Post-Traumatic Stress Disorder (PTSD)

Is PTSD stopping you from living your life? Are you finding yourself having frequent nightmare and flashbacks about a particular event? Are you experiencing isolation irritability and guilt?

Post-traumatic stress disorder (PTSD) and acute stress disorder (ASD) are anxiety disorders caused by events you found terrifying or disturbing.

PTSD sufferers often relive the event through nightmares and flashbacks, and may experience isolation, irritability and guilt. These disorders can develop even if you were a witness to the trauma, as opposed to being directly involved.

The disorder is commonly associated with soldiers and veterans, but events or traumas that have been known to trigger ASD or PTSD in people are diverse and can include terrorism, war, natural disasters, fire events, car crashes, physical and sexual assault and being the victim or witness of a crime. Other less obvious causes include abuse, bullying, childhood neglect, unexpected death of a family member or friend, complicated childbirth, and long-term illness.

Post-traumatic stress disorder does not always develop immediately following a trauma. While symptoms ordinarily develop within three months of the traumatic occurrence, your symptoms might start as late as six months afterwards. And there is an argument that if the trauma is repressed, new or worse symptoms can develop years later, including in some cases of repeat sexual abuse and childhood neglect. This is sometimes called 'complex PTSD'.

Acute stress disorder is sometimes termed 'psychological shock' or 'acute stress reaction'.

Feeling upset, anxious and disconnected is normal following trauma. Most people will experience at least mild ASD after a trauma - exhibiting some of the below symptoms. But if you can't seem to return to normal and your stress continues for more than four weeks or worsens, you may be suffering from PTSD.

Symptoms of ASD and PTSD include:

• Recalling the event through flashbacks, memories, or dreams that feel nerve-racking
• Physical reactions to recalling the event such as a pounding heart, sweating, feeling sick
• Memory loss around the trauma
• Attempting to avoid things that bring the trauma to life
• Inability to connect with people you were previously close to
• Shame, guilt, self-blame, depression and powerlessness
• Reduced libido and interest in social contact
• Substance misuse
• Feelings of numbness and that nothing is real or important
• Fear about the future - thinking you will never regain a normal life
• Unexplained illness or pains
• Constant distress and anxiety
• Restlessness and an inability to concentrate
• Sleep complications including an inability to get to, or stay asleep. Plus the experiencing of nightmares
• Feeling vigilant and 'on edge' and being easily startled
• Mood swings and anger

Additional symptoms in children can include:

• Re-enacting the experience through play
• Frightening dreams without identifiable content
• Fear of death and dying
• Regression including whining, thumb sucking, clinginess

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Acute stress disorder includes symptoms lasting less than a month. If your psychological stress lasts longer, the diagnosis becomes post-traumatic stress disorder.

PTSD is often a result of more extreme experiences, involving an assault or threat to life. This includes abuse, being a victim of crime, kidnappings, and environmental disasters. Those who witness difficult events but whose wellbeing is not threatened, such as witnessing an accident or finding out a loved one has a life-threatening illness, are not as likely to experience severe traumatic stress disorder.

As with PTSD, It's important to seek help for ASD, as treatment means it is less likely to develop into the more challenging to manage post-traumatic shock disorder.

Complex PTSD is the consequence of repeat trauma, such as abuse. It starts weeks or months after the difficult experience but is often not acknowledged until years later. It can involve additional symptoms to general PTSD, including the inability to trust others and 'disassociation' from others and what is going on around you as well as from your feelings. It can also involve an increased propensity to risky behaviour.

It is normal to feel troubled after experiencing or witnessing a frightening event. Acute stress disorder (ASD) is a common stress reaction that will eventually fade away after several days or weeks.

It is estimated up to a third of people suffering from a traumatic experience will develop PTSD. Figures show more women than men experience PTSD, estimated at 8-13% likely for men and 20-30% likely for women.

There is a higher chance of developing one of these anxiety disorders if you are engaged in certain vocations involving a higher level of exposure to trauma. Jobs such as those in the army, police, journalism or emergency roles are more at risk.

While it was previously reported children are less likely to develop PTSD after trauma than adults, it has been found in addition to suffering significantly from traumatic events, if a child's parents then develop PTSD, this can adversely affect a child.

Psychological and physical reasons are responsible for the ways different people react to trauma. For example, flashbacks are the brain's way of defining how best to be prepared should such an experience happen again. The adrenaline the body produces following a trauma is the body's flight-or-flight response, designed to help you defend against danger. If your trauma was severe, this reaction can remain leaving you constantly on edge.

New research around PTSD has uncovered that there are certain factors seemingly to increasing your capacity to develop the disorder following a traumatic experience, including:

● Already experiencing high levels of life stress at time of trauma

● Previous exposure to traumatic experiences as a child

● Abusive childhood

● History of mental health issues, such as depression

There is also some research to suggest certain individuals may be genetically predisposed to developing PTSD. These discoveries link a lower amount of certain proteins and peptides in the brain to increased sensitivities to fear, and a theory that those with a small hippocampus volume in the brain may be more likely to develop PTSD when trauma is experienced.

After deciding if you have experienced a traumatic event, a health care professional will look for certain criteria: signs of re-experiencing the event, avoidance, mood changes and anxiety, and differences in your sleep. If symptoms of psychological stress have been present for over four weeks, the diagnosis will result in PTSD.

For a diagnosis of ASD these symptoms should be present for a minimum of two days and a maximum of four weeks. Symptoms must occur within one month of the event.

Psychological treatment can help with PTSD, even if you only receive help long after the event. Your treatment should be personalised to your needs - depending on how severe your symptoms are and how long you have been suffering.

There is no medication to cure PTSD or ASD. In some cases anti-depressants are prescribed as part of your treatment, to manage the secondary symptoms of PTSD like depression and anxiety, to help you benefit more deeply from other psychological treatments.

Watchful Waiting: This includes monitoring symptoms to see if they naturally recover or worsen. Within four weeks of paying attention to how you are feeling you will be asked to return to your health care expert to understand how you are coping.

Psychotherapy: Talking therapies help you work through the event in an empathetic, safe environment, helping you to find coping strategies that work for you. Find a psychotherapist for PTSD here.

Cognitive Behavioural Therapy (CBT): An evidence-based type of psychotherapy, CBT assists those with ASD and PTSD, helping you focus on regaining control of your thoughts. Find a CBT therapist for PTSD here.

Family Therapy: Suffering from PTSD can impact your ability to communicate with those around you. It may even affect interest in your relationships. Family therapy can help your loved ones to support you and help you to learn better ways of relating to each other.

Eye Movement Desensitisation Reprocessing (EMDR): This involves making several sets of side-to-side eye movements while recalling the traumatic incident you encountered, with the aim of assisting your brain to focus on the flashbacks you experience as part of PTSD, enabling you to deal with the event and think in a more positive way. Find a therapist specialising in EMDR here.

Untreated PTSD can adversely affect your life. The anxiety of PTSD can make leading a regular life far more challenging. Sufferers can find it hard to hold down jobs and maintain relationships. In some cases the mood swings PTSD causes or exacerbates can end in domestic violence. Untreated PTSD can also be a precursor to substance abuse.

Other mental health conditions can develop alongside PTSD including panic disorder, bipolar disorder and depression.

If you suspect you are suffering from ASD or PTSD it is vitally important to find the help you need.

As the UK's leading booking platform for counselling and psychotherapy, we’re available here to help you book therapy online with leading counsellors and psychotherapists to help with PTSD, available at the times and costs that suit you.

At Harley Therapy, our therapists are vetted to ensure they are registered and insured to practice as a therapist in the UK.

Self-help Books

Recommended books about managing trauma include:

• Understanding Trauma: How to Overcome Post-Traumatic Stress. Dr. Roger Baker
• Overcoming Childhood Trauma: A Self Help Guide Using Cognitive Behavioural Techniques. Dr. Helen Kennerley.
• The Survivor’s Guide to Recovery from Rape and Sexual Abuse. Robert Kelly, Fay Maxted, Elizabeth Campbell.

Useful Articles

You may also be interested in our other articles on managing traumatic experiences:

● 7 Warning Signs You Are Suffering Acute Stress Reaction (Emotional Shock)

● Post Traumatic Stress Disorders due to Natural Disasters

Useful Websites

Moodjuice Self-help Workbook For PTSD

NHS Guide to PTSD

Help Guide's Pages on PTSD