiences. The aim of NET is to put traumatic experiences into context. NET helps you to create and express a clear narrative of your life. Mainly focusing on the trauma. But also bringing in some positive events. What is prolonged exposure therapy?Prolonged exposure helps you gradually approach trauma-related memories, feelings, and situations. It helps you to learn that the trauma-related memories and reminders aren’t dangerous and that you don’t need to avoid them. What is eye movement desensitisation and reprocessing (EMDR)?You’ll be led by the therapist to make eye movements while thinking about the traumatic event. Therapists think that this works by making your brain deal with painful memories in a different way. The therapy uses eye stimulation, or other stimulation methods such as ‘taps’ or ‘tones’, to process certain memories. This should be used until the memories are no longer distressing. What is supported trauma-focused computerised cognitive behavioural therapy (CBT)?You can therapy through a computer programme if you’re PTSD symptoms aren’t severe. You may be able to have supported trauma-focused computerised CBT if you prefer it to face-to-face trauma-focused CBT or EMDR. Can medication help with PTSD?Your doctor might offer you medication to treat PTSD. You can choose to have this together with talking therapy. You might be offered venlafaxine or a selective serotonin reuptake inhibitor (SSRI) such as sertraline. You may be offered antipsychotic medication, such as risperidone. This may be offered if you experience psychosis or severe hyperarousal. The treatment will need to be reviewed regularly by a specialist. The antidepressants mirtazapine, amitriptyline, and phenelzine may be recommended. These medicines will only be used if:
Amitriptyline or phenelzine will usually only be used under the supervision of a mental health specialist. Your doctor should inform you about possible side effects, including any possible withdrawal symptoms. Withdrawal symptoms are less likely if the medicine is reduced slowly. You can find out more about:
What is the treatment for complex PTSD?You may respond to trauma-focused therapies if you have complex PTSD. There is some overlap of symptoms between complex PTSD and borderline personality disorder (BPD). If you have complex PTSD you may benefit from certain treatments that help people with BPD. You can find more information about 'Borderline personality disorder (BPD)' by clicking here. What if I have complex needs like complex PTSD or a drug or alcohol issue?You should not be excluded from treatment because if have a drug or alcohol issue. If you have complex PTSD or a drug or alcohol issue your health professional should:
You can find more information about 'Drugs, alcohol and mental health' by clicking here. I’ve lived with PTSD for a long time. Can treatment still help?It is possible to be successfully treated from PTSD years after the trauma, so it’s never too late to seek help. Some think:
What can I do if I’m not happy with my treatment?If you aren’t happy with your treatment you can:
There is more information about these options below. How can I speak to my doctor about my treatment options?You can speak to your doctor about your treatment. Explain why you aren’t happy with it. You could ask what other treatments you could try. Tell your doctor if there is a type of treatment that you would like to try. Doctors should listen to your preference. If you aren’t given this treatment, ask your doctor to explain why it isn’t suitable for you. What’s a second opinion?A second opinion means that you would like a different doctor to give their opinion about what treatment you should have. You can also ask for a second opinion if you disagree with your diagnosis. You don’t have a right to a second opinion. But your doctor should listen to your reason for wanting a second opinion. What is advocacy?An advocate is independent from the mental health service. They are free to use. They can be useful if you find it difficult to get your views heard. There are different types of advocates available. Community advocates can support you to get a health professional to listen to your concerns. And help you to get the treatment that you would like. NHS complaints advocates can help you if you want to complain about the NHS. You can search online to search for a local advocacy service. What is the Patient Advice and Liaison Service (PALS)?PALS is part of the NHS. They give information and support to patients and a good place to start if you’re not happy with any aspect of the NHS. You can find your local PALS’ details through this website
link: How can I complain?You can complain about your treatment or any other aspect of the NHS verbally or in writing. See our information on ‘Complaining about the NHS or social services’ for more information. You can find out more about:
Self-care and managementWhat self-care and management skills can I try?There are things that you can do to help yourself. This is also known as self-care or self-help. When it comes to what helps people, everyone is different. Self-care is how you take care of your diet, exercise, daily routine, relationships and how you are feeling. You can learn how to notice when you are becoming unwell and know what your triggers are. You can find out more about self-help in section 5 of our ‘Worried about your mental health’ factsheet under the heading ‘What can I do to help myself?’ You can download this factsheet by clicking here. Some helpful PTSD resources are:
What are recovery colleges?Recovery colleges are part of the NHS. They offer free courses about mental health to help you manage your symptoms. You can usually self-refer to a recovery college. But the college may tell your community mental health team. To see if there is a recovery college in your area you can click on this link: www.mindrecoverynet.org.uk/search/. Or you can use a search engine such as Google, by typing ‘Recovery college [your location].’ You can find out more about:
RisksWhat risks are associated with PTSD?Alcohol and drug useSome people who live with PTSD use drugs or alcohol to help manage the symptoms. Drug or alcohol misuse can make you more unwell, especially is it is excessive. It can make you more likely to try and harm yourself or take your own life. You can find out more about ‘Drugs, alcohol and mental health’ by clicking here. Mental health conditionsMost people who live with PTSD will have at least 1 other mental health condition. The most common conditions are:
Other mental health conditions have some of the same symptoms as PTSD. This may be why PTSD can sometimes be hard to diagnose. If you think you may be experiencing PTSD, you can tell your healthcare professional. You can explain that you’ve been through a trauma, and you think your symptoms might be related to PTSD. You can find out more about:
Suicidal thoughtsSometimes PTSD symptoms can be long-lasting and can have a significant impact on day-to-day life. This can sometimes lead to suicidal thoughts. You can find out more about ‘Suicidal thoughts – How to cope’ by clicking here. PsychosisThere is a link between PTSD and psychosis. But it isn’t known if psychosis is sometimes a symptom of PTSD. Or if it is a separate mental health condition, that can be developed alongside PTSD. Some people who experience psychosis may have also experienced trauma. It may be a different response to trauma than PTSD. You can find out more about ‘Psychosis’ by clicking here. Physical health issuesPTSD has been linked to a range of physical symptoms and health issues such as:
You can find more information about:
Driving and PTSDPTSD might affect your ability to drive safely. If you think it might, you should inform the Driver and Vehicle Licensing Agency (DVLA) about your condition. You can find more information about ‘Driving and mental illness’ by clicking here. Information for carers, friends and relativesInformation for carers, friends and relativesIf you are a carer, friend or relative of someone who lives with PTSD, you can get support. How can I get support?You can do the following.
What is a carer’s assessment? You can find out more about ‘Carer’s assessment – Under the Care Act 2014’ by clicking here. How do I get support from my peers? You can look on the following websites:
How can I support the person I care for?You can do the following.
You can find out more about:
Can I be involved in care planning? With the permission from your relative or friend, the NHS can give you information about:
You can find out more about:
You can find more information about ‘What benefits are available for mental health carers’ at: www.rethink.org/advice-and-information/living-with-mental-illness/money-benefits-and-mental-health Useful ContactsVictim Support Telephone: 08 08 16 89 111 Anxiety, grief, and trauma Anxiety UK Telephone: 03444 775 774 Assistance Support and Self Help in Surviving Trauma (ASSIST) Phone:
01788 551 919 Military and trauma Combat Stress Telephone (ex-military): 0800 138 1619 PTSD Resolution Telephone: 0300 302 0551 Veterans UK Telephone (UK only): 0808 1914 218 Torture and trauma Freedom from Torture Telephone: 020 7697 7777 Child abuse and childhood abuse The National Association for People Abused in Childhood (NAPAC) Telephone: 0808 801 0331 Help for Adult Victims of Child Abuse (HAVOCA) Email:
www.havoca.org/every-survivor-has-the-right-to-become-a-thriver/contact-us/ Sexual and domestic violence and relationships Rape Crisis Address: Rape Crisis, Suite E4, Hanover Walk, Leeds, LS3 1AB Refuge Telephone (National Domestic Abuse Helpline): 0808 2000 247 Women’s Aid Email:
Survivors UK Telephone: 0203 5983 898 RISE Telephone: 07495 099 694 Respect
Phoneline Telephone (for perpetrators & those supporting): 0808 8024 040 Need more advice?If you need more advice or information you can contact our Advice and Information Service. Is PTSD an anxiety disorder?Post-Traumatic Stress Disorder, PTSD, is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened.
What is PTSD psychology?Post-traumatic stress disorder (PTSD) is a mental health condition that's triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.
Which of the following are disorders that involve trauma?Trauma and stressor-related disorders include:. Post-traumatic stress disorder (PTSD). ... . Acute stress disorder (ASD). ... . Adjustment disorders. ... . Reactive attachment disorder (RAD). ... . Disinhibited social engagement disorder (DSED). ... . Unclassified and unspecified trauma disorders.. Which type of disorders occur when people experience extremely upsetting events that are outside their ability to cope?Posttraumatic stress disorder (PTSD) is a psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident, a terrorist act, war/combat, or rape or who have been threatened with death, sexual violence or serious injury.
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