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What is PTSD?
Post-traumatic stress disorder (PTSD) is a mental health condition that some people develop after they’ve experienced something distressing and difficult to cope with.
What is a traumatic event?
The distressing events that people with PTSD have experienced are called traumatic events. A traumatic event makes someone feel scared, unsafe, or stressed – for example, if what happened felt out of control or impossible to cope with. A traumatic event can be a one-off incident, a series of events, or an ongoing experience that continued over a period of time (like coping with a serious illness, for example).
There’s no set definition of events that are or are not traumatic. This is because people respond differently to similar experiences – it’s possible for two people to go through the same difficult experience but for only one of them to find it traumatic.
What types of trauma are there?
You might hear people describing ‘types’ of trauma.
Childhood trauma is related to things that happen when someone is a child or young person – for example, childhood abuse or neglect.
Collective trauma is when a traumatic event happens to a lot of people at once. Often, not everyone will experience the event as traumatic. The people who experienced the same event may have different feelings and ways of coping. An example of collective trauma might be a natural disaster or the COVID-19 pandemic.
Generational (or intergenerational, or transgenerational) trauma is when trauma is experienced across generations of a family or culture. For example, this might be because trauma that a parent has experienced affects the way they look after and raise their children, or because of the things young people hear older generations saying. Examples of generational trauma might be if someone in your family grew up in poverty or escaped war, or if your family has experienced racism.
Secondary or vicarious trauma is when someone sees something traumatic without experiencing it for themselves. For example, someone working in a hospital who sees lots of upsetting injuries or someone who works helping distribute aid in a war might experience vicarious trauma.
What types of experiences can lead to PTSD?
It’s impossible to list all of the possible experiences and events that can lead to someone experiencing PTSD. If something you’ve gone through isn’t listed here, it does not mean that it cannot cause PTSD.
PTSD can develop after you’ve:
- been physically or sexually assaulted
- experienced abuse (including when you’re a child or young person)
- experienced harassment (including racism, homophobia, or transphobia)
- experienced (or witnessed) a serious accident
- had involvement with the police or criminal justice system
- had a serious mental or physical health problem (including if you’ve spent time in hospital, had difficult treatment for a condition, or have been diagnosed with a life-changing or life-threatening condition)
- experienced trauma during giving birth
- survived a natural disaster or pandemic
- been bereaved (when someone you care about has died)
- been a refugee or asylum seeker
- experienced violence (for example, because of a terrorist attack or gang activity), including seeing other people get hurt or killed
- experienced war and conflict
Not everyone who experiences these things will develop PTSD and there are lots of other things that might cause someone to develop the condition.
After a traumatic event
Most people experience some of the symptoms of PTSD immediately after a traumatic event. This is sometimes called an acute stress reaction – the ‘acute’ means it does not last for long period of time, usually up to about a month.
If these symptoms last for longer than a month, that is when you might be given a diagnosis of PTSD, as your symptoms have lasted for longer than an ‘acute stress reaction’ would be expected to last.
In some cases, people might not have any symptoms of PTSD until weeks or months after their traumatic experience. If there’s more than six months between the traumatic experience and someone’s symptoms, they might be diagnosed with delayed-onset PTSD. This is not any less serious and it is still important that they get help and support.
What is complex PTSC (C-PTSD)?
Complex PTSD (or C-PTSD) is a mental health condition similar to PTSD but with some additional symptoms.
People are more likely to develop complex PTSD if they:
- experienced trauma at an early age
- experienced trauma that lasted for a long time
- repeatedly experienced traumatic situations
- were in a situation where it was unlikely (or impossible) for them to escape or be rescued
- have experienced more than one trauma
- were hurt or harmed by someone close to them
- Most of the information on this page applies to both PTSD and complex PTSD. Where information is different, we’ll make it clear which condition we’re talking about.
Symptoms and signs of PTSD and C-PTSD
Re-living trauma
Re-experiencing parts of the trauma you’ve experienced is a key symptom of PTSD. It’s often the symptom people are most aware of.
People might re-experience the traumatic experience through flashbacks, which make it feel like the experience is happening right there and then, in the present moment. Some people experience flashbacks as though they’re watching a video of the traumatic experience, but other people don’t see anything at all. People might experience the same sounds, smells, tastes, physical sensations (like pain or shaking), or emotions that they experienced during the trauma.
Re-living trauma can also happen through intrusive thoughts and images (repeated and distressing thoughts or mental images) and through nightmares. Children might re-enact trauma through play.
Avoiding memories and feelings about trauma
It’s common for people with PTSD to try to avoid memories of their trauma and any feelings associated with it.
This might include:
- not wanting to talk to anyone about the trauma, or anything that reminds you of it
- not being able to remember parts of the trauma
- avoiding people or places that remind you of the trauma
- spending a lot of time trying to push feelings or memories away
- trying to distract yourself (or feeling like you have to keep busy) so you never have to think about memories or feelings
- trying not to feel anything at all or feeling cut off from your emotions
Feeling on edge
You might also hear this called hyperarousal, which means you feel tense a lot of the time and struggle to relax.
You might be hypervigilant, which means you’re always looking out for signs of danger so you can try to make sure everything (and everyone) is safe and OK.
Signs you might be feeling on edge or hypervigilant include:
Experiencing physical symptoms
Some people also experience physical symptoms because of PTSD. These symptoms are often similar to the physical symptoms that people with anxiety disorders experience, as they’re caused by some of the same biological factors.
The difference is that someone with PTSD produces hormones like adrenaline when the traumatic experience has ended and they’re no longer in danger.
Watch this video to find out more about how adrenaline affects your body and causes physical symptoms:
Symptoms of complex PTSD
Someone who has complex PTSD experiences symptoms of PTSD as well as other symptoms, including feeling:
- angry at the world (or specific people or groups of people)
- empty, numb or hopeless
- worthless, ashamed or guilty
- isolated, like no one else can understand their experiences or they can’t trust the world (or anyone in it)
Someone with complex PTSD might also:
- find it difficult to control their feelings
- struggle to build (or keep) friendships or relationships, or avoid them on purpose
- have suicidal thoughts and feelings
How do you know if you have PTSD?
Specialist child and adolescent mental health services (CAMHS) diagnose people using diagnostic criteria – specific guidelines about the signs and symptoms that mean someone has PTSD, rather than any other mental health condition.
To do this, a specialist CAMHS clinician will talk to you about your symptoms – they might ask you to fill out some questionnaires that ask you about how often you experience certain symptoms too. It’s likely that they’ll ask you whether you’ve experienced something traumatic and whether you experience any of the symptoms listed above. You won’t have to talk about your trauma in detail, if you don’t want to.
How does PTSD affect someone’s life?
The symptoms of PTSD can be very distressing and can make day-to-day life very challenging.
They can make it hard to take care of yourself and focus on education or work. It can also be hard to make (and keep) friendships and relationships, especially if you find it difficult to trust people.
If you struggle to relax, it can be really hard to enjoy your free time and this can also affect your mental health.
People might also experience other mental health conditions like depression or anxiety disorders at the same time as PTSD. Many (but not all) people with PTSD also self-harm and/or experience suicidal thoughts and feelings.
What causes PTSD?
PTSD develops after someone has experienced a traumatic experience, but not everyone who experiences something traumatic will go on to develop PTSD.
There are lots of reasons that someone might be more likely to develop PTSD following a traumatic experience, including:
The nature of the trauma
Experts think someone might be more likely to develop PTSD if they’ve experienced interpersonal trauma (such as assault) rather than an accident, of if there was a greater sense of threat involved.
Finding it difficult to get support
If you don’t get the support you need from friends, family, and professionals, this can mean you’re more likely to develop PTSD. This can also be the case if the support available doesn’t understand you or meet your needs – for example, if you’re a refugee, have been in foster care, or are LGBTQ+.
Experiencing anxiety and depression
Someone might be more likely to develop PTSD after a traumatic experience if they’ve previously had depression or an anxiety disorder.
Additional stress
If you’re experiencing extra stress at the same time as dealing with trauma, you might be more likely to develop PTSD. This extra stress could be anything, from worrying about work or money to experiencing discrimination or coping with someone important to you dying.
Genetics
Research suggests that people who have a family member with a mental health condition might be more likely to develop PTSD if they experience something traumatic. This might be because of the genes you inherit from your biological parents, but the science is complex, and we don’t yet know exactly how genes are involved.
Treatment if you have PTSD
Treatment for PTSD usually involves talking therapies such as cognitive behavioural therapy (CBT) and eye movement desensitisation and reprocessing (EMDR).
It’s less common for people to be given medication for PTSD. If you’re under 18 you will not usually be offered medication, while adults can be given medication to help with their symptoms in some circumstances.
People of all ages might be prescribed medication if they have another mental health condition (like depression or bipolar disorder) as well as PTSD.
People with complex PTSD often need more long-term support to recover, and they’re more likely to need support for other things (like depression or alcohol or drug use) at the same time.
It’s never too late to get help for PTSD or complex PTSD, even if it has been years since your traumatic experience or experiences.
Looking after yourself if you have PTSD
Living with PTSD can be really challenging. There are things you can try to help you cope when things are difficult.
Alongside getting treatment for PTSD, people find different things helpful for managing everyday life.
Know your triggers
Some people find that certain places or experiences (including smelling or hearing something, for example) can cause symptoms of PTSD, or that it’s more difficult to manage on specific dates. It might not be possible to entirely avoid your triggers, but knowing what they are can help you feel prepared to cope.
Talk to someone you trust
It can make a big difference for a trusted adult to understand how you’re feeling. You don’t need to tell them about your traumatic experience in detail for them to be able to support you with how symptoms of PTSD affect you now. They can also help you to access treatment.
Try to do things you usually enjoy
It can feel difficult to carry on with things when you’re experiencing PTSD, but spending even a short amount of time trying to engage with a hobby or chat to a friend or family member can be really helpful for coping with symptoms.
Take care of yourself and your body
PTSD can make it challenging to take care of yourself, but prioritising healthy sleep, eating enough, and personal hygiene can make a positive difference. If you’re finding it difficult, check out our tips for when you’re struggling with self-care.
Make a self-soothe box
Self-soothe boxes are filled with items that can help you cope when things feel overwhelming. What you put in a self-soothe box is up to you, but people often choose items that help them engage with their senses.
How do I cope with flashbacks?
Flashbacks can be really scary and upsetting. It can be helpful to think about how you can cope in advance, so you’re more prepared if and when they happen. Having someone to support you during a flashback can also make a big difference. Some people agree a signal with a parent, carer, or partner that they can use if they’re experiencing (or recovering from) a flashback, like messaging them a specific emoji, for example.
Lots of people find it helpful to try to recognise and name that they are having a flashback. This could mean that you say ‘I am having a flashback’ out loud, for example. Alongside this, try to tell yourself that you are safe and the trauma is not currently happening – it is over. This is not always easy, so some people find it helpful to write down some prompts (or even a script) that they can use to help them during a flashback.
It can also be helpful to use breathing and grounding techniques. If a flashback makes you feel scared, you might find your breathing speeds up or gets shallow – this can make you feel more panicked, so breathing exercises can help your body return to a state of calm. Grounding exercises can also help remind you that you are safe and in the present.
Some people use comforting objects to help ground or comfort them and remind them that they’re safe in the present. It can be helpful to have an object you can take out with you, like a keyring.
It can be helpful to plan some other ways you can comfort yourself, too. Some people listen to music or watch a familiar TV show or film, while others like the physical comfort of wrapping themselves in a blanket or being under a weighted blanket. Cuddling a soft toy or pet can also be comforting.
Getting more help for PTSD
Emergency?
If anyone is in immediate danger, call 999 now.
If you need urgent help for mental or physical health, call NHS 111 or get help from NHS 111 online.
If you think you may have PTSD (or have a diagnosis but are struggling to manage), the first step is to speak to an adult you trust. This might be a parent or carer, teacher, youth worker, or GP. Find out more about getting help from an NHS GP in England.
Together, you can make a plan so that you get the support you need to cope.
If you’re not sure where to start or want to practise talking about PTSD before you have a conversation with an adult in your life, you might find it helpful to contact NATTER.
Text NATTER for help
Anyone can text ‘NATTER’ to 85258 to seek
help, wherever they are in the UK. It’s a free, anonymous service and available 24/7.
More about NATTER
How to help someone else with PTSD
If someone you care about has PTSD, it can be difficult to know how to support them. You might be able to offer support in different ways, depending on your own life and your relationship with them.
Learn about PTSD
If you learn more about PTSD, people with the condition don’t have to spend as much time raising awareness. It also means you can better understand what’s going on for them, which can be really helpful if they do something you find difficult.
Listen to what they tell you
Everyone has their own experience of PTSD, so it’s important to listen to people if they want to tell you what it’s like for them. It’s OK to ask how you can help, too – especially if you can plan ahead and ask when the person is feeling safer and grounded.
Don’t judge them
It’s OK if you don’t understand why someone has developed PTSD, but it’s important to remember it is not their fault. It is not helpful to try to minimise their trauma (for example, by saying it could have been worse) or to compare them to other people who haven’t developed PTSD after trauma.
Be aware of their triggers
You can’t protect someone from every trigger, and it is not your responsibility to try – but if someone tells you about their triggers, you can try to plan to spend time together in places that are less likely to be triggering, or make a plan for what you’ll do if they experience a trigger while out and about.
Know what to do during a flashback
It can be upsetting or scary to watch someone have a flashback, so it’s helpful to talk in advance about what you can do to help. It can be as simple as staying calm and gently reminding someone that they’re safe in the present and experiencing a flashback. You could also help them to try breathing or grounding exercises, if they find those helpful.
Be patient
People with PTSD might find it more difficult to trust people and open up, or they might not like being touched or hugged without permission. Respect their choices and boundaries and remember that it’s because they have experienced something really difficult – it isn’t about you, or your friendship or relationship.
Supporting other people
Find more information about supporting others, including how to ask someone if they’re OK, how to listen, and understanding boundaries and responsibility.
There’s also support if you’re a young carer, and tips for looking after yourself while supporting someone else.
