Post-traumatic stress disorder (PTSD) explained

What PTSD is

PTSD can develop after a traumatic event such as a serious accident, violent assault, abuse, a disaster, military combat, or a frightening medical event. It can follow a single event or repeated trauma over time, and it can also affect people who witnessed something happen to someone else, or whose work exposes them to trauma. Feeling distressed in the weeks after trauma is normal, and often eases with time and support. PTSD is diagnosed when the symptoms are severe, last longer than about a month, and interfere with everyday life. Complex PTSD is a related pattern that can follow prolonged or repeated trauma, often from childhood, and includes difficulties with emotions, relationships and sense of self alongside the core symptoms.

The main symptoms

PTSD symptoms usually fall into a few groups. The first is re-experiencing: reliving the trauma through vivid flashbacks, nightmares, or intrusive memories and images that arrive uninvited, often with the same fear felt at the time. The second is avoidance: staying away from reminders, places, people or conversations linked to the event, and trying to push the memories away. The third is feeling constantly on edge, known as hyperarousal — being jumpy, irritable, unable to relax or sleep, and always scanning for danger. Many people also feel emotionally numb, cut off from others, low in mood, or burdened by guilt and shame. Children may show it through play, clinginess or bedwetting. These symptoms are the mind and body still reacting as though the danger is present.

Why trauma affects the mind and body

During a traumatic event, the brain's alarm system takes over to help the person survive, and the memory can be stored in a raw, fragmented way rather than being neatly filed as a past event. In PTSD, this alarm system stays switched on afterwards, so reminders can trigger the same rush of fear as if the danger were happening again. This is why a smell, sound or place can bring on a flashback so powerful it feels real. The constant sense of threat keeps the body tense and watchful, disturbing sleep and concentration. Understanding that these reactions are the nervous system doing its job too well, rather than a character flaw, can reduce the shame many people feel and make it easier to seek help.

How PTSD is treated in the UK

PTSD is treatable, and most people improve with the right help. The main NHS treatments are specific talking therapies. Trauma-focused cognitive behavioural therapy helps people process the memory safely and change the beliefs that keep them stuck. Eye movement desensitisation and reprocessing, known as EMDR, uses guided eye movements or other rhythmic stimulation to help the brain process traumatic memories. In England, people can often self-refer to NHS Talking Therapies, and a GP can also refer to specialist services. Medicine, usually an antidepressant, may be offered for some people, particularly when therapy alone is not enough or is not yet possible. Support with sleep, alcohol, and staying connected to others all help recovery. Getting help early tends to lead to better outcomes.

Getting support and staying safe

PTSD can be isolating, and it sometimes comes with low mood, self-harm or thoughts of suicide. Reaching out is a strength, not a failure. Start with your GP, or self-refer to NHS Talking Therapies in England. Charities such as Mind and PTSD UK offer information and support, and veterans can access dedicated services such as Op COURAGE. If you are struggling to cope, you can call NHS 111 and choose the mental health option at any time. Samaritans are available free, day or night, on 116 123, and you can text SHOUT to 85258 for crisis support. If you or someone else is in immediate danger or has seriously harmed themselves, call 999 or go to A&E. You do not have to face this alone.