Post traumatic stress disorder (PTSD)

What is PTSD?

Post traumatic stress disorder (PTSD) is a psychiatric disorder that you may suffer if you experience or witness a life-threatening or traumatic event.

What causes PTSD?

For men, the traumatic events most often associated with PTSD are rape, events of war, childhood neglect and childhood physical abuse. For women, it is rape, sexual assault, physical attack, being threatened with a weapon and childhood physical abuse.

Natural disasters, terrorist attacks, serious accidents, or even being told you have cancer, can also cause PTSD.

Who gets PTSD?

The symptoms of PTSD have been recorded throughout history, most notably in the 20th century by people who have been involved in war.

However, because its causes are widespread, anyone can suffer PTSD, whatever their age, sex or race. In America, for example, about 3.6% of adults aged 18 to 54 (5.2 million people) suffer the illness during any given year. Women are twice as likely as men to suffer PTSD.

What are the symptoms of PTSD?

There are both psychological and physical symptoms. These usually develop within three months of the traumatic event, although they can appear up to a year later. They include:

reliving the experience through nightmares and flashbacks;
a numbness and loss of deep feelings;
difficulty concentrating;
suffering painful emotions such as guilt, anger and anxiety;
avoiding dealing with grief, anger and anxiety;
avoiding activities that could trigger memories of the event;
depression;
drug and alcohol abuse;
headaches, dizziness and chest pains;
irritability and difficulty sleeping.

If left untreated, these symptoms can be severe and long lasting, affecting your family, social and work life.

How does PTSD develop?

Most people exposed to a traumatic event experience some of the symptoms of PTSD in the following days and weeks. About 8% of men and 20% of women go on to develop PTSD, with 30% of these people developing a chronic form that continues throughout their lives. Chronic PTSD involves cycles of symptoms, although some people experience continuous and severe symptoms.

How is PTSD diagnosed?

To assess if you have got PTSD, you may undergo structured interviews and psychological assessments, and the symptoms of PTSD must last for at least a month.

Does PTSD cause other psychiatric disorders?

A large-scale study has shown that 88% of men and 79% of women suffered from a psychiatric disorder as a side effect of PTSD.

Most common for men was alcohol abuse or dependency (51.9%), depression (47.9%), behavioural problems (43.3%), and drug abuse and dependency (34.5%). Most common among women were depression (48.5%), simple phobias (29%), social phobias (28.4%), and alcohol abuse or dependency (27.9%).

How is PTSD treated?

To make sure you respond to the PTSD treatment, the first step is to treat any associated illnesses, such as drug dependency or depression. You will then be ready to receive a course of psychological therapy and possibly medication.

What types of therapy are used to treat PTSD?

Cognitive behaviour therapy (CBT)
CBT helps you understand your thought processes and how to change your feelings and reactions to your symptoms.

Exposure therapy is one form of CBT that is unique to treating trauma. It involves you imagining the trauma in a safe, controlled environment to help you face up to your fears, and allow us to examine your reactions to the event. It will help you overcome your anger, shame or guilt, and deal with the post-traumatic memories, reminders, reactions, and feelings without becoming overwhelmed or emotionally numb.

CBT is also used to:

manage anger;
prepare for stress reactions;
handle symptoms of future trauma;
learn skills for coping with anxiety;
deal with urges to use alcohol or drugs when you experience symptoms of trauma; and
relearn social skills.

Eye movement desensitisation and reprocessing (EMDR)
EMDR combines elements of exposure therapy and CBT with eye-movement techniques. While concentrating on your traumatic experience, special rapid eye movements will help you through the healing process and improve your confidence.

Group treatment
By discussing your emotions and trauma with a group of other PTSD sufferers, you will achieve greater understanding of your condition and emotions. It will help you become more confident and trusting, and to focus on the present rather than the past.

Brief psychodynamic psychotherapy
This focuses on the emotional conflicts caused by the traumatic event, particularly experiences when you were young. By working with a calm and unbiased therapist, you will achieve a greater sense of self-esteem and develop effective ways of thinking and coping with intense emotions.

What medication might I be given?

You may be prescribed medication to reduce the anxiety, depression and insomnia often experienced with PTSD. In some cases, it may help relieve the distress and emotional numbness caused by traumatic memories, and help you take part in psychotherapy. Several kinds of antidepressant drugs are used.

Self help

Finding help

If you feel that you or a close relative are affected by PTSD and would like help more information, you can speak to your GP or contact any of the following organisations:

NHS Direct (England and Wales)
0845 4647 (www.nhsdirect.nhs.uk)

NHS 24 (Scotland)
08454 242424 (www.nhs24.com)

The Samaritans
08457 909090 (www.samaritans.co.uk)

Priory
0845 2 774 679 (www.priorygroup.com)

If you are interested in receiving treatment from us, your GP will be able to refer you.

If you or your relative have private medical insurance, your insurer will probably insist that your GP refers you to us.

To view a list of the Priory hospitals that can help with post traumatic stress disorder (PTSD) please click here.

Why should I choose Priory?

Our service

At Priory, our committed and professional staff provide the highest standards of care, understanding and service for everyone. This service brings hope and confidence, allowing our patients to take control of their lives within a safe and secure environment.

Expertise and innovation

As Europe's leading independent provider of specialist mental health, neuro-rehabilitation and special education services, we bring experience and an excellent reputation. Through our close links with the public and private sectors, we've developed the expertise and innovation to offer consistent and successful treatment.

We admit patients 24 hours a day, seven days a week.

This document has been edited by Dr Austin Tate MB ChB FRCPsych DPM, with the help of Plain English Campaign (www.plainenglish.co.uk)

For more information please click here to download our self-help leaflet.