Trauma and Post-traumatic Stress Disorder (PTSD)

Trauma and Post-traumatic Stress Disorder (PTSD) work map in a brain shape

What is PTSD?

Post-traumatic stress disorder (PTSD) is a mental health condition arising when a person is overwhelmed by trauma. Sometimes a single event, such as a car accident, can lead to PTSD. Other times it can be a series of events; repeated abuse, for example.

It’s not just events that happened to you that can lead to PTSD. Sometimes it’s triggered by events you witnessed, or even “near misses”, where you genuinely believed something was going to happen; even if it didn’t. Some people develop PTSD through indirect exposure, such as viewing distressing images as part of your work.

What are the symptoms of PTSD?

It is very normal for us to have extreme reactions to traumatic events, and the effect can last a few weeks. However, if you are still experiencing difficulties after a month or so, you might be suffering from post-traumatic stress. Sometimes symptoms don’t appear at the time but can emerge much later, even years later.

The symptoms of PTSD can affect every aspect of your life: social functioning, relationships, work and even daily living. They can also be quite frightening, especially if you don’t know what’s causing them.

The symptoms of PTSD are grouped into four categories: intrusive thoughts, avoidances, changes in mood and thinking, and changes in physical and emotional responses. Not all people experience the same symptoms, and the symptoms you do experience might change over time.

Intrusive thoughts, sensations or images

Intrusive thoughts include:

  • unwanted distressing memories of what happened
  • reliving the trauma, or some aspect of it, as though it was happening again
  • upsetting dreams or nightmares about what happened
  • experiencing emotional distress or a physical reaction to something that reminds you of the trauma

Not all intrusions come in the form of thoughts. They can come as sounds, images, smells and bodily sensations too.


You might find that you avoid:

  • thinking or talking about what happened
  • seeing people or going to places that remind you of the trauma
  • activities that you used to enjoy that are now tainted by what happened

Changes in thinking and mood

Trauma can lead to all kinds of changes in how we think and feel. These include:

  • persistent, negative beliefs about yourself, other people or the world
  • unreasonably blaming yourself or others for what happened
  • memory problems and difficulty putting things in chronological order
  • trouble remembering important parts of what happened
  • feeling detached from others or the world around you
  • persistent feelings of anger, shame, or guilt about what happened
  • difficulty forming or maintaining close relationships
  • loss of interest in things you used to enjoy
  • finding yourself unable to experience positive emotions or emotionally numb

Changes in physical and emotional responses

Post-traumatic stress change in our emotional reactions (arousal symptoms) in all kinds of ways, including:

  • being irritable or angry, with little or no provocation
  • behaving recklessly or in self-destructive ways
  • being startled very easily
  • looking out for dangers all the time
  • having problems concentrating
  • sleep difficulties, restlessness

How is PTSD treated?

In the first month

The NHS recommends “watchful waiting” for the first month following a traumatic event. Our mind and body need time to process and adjust to what happened, even though that process can seem arduous. However, if you are feeling suicidal or thinking of harming yourself or anyone else, you must get help right away. You can contact your GP or present at any A&E. You can also call the Samaritans on 116 123. Sometimes just having someone to talk to can be a substantial help.

If symptoms persist

If your symptoms are still happening a month after the trauma, you might be suffering from post-traumatic stress and could benefit from treatment. Several therapies have proven to be effective in treating PTSD. These include trauma focussed CBT (TFCBT), eye movement desensitisation and reprocessing (EMDR) and emotional freedom techniques (EFT). The NHS does not recommend medication as drugs an ineffective treatment for PTSD.

When to seek help

If you are still experiencing symptoms such as those listed above a month after the trauma, you might benefit from seeing a counsellor.

Frequently asked questions

My trauma happened years ago. Can it still be affecting me?

Yes. It doesn’t matter how long ago the trauma happened; it can still cause symptoms of post-traumatic stress. Often, early trauma can lay dormant until something small brings it to the surface.

Do I have to talk about what happened?

Not necessarily. Some therapies, such as TFCBT, require you to talk in depth about the trauma. Others such as EFT can take a less direct approach, for example, using metaphor. Whatever form of therapy you choose, your counsellor would work with you to ensure that you proceed at a safe pace and do not get overwhelmed.

What can I do to help myself?

While self-help is great for some things, PTSD probably isn’t one of them. While there are things such as mindfulness, loving-kindness meditation and EFT which you can practice at home, none are without risks. However, if you want to try self-help, Cumbria, Northumberland, Tyne and Wear NHS Trust has produced some excellent self-help guides.

How long does it take to recover?

If you are experiencing post-traumatic stress because of a single, recent incident 8–12 sessions of counselling could be sufficient. However, everyone is different. If you have a history of trauma or abuse, you might require much longer therapy.

What is the next step?

If you are experiencing symptoms of post-traumatic stress and would like to talk with someone, please complete our online referral form, call us on 0151 329 3637 or email Or, if you prefer, you can ask your GP to refer you for counselling on the NHS.

Further reading

NICE (2018) NICE guideline [NG116]: Post-traumatic stress disorder.
APA (2013) Diagnostic and Statistical Manual of Mental Disorders, 5th Edition: DSM-5.
NCBI (2020) DSM-5 Diagnostic Criteria for PTSD.
CNTW NHS Trust (2020) Self-help Guides.