Post-traumatic stress disorder (PTSD)

What causes PTSD?

There are many different traumatic events that can lead to PTSD. Some examples include:

• a serious road accident
• rape or sexual assault
• a mugging or robbery
• abuse, harassment or bullying, including racism, sexism or abuse targeting your identity
• kidnap or being held hostage
• an event where you fear for your life
• witnessing violence, including in military combat, a terrorist attack or violent assault
• seeing other people injured or killed
• natural disasters, like severe floods or earthquakes
• being diagnosed with a life-threatening condition
• an unexpected injury or death of someone you’re close to
• doing a job where you see or hear traumatic things, for example in the armed forces or emergency services
• traumatic childbirth

The Royal College of Psychiatrists have advice on coping after a traumatic event.

Treatment for PTSD

PTSD can be treated even if it develops many years after a traumatic event.

There are different treatments for PTSD. The best option for you will depend on how severe your symptoms are and when they developed.

Watchful waiting

Your GP may recommend ‘watchful waiting’ if:

• you have had symptoms of PTSD for less than 4 weeks, or
• your symptoms are mild

Watchful waiting means your GP will monitor your symptoms to see if they improve or get worse. You should have a follow-up appointment within one month.

PTSD and complex PTSD (CPTSD) self-help guide

The PTSD and CPTSD self-help guide is for people with mild-to-moderate symptoms. It aims to help you:

• consider whether you’re experiencing symptoms of PTSD or CPTSD
• understand more about PTSD and CPTSD
• think about ways to manage or recover from PTSD or CPTSD

Trauma-focused cognitive behavioural therapy (CBT)

Trauma-focused CBT uses a range of techniques to help you come to terms with the traumatic event. For example, your therapist may ask you to address your traumatic memories by thinking about them in detail.

During this process, the therapist will help you cope with any distress you feel. They’ll also identify any unhelpful thoughts or misrepresentations you have about the experience. For example, feeling you’re to blame for what happened or feeling scared that it’ll happen again.

You’ll usually have 8 to 12 weekly sessions of trauma-focused CBT, although fewer may be needed. Sessions usually last for around 60 to 90 minutes. You’ll see the same therapist each week.

Eye movement desensitisation and reprocessing (EMDR)

Eye movement desensitisation and reprocessing (EMDR) is quite a new treatment for PTSD. It involves making rhythmic eye movements whilst describing the traumatic event to a therapist.

The rapid eye moments aim to mirror the way your brain processes information when you’re asleep.

Further information about EMDR

Medication

Medication isn’t regularly used to treat PTSD. It may be recommended if you:

• are unable to, or don’t want to try, talking therapies like CBT
• also have depression
• have sleep problems caused by PTSD

If you’re offered medication to treat PTSD, it’ll usually be an antidepressant.

Group therapy

It can be helpful to talk about your experience of PTSD with other people who have it. You can do this through group therapy.

Group therapy can help you understand PTSD. It also teaches you different ways to manage your symptoms.

Treatment for PTSD in children and young people

It’s usually recommended that children and young people with PTSD have trauma-focused CBT. This will usually be in 8 to 12 sessions. These are adapted to suit the child’s age, circumstances and development. If it’s appropriate, the treatment will involve the child’s family.

Medication isn’t usually recommended for children and young people with PTSD.

Further support with PTSD

There are many organisations that provide counselling and support for PTSD. This includes:

• Combat Stress – a military charity specialising in helping ex-servicemen and women
• Rape Crisis Scotland – provide services for women and girls who have experienced abuse, domestic violence and sexual assault
• Turn to SARCS – information on where to find support if you’ve been raped or sexually assaulted
• Victim Support Scotland – provide support and information to victims or witnesses of crime
• Cruse Bereavement Support – provide support and information for people who have experienced bereavement

Don’t include personal information e.g. name, location or any personal health conditions.

People with PTSD often try to avoid anything that brings the traumatic event back to mind. Because of this, you may:

• avoid people and places that remind you of the trauma
• avoid talking about what happened
• try to distract yourself with things like work or hobbies
• be unable to remember details of the event
• feel numb or cut off from your feelings
• feel detached from your body
• be unable to show affection
• do self-destructive or reckless things
• use alcohol or drugs

Difficult beliefs or feelings

PTSD can bring on difficult beliefs or feelings. You may feel like:

• you cannot trust anyone
• nowhere is safe
• nobody understands
• you are to blame for what happened

You may also feel overwhelming anger, sadness, guilt or shame.

PTSD in children

PTSD can affect children as well as adults.

Children with PTSD can have symptoms similar to adults. They may also:

• wet the bed
• become very anxious about being separated from a parent or another adult
• re-enact the traumatic event through play

Further information on PTSD in children