PTSD: Signs, and the Treatments That Work

Post-traumatic stress disorder (PTSD) is a condition where the mind stays stuck in danger mode long after a traumatic event has ended. It can follow an assault, a crash, combat, abuse, a disaster, a hard birth, or the sudden death of someone close. Most people who live through trauma do not develop PTSD. Those who do can get better with the right treatment.

The four groups of symptoms#

PTSD often shows up in the body too, with headaches, stomach trouble and tiredness. It also commonly sits alongside depression and anxiety. If that is part of the picture, the mood check can help you put it into words before an appointment.

Normal reactions vs PTSD#

In the first days and weeks after trauma, shock, poor sleep, replaying the event, tearfulness and jumpiness are normal. They are the brain working through something overwhelming. For most people they ease over the following weeks.

PTSD is considered when symptoms last more than a month, stay intense, or start to shape daily life. Sometimes symptoms appear months or years later. In the early weeks, rest, practical support and time with people you trust usually help most. A doctor may suggest checking in again after about a month rather than starting therapy straight away. Pushing someone to retell every detail right after the event is not recommended.

Complex PTSD#

Complex PTSD can follow repeated or long-lasting trauma, often where escape was hard. Examples include childhood abuse, domestic violence or captivity. It includes the core PTSD symptoms plus lasting trouble managing emotions, a deep sense of shame or worthlessness, and difficulty feeling close to others. Treatment uses the same approaches, often over a longer time, with more focus on safety and stability first.

Treatments that work#

Trauma-focused CBT helps you process the memory and change the beliefs it left behind, such as "it was my fault" or "nowhere is safe". It also helps you slowly return to things you have been avoiding.

EMDR asks you to hold the memory in mind while following side-to-side eye movements or tones. Over sessions, the memory loses its raw charge.

Both are first-line treatments with strong evidence. Courses often run for around 8 to 12 sessions, sometimes more. They are hard at first, because they involve facing memories, but a good therapist sets the pace with you.

Medication can help, especially when therapy is not available or not enough, or when depression is also present. Antidepressants from the SSRI and SNRI classes are used most. They usually take several weeks to work. Stopping should be planned with the prescriber, because stopping suddenly can cause discontinuation symptoms.

How to support someone with PTSD#

• Listen without pushing for details. Let them choose what to share and when.
• Avoid "just move on" or "it could have been worse".
• Learn their triggers and help reduce surprises.
• Encourage treatment and offer practical help, such as booking or going along.
• Look after yourself too. Supporting someone through trauma is tiring.

When to get help now#

PTSD can bring dark thoughts, especially at night or around anniversaries. If that happens, please reach out today. These feelings can pass, and help works.

• If you might act on thoughts of suicide or self-harm: call your local emergency number now.
• US and Canada: call or text 988, any hour.
• UK and Ireland: Samaritans, 116 123, any hour.
• Anywhere else: findahelpline.com lists free lines by country.

What I see in clinic#

Many people with PTSD come in about something else: poor sleep, headaches, drinking more, a short temper. The link to an event months or years earlier often comes out only when asked. In occupational health I see it after serious workplace accidents, in the injured worker and in colleagues who saw it happen.

Where to take this next#

Poor sleep and nightmares are often the hardest part, and the guide to fixing insomnia covers what helps at night. If you want help finding the right kind of therapist, a 20 minute video session with a doctor on our team costs $79.