Post-traumatic stress disorder (PTSD) is a mental health problem you may develop after experiencing traumatic events. The condition was first recognised in war veterans. It has had different names in the past, such as ‘shell shock’, but it’s not only diagnosed in soldiers. A wide range of traumatic experiences can be causes of PTSD.
Watch Larry, Anamoli, Paul and Maisie share their experiences of what it’s like to live with PTSD, what has helped them and how they see their future. Our thanks to Mind for allowing us to share this film.
When you go through something you find traumatic it’s understandable to experience some symptoms of PTSD afterwards, such as feeling numb or having trouble sleeping. This is sometimes described as an ‘acute stress reaction’.
Many people find that these symptoms disappear within a few weeks, but if your symptoms last for longer than a month, you might be given a diagnosis of PTSD. Your GP might refer you to a specialist before this if your symptoms are particularly severe.
If you are given a diagnosis of PTSD, you might be told that you have mild, moderate or severe PTSD. This explains what sort of impact your symptoms are having on you currently – it’s not a description of how frightening or upsetting your experiences might have been.
PTSD may be described differently in some situations:
If you experience some PTSD symptoms while supporting someone close to you who’s experienced trauma, this is sometimes known as secondary trauma.
See our pages on trauma for more information on how traumatic experiences can affect your mental health.
There are lots of misconceptions about PTSD. For example, people may wrongly assume it means you are ‘dwelling’ on past events. They might even suggest that you should ‘get over it’ or ‘move on’. But having PTSD isn’t a choice or a sign of weakness, and it’s important to remember that you are not alone.
See Mind’s page on stigma and misconceptions for lots of ideas on how to deal with stigma.
This page covers:
Each person’s experience of PTSD is unique to them. You might have experienced a similar type of trauma to someone else, yet be affected in different ways.
These are some common signs and symptoms that you might recognise. Everyone’s experience is different, so you may experience some, none or all of these things.
This can include:
This can include:
This can include:
This can include:
This could be because when we feel stressed emotionally, our bodies release hormones called cortisol and adrenaline. This is the body’s automatic way of preparing to respond to a threat, sometimes called the ‘fight, flight or freeze’ response.
Studies have shown that someone with PTSD will continue producing these hormones when they’re no longer in danger, which is thought to explain some symptoms such as extreme alertness and being easily startled.
Some people also experience physical symptoms similar to symptoms of anxiety, such as headaches, dizziness, chest pains and stomach aches.
A flashback is a vivid experience in which you relive some aspects of a traumatic event or feel as if it is happening right now. This can sometimes be like watching a video of what happened, but flashbacks do not necessarily involve seeing images, or reliving events from start to finish. You might experience any of the following:
You might notice that particular places, people or situations can trigger a flashback for you, which could be due to them reminding you of the trauma in some way. Or you might find that flashbacks seem to happen at random. Flashbacks can last for just a few seconds, or continue for several hours or even days.
You can read some tips on how to cope with flashbacks on our page on self-care for PTSD.
If you are experiencing symptoms of PTSD, you might also find that you have difficulty with some everyday aspects of your life, such as:
If you drive you may have to tell the DVLA that you have PTSD. For more information on your right to drive, including when and how to contact the DVLA, see Mind’s legal pages on fitness to drive.
It’s common to experience other mental health problems alongside PTSD, which could include:
See our pages on anxiety and panic attacks, sleep problems, phobias, depression, dissociative disorders, self-harm and suicidal feelings for more information on these topics.
The situations we find traumatic can vary from person to person. There are many different harmful or life-threatening events that might cause someone to develop PTSD. For example:
Some factors may make you more vulnerable to developing PTSD, or may make the problems you experience more severe, including:
If you experienced trauma at an early age or you have experienced long-lasting or multiple traumas, you might be given a diagnosis of complex PTSD.
Find out more about complex PTSD below.
The impact racism can have on your mind and body is sometimes described as racial trauma. There’s no universal definition of racial trauma. Some researchers say that it should be included as part of PTSD. Others say that it should be separate from PTSD, to reflect the specific traumatic experiences and effects of racism.
But however you choose to define your experiences, it is always ok to ask for help with your mental health.
Anyone can experience traumatic events, but you may be particularly likely to have experienced trauma if you:
If you experience symptoms of PTSD while supporting someone close to you who has experienced trauma, this is sometimes known as ‘secondary trauma’ or ‘secondary traumatic stress’.
‘Secondary’ means that although the original (primary) trauma happened to someone else, the impact it’s having in your life is traumatic for you. It doesn’t mean it’s any less significant than any other kind of PTSD, or any easier to deal with. Our page for friends and family has some tips on looking after yourself.
Repeatedly witnessing or hearing about traumatic events in the course of your job is also sometimes called ‘secondary trauma’, although this experience is increasingly thought of by professionals as an original (primary) trauma.
Complex post-traumatic stress disorder (complex PTSD, sometimes abbreviated to c-PTSD or CPTSD) is a condition where you experience some symptoms of PTSD along with some additional symptoms, such as:
Complex PTSD is a fairly new term. Professionals have recognised for a while that some types of trauma can have additional effects to PTSD, but have disagreed about whether this is a form of PTSD or an entirely separate condition, and what it should be called.
For example, you may find some doctors or therapists still use one of the following terms:
If you have complex PTSD you may be particularly likely to experience what some people call an ’emotional flashback’, in which you have intense feelings that you originally felt during the trauma, such as fear, shame, sadness or despair. You might react to events in the present as if they are causing these feelings, without realising that you are having a flashback.
See our sections explaining what flashbacks are and tips for coping with flashbacks for more information.
The types of traumatic events that can cause complex PTSD include:
You are more likely to develop complex PTSD if:
Some of the symptoms of complex PTSD are very similar to those of borderline personality disorder (BPD), and not all professionals are aware of complex PTSD.
As a result, some people are given a diagnosis of BPD or another personality disorder when complex PTSD fits their experiences more closely. Professionals disagree about when it’s helpful to diagnose someone with a personality disorder or when another diagnosis or description is better. To find out more see our page on why personality disorders are controversial?
If you’re worried that the diagnosis you’ve been given doesn’t fit the way you feel, it’s important to discuss it with a mental health professional so you can make sure you’re getting the right treatment to help you.
See our pages on borderline personality disorder and personality disorders for more information on these diagnoses.
These pages on seeking help for a mental health problem provide information on how to make sure your voice is heard, and what you can do if you’re not happy with your doctor.
The National Institute for Health and Care Excellence (NICE) – the organisation that produces guidelines on best practice in health care – has not yet developed recommendations specifically for complex PTSD. They caution that the existing guidelines for PTSD weren’t developed for this kind of diagnosis.
You may find standard treatments for PTSD helpful, but many people with complex PTSD need more long-term, intensive support to recover. As part of your treatment you should also be offered support for other problems you experience, such as depression, drug and alcohol use or dissociation. The treatment you are offered may depend on what’s available in your local area.
See our treatment for PTSD page for more about the treatments available, which may be useful for complex PTSD. Or visit our page on self-care for PTSD for tips on how to look after yourself when you have complex PTSD.
We also have a page for friends and family of someone with PTSD, with ideas on supporting someone who is struggling.
Living with PTSD can feel overwhelming. This page offers some practical suggestions for looking after yourself.
Flashbacks can be very distressing, but there are things you can do that might help. You could:
You might find that certain experiences, situations or people seem to trigger flashbacks or other symptoms. These might include specific reminders of past trauma, such as:
Some people find things especially difficult on significant dates, such as the anniversary of a traumatic experience. It can help to plan ahead for these times and use these self-care tips to help you.
When experiencing PTSD it can be hard to open up to others. This may be because you feel unable to talk about what has happened to you or because you find it difficult to trust others after your traumatic experience.
You don’t need to be able to describe the trauma to tell someone how you are currently feeling though. It could help to talk to a friend or family member, or a professional, such as a GP or a trained listener at a helpline.
Everyone has their own unique response to trauma and it’s important to take things at your own pace.
For example, it may not be helpful to talk about your experiences before you feel ready. Try to be patient with yourself and don’t judge yourself harshly for needing time and support to recover from PTSD.
Peer support brings together people who have had similar experiences, which some people find very helpful.
See these pages on peer support for more information about what it involves and how to find a peer support group to suit you.
You might find it useful to contact an organisation that specialises in advice and support for PTSD, such as ASSIST Trauma Care.
It could also be helpful to find an organisation with expertise in the particular type of trauma you have experienced.
See our useful contacts page for details of relevant organisations.
Coping with PTSD can be exhausting. You might feel like you can’t find the energy to take care of yourself, but looking after your physical health can make a difference to how you feel emotionally.
For example, it can help to:
Lots of people who experience PTSD have problems sleeping. You might:
See our page on coping with sleep problems for more information.
This page covers:
If you have had PTSD symptoms for less than four weeks or they are relatively mild, your GP might suggest an approach called ‘watchful waiting’ before offering you any treatment. This involves monitoring your symptoms yourself to see if things improve. In this case you should be offered a follow-up appointment within one month,
The National Institute for Health and Care Excellence (NICE) – the organisation that produces guidelines on best practice in health care – currently recommends two types of talking treatment for PTSD:
NICE may recommend other talking treatments in future if they are found to help with PTSD, but more research is needed.
If the talking treatment you try doesn’t seem to be helping, NICE suggests that you:
Your doctor or therapist should offer you a second course of treatment or a follow-up appointment. You can read the full guidelines for PTSD treatment on the NICE website.
People experiencing PTSD aren’t routinely prescribed medication. However, you might be offered medication if:
If you are offered medication for PTSD, this will usually be an antidepressant. While PTSD is not the same as depression, this type of medication has been found to help.
NICE recommends that doctors consider prescribing venlafaxine or a type of antidepressant called selective serotonin reuptake inhibitors (SSRIs), such as sertraline. See Mind’s pages on antidepressants for more information about this kind of medication.
If you also experience symptoms of psychosis or severe hyperarousal (constantly feeling on high alert), and other medications have not helped you, you may be offered an antipsychotic to treat these symptoms. Antipsychotic treatment should be reviewed regularly by a specialist such as a psychiatrist. See our pages on antipsychotics for more information about this kind of medication.
Before you decide to take any medication, you should make sure you have all the facts you need to feel confident about your decision. For guidance on what you might want to know about any drug before you take it, see Mind’s pages on:
Some people with PTSD say they have found other treatments helpful in managing their condition, such as group therapy, arts therapies or dialectical behaviour therapy (DBT).
Trauma can affect the body physically as well as psychologically and there is growing evidence to show that body-based therapy can help people experiencing PTSD to ground themselves and regulate emotions. You can find out more about body-based therapy and find a therapist via the Body Psychotherapy Network.
However, the NICE guidelines recommend that treatments that have not been designed or properly tested for people who have experienced trauma should not be used on their own.
Here are some ways you could access treatment:
See these pages on seeking help for a mental health problem and talking treatments for more information about accessing treatment.
It can be really hard to see someone you care about experiencing the symptoms of PTSD or complex PTSD. This page has some suggestions for ways you can support them while also looking after your own wellbeing.
If you feel able to, you could help by:
If you’ve not experienced PTSD yourself, it can be hard to understand why your friend or family member can’t seem to ‘move on’. It’s understandable to wish things could get back to normal, but it’s important not to blame them or put pressure on them to get better without the time and support they need.
Each person will have a different experience of PTSD, so it might help to talk about what sorts of situations or conversations might trigger flashbacks or difficult feelings. For example, they might be particularly distressed by loud noises, arguments or particular places. Understanding their triggers could help you to avoid these situations, and feel more prepared when flashbacks happen.
When your friend or relative is feeling well, it can be helpful to discuss with them how you can help if they become unwell or if a crisis happens. You could:
This can help them to avoid crises or manage them differently in future where possible. When having these conversations, make sure you also think about how much you can cope with and try to only offer support that you feel able to give. It is important to look after yourself too.
For more information see these pages on planning for a crisis, helping someone else seek help and advocacy.
Flashbacks are vivid experiences in which someone relives aspects of a traumatic event. It can be hard to know how to help during a flashback, but you don’t need special training to support someone who is having one. It could help if you:
See our sections on what flashbacks are and tips for coping with flashbacks for more information.
People who experience PTSD may often feel jumpy or on edge. They may be easily startled or feel they need to constantly watch out for danger. It can help if you:
You might see a change in the behaviour of the person you want to support. For example:
If you notice these sorts of changes in someone close to you, you could ask them how they are feeling. This might encourage them to open up.
If they want you to, you could help your friend or family member to find further support. For example you could:
It’s important to remember that your mental health matters too. These pages on supporting someone else to seek help, how to cope when supporting someone else, managing stress and maintaining your wellbeing all have lots of information and tips on how to look after yourself.
A traumatic event can have a major impact not just on those who lived through it, but also on that person’s close family, friends and colleagues.
If you experience symptoms of PTSD yourself while supporting someone through a trauma (sometimes called secondary trauma), it might help to try some of the tips on our self-care for PTSD page.
It’s also a good idea to talk to your GP about how you’re feeling, and ask if they can offer you any treatment or support.
The National Institute for Health and Care Excellence (NICE) – the organisation that produces guidelines on best practice in healthcare – says professionals should consider the impact of traumatic events on relatives and think about how to provide appropriate care.
Anxiety UK
03444 775 774 (helpline)
07537 416 905 (text)
anxietyuk.org.uk
Advice and support for people living with anxiety.
ASSIST Trauma Care
assisttraumacare.org.uk
Information and specialist help for people who’ve experienced trauma or are supporting someone who has.
Birth Trauma Association
birthtraumaassociation.org
Support for anyone affected by birth trauma, including partners.
Body Psychotherapy Network
bodypsychotherapynetwork.co.uk
An organisation aiming to provide a community, a platform and a voice for Body Psychotherapy and body psychotherapists.
Combat Stress
0800 1381 619
combatstress.org.uk
Treatment and support for armed forces veterans who have mental health problems.
Disaster Action
disasteraction.org.uk
Information and support for people affected by major disasters in the UK and overseas.
EMDR Association UK
emdrassociation.org.uk
Professional association of EMDR clinicians and researchers in the UK and Ireland. Provides lots of information about EMDR. Includes a search tool to find EMDR-accredited therapists.
Freedom from Torture
freedomfromtorture.org
Supports survivors of torture.
Help for Adult Victims of Child Abuse (HAVOCA)
havoca.org
Information and support for adults who have experienced any type of childhood abuse, run by survivors.
Mind
Mind’s helplines provide information and support by phone and email.
Local Minds offer face-to-face services across England and Wales. These services include talking therapies, peer support and advocacy.
Side by Side is Mind’s supportive online community for anyone experiencing a mental health problem.
The National Association for People Abused in Childhood (NAPAC)
0808 801 0331
support@napac.org.uk
napac.org.uk
Supports adult survivors of any form of childhood abuse. Offers a helpline, email support and local services.
NHS UK
nhs.uk
Information about health problems and treatments, including details of local NHS services in England.
NHS talking therapies self-referral
nhs.uk/service-search/mental-health/find-an-nhs-talking-therapies-service
Information about local NHS therapy services for certain mental health problems. You can self-refer (England only) but you must be registered with a GP.
PTSD Resolution
0300 302 0551
ptsdresolution.org
Helps veterans, reservists and their families with trauma and distress.
PTSD UK
ptsduk.org
Provides information about PTSD and C-PTSD, including different types of treatment, ways to help yourself and how to support someone with PTSD.
RoadPeace
08454 500 355
roadpeace.org
Information and support for people bereaved or seriously injured due to road crashes.
The Survivors Trust
0808 8010 818
thesurvivorstrust.org
Lists local specialist services for survivors of sexual violence, including advocates and Independent Sexual Violence Advisors (ISVAs).
Victim Support
0808 168 9111
victimsupport.org.uk
Provides emotional and practical support for people affected by crime and traumatic events.
Our friendly team at the Portsmouth Mental Health Hub are here to help.
Enter your details and someone will call you back between 8am and 6pm, Monday to Friday.
If you or someone you know needs urgent mental health help, please call 111 – the NHS non-emergency number. It’s available 24 hours a day, 7 days a week and is free from any phone. They have specialist mental health nurses who can support adults and young people.
In a life-threatening emergency, always call 999.