--- title: "Post-traumatic stress disorder (PTSD): Symptoms & Treatment" description: "PTSD — flashbacks, nightmares, and hypervigilance after trauma; NHS treatments including trauma-focused CBT and EMDR." url: https://healthanswers.co.uk/conditions/post-traumatic-stress-disorder/ robots: noindex --- # Post-traumatic stress disorder (PTSD): Symptoms & Treatment Health A–Z PTSD — flashbacks, nightmares, and hypervigilance after trauma; NHS treatments including trauma-focused CBT and EMDR. Written by HealthAnswers editorial team Medically reviewed by [Dr Neil Singh MBChB - nMRCGP](https://healthanswers.co.uk/our-doctors/neil-singh/) · GMC 7039648 Reviewed 28 June 2026 ## Quick answer What is post-traumatic stress disorder? 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. ## Who is this page for? This page is for people in the UK who want a plain-English overview of Post-traumatic stress disorder (PTSD), including when to seek help and what NHS care usually involves. It explains general information, not what is wrong with you personally. ## Who should skip this page? Skip this page if you need a diagnosis, a prescription, or emergency care. It cannot replace a GP, pharmacist, NHS 111 or 999. If you are in immediate danger, call 999; for urgent advice that is not life-threatening, call 111 in England, Scotland or Wales, or use your GP out-of-hours service in Northern Ireland. On this page 9 sections ## Key facts about post-traumatic stress disorder - PTSD affects about 1 in 3 people after severe trauma at some point — not everyone develops it. - Symptoms must persist over 1 month (PTSD diagnosis) and cause significant distress or impairment. - Trauma-focused CBT and EMDR have strongest evidence — general counselling alone less effective. - PTSD can start months or years after trauma — delayed onset recognised. - Complex PTSD from repeated childhood trauma may need longer specialist therapy. ## 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** ## ! When to see a GP about post-traumatic stress disorder See a GP if you have nightmares, flashbacks, severe anxiety, or avoidance after trauma lasting over 4 weeks — or anytime symptoms overwhelm coping. Seek urgent help for suicidal thoughts or self-harm. IAPT services offer trauma-focused therapy — ask for therapist trained in PTSD protocols. Blue Light services support emergency workers. ## Common questions about post-traumatic stress disorder 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. How do I find a trauma or EMDR therapist? For free help in England, refer yourself to NHS Talking Therapies and ask for a therapist trained in trauma-focused CBT or EMDR. For private therapy, use the directories of recognised bodies such as the BACP, UKCP or HCPC and search for trauma or EMDR specialists by postcode, checking they are registered. Veterans can contact Op COURAGE and Combat Stress for specialist support. ## Sources - [NHS — Post-traumatic stress disorder](https://www.nhs.uk/mental-health/conditions/post-traumatic-stress-disorder-ptsd/overview/) - [NICE — PTSD management](https://www.nice.org.uk/guidance/ng116) - [Combat Stress / PTSD UK charities](https://www.combatstress.org.uk/)