Trauma-Related Stress and PTSD: Understanding and Getting Help

If you need help now

If you are in immediate danger, call 911 (in the US). If you or someone you know is struggling or having thoughts of suicide, call or text the 988 Suicide & Crisis Lifeline at 988, or chat at 988lifeline.org; it is free, confidential and open 24 hours a day. [1][2] Outside the US, use your local emergency number or look up your country's crisis line. This page is educational and does not replace trauma-informed professional care.

Reactions after trauma

After a traumatic event such as a natural disaster, act of violence or serious accident, common reactions include feeling anxious, sad or angry, trouble concentrating and sleeping, and thinking about what happened. Most people recover, and reactions lessen over time. [1] The U.S. Department of Veterans Affairs' National Center for PTSD says it is normal to have upsetting memories, feel on edge or have trouble sleeping after trauma, and most people start to feel better after a few weeks. [3]

What PTSD is

Post-traumatic stress disorder (PTSD) may be diagnosed if symptoms last for an extended period after the event and interfere with daily life, such as relationships or work. People with PTSD may continue to feel stressed or frightened even though they are not in danger. [1] The National Center for PTSD says symptoms lasting longer than a month and causing problems in your life could be PTSD. [3]

Most people who live through a dangerous event do not develop PTSD; many factors play a part. [1] Previous adversity, especially in childhood, can raise the chance. [1] After the event, stress can make PTSD more likely, while social support can make it less likely. [3]

The NHS describes the main symptom as repeated distressing thoughts about the event, as flashbacks, intrusive images or nightmares. Other features can include avoiding reminders, negative thoughts about yourself, feeling disconnected, irritability, trouble sleeping and feeling on guard. Symptoms can start straight after the event or many months or years later. [4] A list like this cannot diagnose PTSD; a mental health professional does that. [4]

Established care

Established recommendation: PTSD treatment works, and there are several options. [5]

• Trauma-focused talk therapy has the most research support. The therapies named by the National Center for PTSD are Cognitive Processing Therapy, Eye Movement Desensitization and Reprocessing (EMDR) and Prolonged Exposure, usually lasting about 8 to 16 sessions. [5] The NHS lists trauma-focused CBT and EMDR. [4]
• Medicines: the options with the most evidence are paroxetine, sertraline and venlafaxine. Benefits take time and end after you stop taking them. [5] Do not stop a PTSD medicine unless a doctor tells you to, even if you feel better. [4]
• Other approaches such as complementary practices may be used along with conventional treatments. [5]

NCCIH adds a caution about relaxation: a 2018 review found relaxation therapy seemed less effective than CBT for PTSD. [6] Rare reports also suggest that certain relaxation techniques can worsen symptoms in people with a history of abuse or trauma. [7] If you have trauma history and a practice such as meditation or relaxation feels distressing, stop and discuss it with a professional.

Things that may help alongside care

The NHS suggests talking to someone, keeping a diary of what triggers flashbacks, trying breathing exercises, staying active, eating a balanced diet and getting enough sleep, and avoiding recreational drugs, smoking and heavy drinking. [4] PTSD is also often accompanied by depression, substance use or anxiety disorders. [1]