11 May 2022

PTSD, advice and treatment

PTSD is estimated to affect about one in every three people who have a traumatic experience, but unfortunately, many people do not know that they have post-traumatic stress disorder (PTSD), or do not seek treatment. Our experts have shared their insights on PTSD, its symptoms, treatments, as and where to find support. 

What is PTSD?

PTSD is an anxiety disorder that that can occur following the experience or witnessing of a life-threatening event. Typical traumatic events can include:

  • Serious accidents 
  • Violent personal assault (sexual assault, physical attack, abuse, robbery, mugging) 
  • Natural or man-made disasters 
  • Being diagnosed with a life-threatening illness
  • Military combat 
  • Being taken hostage
  • Terrorist attack 
  • Being a prisoner of war

Most people exposed to traumatic events experience some short-term distress, but eventually, their trauma fades to a memory – painful, but not destructive. However, around a third of people who experience a trauma go on to develop PTSD. It is still an incredibly misunderstood, often misdiagnosed, and stigmatised condition.

  • PTSD can develop immediately after someone experiences a disturbing event. Alternatively, it can occur weeks, months or even years later. 
  • Affects about one in every three people who have a traumatic experience. However, it is unclear exactly why some people develop the condition and others do not.

The term ‘Post Traumatic Stress Disorder’ (PTSD) was only introduced in the 1980s, even though it is a condition that has been around for thousands of years. It has had different names in the past, such as ‘shell shock’, which is combat stress diagnosed in soldiers. 

The first official documented case of ‘psychological distress’ was reported in 1900 BC by an Egyptian physician, who described a ‘hysterical reaction’ to trauma – although ‘chronic mental symptoms caused by sudden fright’ were reported in the account of the battle of Marathon by Herodotus, written in 440 BC.

The Symptoms

These usually begin early, within three months of the traumatic incident, but sometimes they start years after.

  • Someone with PTSD often relives the traumatic event through nightmares and flashbacks
  • They may have problems sleeping, such as insomnia and find concentrating difficult
  • They may also experience feelings of isolation, irritability and guilt

These symptoms are often severe and persistent enough to have a significant impact on the person’s day-to-day life. 
Complex PTSD may be diagnosed in adults or children who have repeatedly experienced traumatic events, such as violence, neglect or abuse. 

What are the treatment options?

PTSD can be successfully treated, even when it develops years after a traumatic event. Treatment depends on the severity of symptoms and how soon they occur after the traumatic event.

Any of the following treatment options may be recommended:

  • Watchful waiting – monitoring your symptoms to see whether they improve or get worse without treatment 
  • Antidepressants – such as paroxetine or mirtazapine 
  • Psychological therapies – such as trauma-focused cognitive behavioural therapy (CBT) or eye movement desensitisation and reprocessing (EMDR). There may be feelings of guilt or shame about something that is not their fault. The therapist helps people with PTSD look at what happened in a realistic way.
  • Trauma-focused Therapy: EMDR or CBT can help you to remember your traumatic experiences with less distress and more control. Other psychotherapies, including psychodynamic psychotherapy, can also be helpful. Care needs to be taken in complex PTSD because these treatments can make the situation worse if not used properly
  • Exposure therapy: this helps people face and control their fear. It gradually exposes them to the trauma they experienced in a safe way. It uses imagining, writing or visiting the place where the event happened. The therapist uses these tools to help people with PTSD cope with their feelings 
  • Cognitive restructuring: this helps people make sense of bad memories. Sometimes people remember the event differently to how it happened

The important thing is that PTSD can be treated. Early treatment is important and may help reduce long-term symptoms. But unfortunately, many people do not know that they have PTSD or do not seek treatment.

Advice for friends, relatives and colleagues:

  • Look out for any changes in behaviour – poor performance at work, lateness, taking sick leave, minor accidents 
  • Watch for anger, irritability, depression, lack of interest, lack of concentration 
  • Take time to allow a trauma survivor to tell their story 
  • Ask general questions. Let them talk, don’t interrupt the flow or come back with your own experiences

Support groups which may be helpful include:

  • https://combatstress.org.uk/ military charity specialising in the welfare of ex-service people suffering from psychiatric disabilities. Services include brief bespoke residential treatments 
  • https://rapecrisis.org.uk/ charity providing specialist services for all those affected by sexual violence 
  • https://www.victimsupport.org.uk/ a free, confidential help to victims of crime, witnesses of crime, their families, friends and anyone else affected