Post-traumatic Stress Disorder: key facts
How does it feel to have this disorder?
What is PTSD?
Any of us can, without warning, be caught up a traumatic event
that is overwhelming, frightening, life-threatening (to ourselves
or others) and beyond our control. This could be:
- getting a diagnosis of a serious
- having (or seeing) a serious road
- the unexpected injury or violent death of
- being taken hostage or assaulted
- being a prisoner-of-war.
After such an event, most people feel
distressed and can have symptoms for some time. Everyone will react
differently, bit it is common to feel anxious, angry, emotional,
shaky and to have difficulty putting the event out of our mind.
This is called Acute Stress Reaction. Fortunately, this usually
fades over a period of days or weeks.
But sometimes, the acute reaction doesn't go away and
you can develop a more severe condition that we call
Post-Traumatic Stress Disorder, or PTSD.
The condition can also be triggered by less acute, but equally
distressing and longer-lasting traumas, such as on-going
mistreatment, and physical or sexual abuse in the home.
Does everyone get PTSD after a traumatic experience?
No. Most people get an Acute Stress Reaction which has some
overlap with PTSD symptoms. These usually go way, but not everyone
is so lucky. About 1 in 3 people will find that their symptoms just
carry on and that they can't come to terms with what has happened.
It is as though the process has got stuck.
When does PTSD start?
The symptoms usually start within a few
weeks of the trauma, but they can start up to 6 months later.
What does PTSD feel like?
After the traumatic event you can feel
grief-stricken, depressed, anxious, guilty and angry. In PTSD you
- have flashbacks and
nightmares - you relive the event in your mind, again and
- avoid thinking about it
and feeling upset by keeping busy and avoiding anything or anyone
that reminds you of it
- be ‘on guard’ – you stay
alert all the time, can’t relax, feel anxious and can’t sleep
- get physical symptoms –
aches and pains, diarrhoea, irregular heartbeats, headaches,
feelings of panic and fear, depression
- start drinking too much alcohol or
using drugs (including painkillers).
Treatments that can help
Psychological (talking) therapies. These are
usually delivered on a one-to-one basis with your therapist. The
ones with the best evidence-base are:
- Cognitive behavioural therapy
(CBT) – helps you to think differently about your
memories, so that they become less distressing and more manageable.
It usually involves relaxation to help you tolerate the discomfort
of recalling the traumatic events.
- Eye movement desensitisation & reprocessing
(EMDR) - uses eye movements to help the brain to process
flashbacks and to make sense of the traumatic experience.
Medication. Antidepressant tablets can
help. If you find them helpful, you should carry on taking them for
around 12 months before slowly tailing them off. If you are so
distressed that you can't sleep or think clearly, you may need
sedative medication. But you should only take this for a short
time, 2 weeks or so.
How do treatments compare?
CBT, EMDR and antidepressants seem to be most helpful. The
evidence for other forms of psychotherapy or counselling is much
weaker. Trauma-focused psychological therapies (CBT and EMDR)
should usually be offered before medication.
How do I know when I've got over a traumatic
When you can:
- Think about it without becoming distressed
- Not feel constantly under threat
- Not think about it at inappropriate times.
How to help yourself
- Seek help and support - from professionals,
friends and family.
- If possible, try to get back to your usual
- Talk about what happened to someone you
trust and try relaxation exercises.
- Eat regularly, take exercise and spend time
with family and friends.
- The event may have made you avoid something
- perhaps driving or going out. Be aware of this and, if you think
it's possible, try to overcome the fear. This may be difficult and
may need to be done gradually.
- Take care with driving - you are more
likely to have an accident while you feel like this. Speak to your
doctor and keep hopeful.
- Try not to avoid other people.
- Try not to resort to alcohol or street
drugs to help you cope. These will make it more difficult to get
- Body-focused therapies, such as physiotherapy and osteopathy,
massage, acupuncture, reflexology, yoga, medication and Tai Chi.
These can help you to control your distress, to reduce the feeling
of being 'on guard' at all time, and to focus on the 'here and now'
experiences rather than the past.
Most importantly, don't be hard on yourself
or expect too much of yourself. PTSD is not a sign of weakness. The
strongest person can get it.
How other people can help you
Some people think it can be helpful to let
those around you know about your mental health problems, whether
they are family, friends or colleagues at work. This may help
people know what things can help you, especially during times of
It is not easy to be open with people about these issues. It may
help to discuss this with your doctors or mental health team to
decide if this is the right approach for you.
How can I help someone who has PTSD?
Remind yourself that they are irritable and jumpy because they
are still reliving the trauma. Give them time to tell you about
For more in-depth information see our main leaflet:
This leaflet reflects the most up-to-date evidence at the time
Produced by the RCPsych Public Education Editorial Board.
Series Editor: Dr Philip Timms
Reviewed by Dr Michael Yousif
© February 2014. Due for review: February 2016. Royal
College of Psychiatrists. This leaflet may be downloaded,
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