Post-traumatic stress disorder (PTSD)

Post-traumatic stress disorder (PTSD) is a type of anxiety disorder that can be caused by witnessing or being involved in a very traumatic, distressing or frightening event. PTSD affects people differently. Many people will relive the traumatic event through flashbacks and nightmares that leave them feeling on edge, and some will feel guilt or shame or suffer from insomnia, and many sufferers become isolated.

It is common to experience some of the symptoms associated with PTSD after going through a traumatic event. Many people find that their symptoms disappear after a few weeks, but if the symptoms you are experiencing last for longer than a month, a diagnosis of PTSD might be given.

Symptoms of PTSD

Your experience of PTSD is unique to you. You may be affected differently, even when you have encountered a similar type of trauma to someone else, but generally the specific symptoms of PTSD fall into the categories described below:

Physical
- Nausea, trembling, pain, sweating
- Hyperarousal
- Feeling physically numb or detached from your body
Cognitive
- Reliving aspects of what happened - flashbacks
- Hypervigilance
- Repetitive and distressing images or sensations
- Difficulty concentrating
Emotional
- Anxiety
- Irritability
- Shame or guilt
Behavioural
- Avoiding certain people, situations or places
- Avoiding talking about the experience
- Attempts to self-sooth for example through alcohol or drugs use

Different types of PTSD

To explain the impact your symptoms are having on you, you might be told that you have mild, moderate or severe PTSD.

Delayed-onset PTSD – or ‘delayed PTSD’ describes your symptoms if they emerge more than six months after experiencing trauma.
Complex PTSD – you might be given a diagnosis of ‘complex PTSD’ if you have experienced multiple traumatic events over a longer period of time throughout your life.
Birth trauma – if you experience traumatic childbirth and develop PTSD, this is known as ‘birth trauma’.
Secondary trauma – if you are supporting someone close to you who has experienced trauma, and you experience some PTSD symptoms, this is sometimes known as ‘secondary trauma’.

Causes of PTSD

Post-traumatic stress disorder (PTSD) can develop after a frightening, distressing or stressful event or after a prolonged traumatic experience. Although situations we find traumatic vary from person to person, PTSD is not usually related to upsetting situations such as losing one's job, failing an exam or getting divorced.

Events that trigger PTSD include:

Serious road accidents
Being raped or sexually assaulted
Any event where you have feared for your life
Witnessing people being hurt or killed violently
Natural disasters – e.g. earthquakes or severe flooding
The death of someone close to you in particularly upsetting circumstances
Violent personal attacks – mugging or robbery
Being abused, harassed or bullied
Terrorist attacks
Military combat
Doing a job where you repeatedly see or hear details of traumatic events
Being diagnosed with a life-threatening condition

How to look after yourself when living with PTSD

Many people with PTSD find it hard to open up to others about what they are going through. However, it can really help to confide in someone if you can. You don’t have to open up to them about the particular trauma – just telling them how you are currently feeling might be helpful.

It might be a good idea to seek some professional help. Going to a GP for advice can be the first step to getting the help you need. It is important to give yourself time and to be patient with yourself. Everyone responds to trauma differently and it is important to take your recovery at your own pace.

How to support a loved one going through PTSD

Watching a loved one experiencing PTSD can be particularly distressing for both parties. Here are some ways you can support them while looking after your own mental health.

Listen

Allow them to be upset about what has happened and let them talk about their experience at their own pace. It is important not be dismissive and for them not to feel pressured into speaking about the traumatic event. Try not to make assumptions about how they feel or question why they did not do something differently either.
Try not to judge

It can be difficult to understand why a loved one can’t seem to ‘get over it’ and ‘move on’ if you haven’t experienced PTSD yourself. Instead of putting pressure on them to get better, support them and give them the time they need.
Learn their triggers

Talking about the different situations that might trigger difficult feelings or flashbacks could help you feel more prepared when flashbacks happen. PTSD is unique to the individual experiencing it. For example, they might find significant dates such as the anniversary of the traumatic experience particularly tricky. Noises, sounds, places or words can all have trigger reminders too.
Look out for warning signs

If you notice a change in your loved one, such as a change in their behaviour, mood or energy levels, you could ask them how they are feeling to encourage them to open up.
Respect their personal space

If a loved one is experiencing PTSD, you could find that they are easily startled or often feel on edge and looking out for danger. Avoid overcrowding them and give them the space they need. It might be a good idea to ask their permission before touching them or hugging them.
Look after your mental health

Supporting someone who is experiencing PTSD can be difficult and it’s vital that you look after your mental wellbeing too. Your GP or local IAPT service will be able to offer you support or provide you with appropriate care.

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