After a traumatic event, an intense reaction is normal. When symptoms persist and limit life, it may be post-traumatic stress disorder, which is treatable.
An accident, an assault, a war situation, the sudden loss of someone or the experience of seeing one’s own life at risk can leave marks that do not go away on their own.
What it is
Post-traumatic stress disorder can develop after exposure to a threatening or horrific event, experienced directly or witnessed. In the first weeks, many people have intense symptoms that gradually improve. It is called a disorder when symptoms persist, cause significant distress and interfere with daily life.
Emergency workers, security forces, military personnel and healthcare professionals are particularly exposed.
Re-experiencing
Avoidance
Changes in mood and thinking
Hyperarousal
The four groups of symptoms of post-traumatic stress.
Symptoms
re-experiencing: intrusive memories, nightmares or the feeling of reliving the event;
avoidance of places, people, conversations or thoughts linked to the trauma;
changes in mood and thinking: guilt, shame, detachment from others, loss of interest;
hyperarousal: being permanently on alert, startling easily, irritability, difficulty sleeping and concentrating.
When to seek help
When symptoms are still present after a few weeks, get worse, lead to avoiding important situations or to using alcohol or other substances to relieve them. Thoughts of suicide require urgent assessment.
Assessment
The assessment seeks to understand the event, the symptoms and their impact, at the person’s pace and without forcing the account. It also looks for frequently associated conditions such as depression, insomnia, panic attacks or substance use.
Treatment
trauma-focused psychotherapy, such as trauma-focused cognitive behavioural therapy or EMDR, is the first-line treatment;
medication: some antidepressants can help, especially when depression is also present or when psychotherapy is unavailable or not enough;
treating sleep and substance use is part of the plan.
Yes. In the first weeks, many people have intrusive memories, nightmares or anxiety. For most, these symptoms ease over time. When they persist or get worse, an assessment is warranted.
Do I have to tell everything that happened at the first consultation?
No. The assessment respects each person’s pace. What matters at the start is understanding the impact of the symptoms and creating a sense of safety.
Can PTSD appear years later?
Yes. In some people symptoms appear or worsen long after the event, sometimes triggered by new stressful situations.
References
National Institute for Health and Care Excellence. Post-traumatic stress disorder (NG116). 2018.
Bisson JI, et al. Post-traumatic stress disorder. BMJ. 2015;351:h6161.
This page is for information only and does not replace an individual medical assessment. Clinical review: Pedro Zuzarte, psychiatrist · Published and reviewed: .