What is PTSD?

Post-Traumatic Stress Disorder (PTSD) is a mental health condition that can develop after exposure to one or more traumatic events (actual or threatened death, serious injury, or sexual violence). Not everyone exposed to trauma develops PTSD — risk depends on event severity, prior history, supports, and coping resources.

Common Causes & Triggers

• Direct exposure to violence, accidents, natural disasters, combat, or serious assault.
• Witnessing traumatic events (e.g., seeing someone hurt or killed).
• Repeated or prolonged trauma (childhood abuse, ongoing domestic violence).
• Secondary exposure (first responders, clinicians repeatedly exposed to traumatic material).

Diagnostic Features (Core Symptom Clusters)

PTSD is typically identified by four clusters of symptoms that persist for more than one month and cause distress or functional impairment:

1. Intrusion: recurrent intrusive memories, flashbacks, distressing dreams, intense distress at reminders.
2. Avoidance: avoiding thoughts, feelings, places, or people that remind one of the trauma.
3. Negative alterations in cognition & mood: persistent negative beliefs (e.g., “I am bad”), detachment, reduced interest, emotional numbness.
4. Hyperarousal & reactivity: irritability, hypervigilance, exaggerated startle, sleep disturbances, concentration problems.

How PTSD Differs from Normal Stress Responses

• Short-term distress after trauma is common and often resolves; PTSD involves persistent, impairing symptoms.
• PTSD often includes vivid re-experiencing (flashbacks) and avoidance that interferes with daily life.
• Complex PTSD (from chronic relational trauma) can include emotional dysregulation, identity disturbance, and relational difficulties.

Risk & Protective Factors

Assessment — What Clinicians Check

• Direct questions about trauma exposure, symptom onset, frequency, and severity.
• Screening tools: PTSD Checklist (PCL-5), Primary Care PTSD Screen (PC-PTSD).
• Risk assessment: suicidal ideation, self-harm, substance misuse, current safety.
• Comorbidities: depression, anxiety, substance use, traumatic brain injury.
• Functional impact: work, relationships, daily routines.

Evidence-Based Treatment Options

Many effective treatments exist for PTSD. Below are commonly used, evidence-based approaches:

• Trauma-Focused Cognitive Behavioural Therapy (TF-CBT): structured therapy that includes exposure, cognitive restructuring, and coping skills.
• Prolonged Exposure (PE): repeated, controlled exposure to trauma memories and avoided situations to reduce fear.
• Cognitive Processing Therapy (CPT): focuses on modifying unhelpful beliefs about the trauma and its meaning.
• Eye Movement Desensitisation & Reprocessing (EMDR): uses bilateral stimulation while processing traumatic memories — supported by many trials.
• Medication: SSRIs (sertraline, paroxetine) and SNRIs (venlafaxine) are commonly used; medications are adjuncts, not replacements for therapy. Medication decisions should be by a qualified prescriber.
• Skills & Stabilisation: grounding, emotion regulation, distress tolerance — often essential before trauma processing, especially with complex or dissociative presentations.
• Group therapy & peer support: can reduce isolation and provide shared learning.

Practical Stepwise Approach (Typical Care Pathway)

1. Initial assessment and safety check (risk, substance use, comorbidity).
2. Provide psychoeducation about trauma responses and normalisation.
3. Teach stabilisation & coping skills (grounding, sleep hygiene, breathing).
4. When ready, begin trauma-focused therapy (TF-CBT, EMDR, PE, or CPT).
5. Monitor progress, adjust treatment, consider medication when indicated.
6. Plan relapse prevention, follow-up, and community supports.

Self-Help & Immediate Strategies

• Grounding techniques: 5-4-3-2-1 sensory exercise, deep breathing, progressive muscle relaxation.
• Maintain routines: sleep, nutrition, gentle exercise.
• Limit alcohol and drug use — substances worsen recovery.
• Connect with trusted people; share when comfortable.
• Use short distraction tasks when flashbacks or intense memories occur (walking, phone a friend, sensory object).
• Keep a symptoms diary to track triggers and patterns for therapy work.

When to Seek Immediate Help

Special Topics

• Complex PTSD: often follows prolonged relational trauma and may require longer-term, phased treatment (stabilisation, trauma processing, identity/reintegration).
• Children & Adolescents: trauma-focused CBT and family involvement are central; assessment and interventions must be developmentally appropriate.
• First Responders & Healthcare Workers: watch for cumulative trauma; early support, peer programs, and workplace policies matter.

Typical Course & Prognosis

• With timely, evidence-based treatment many people significantly improve and resume functioning.
• Some individuals have persistent symptoms requiring long-term care; combination approaches (therapy + medication + social support) help most.
• Early intervention after trauma reduces risk of chronic PTSD — while not all distress needs formal treatment, monitoring and support are important.

FAQs

Resources & Next Steps

• Contact local mental health services or a licensed trauma specialist for assessment and treatment planning.
• Use validated screening tools (PCL-5) and bring results to your clinician to help with triage.
• Consider peer support groups and trusted community resources while arranging professional care.