PTSD (Post-Traumatic Stress Disorder): Symptoms, Causes and Evidence-Based Treatment
PTSD (post-traumatic stress disorder) is a mental health condition that can develop after a very stressful, frightening or distressing event. It often brings flashbacks, nightmares and a sense of being constantly on guard. Effective PTSD treatment is available, and it can help even when symptoms begin years after the event.
What is PTSD?
Feeling shaken, upset or on edge after something traumatic is a normal response, and most people find these reactions ease over a few weeks. PTSD is when they don't. The memories keep intruding, and the effects are strong and lasting enough to disrupt daily life.
Strong reactions in the first month are sometimes described as acute stress disorder. It’s worth reaching out to a professional if you're still struggling around four weeks after the event, or sooner if your symptoms are particularly troubling.
PTSD is estimated to affect about 1 in 3 people who have a traumatic experience, and it isn't clear why some people develop it and others don't. Across all adults in England, around 1 in 20 screened positive for PTSD in the most recent national survey (Adult Psychiatric Morbidity Survey, 2023/4).
People who go through repeated trauma, such as ongoing abuse, neglect or violence, may be diagnosed with complex PTSD. Its symptoms are largely the same, but it has different causes and may not develop until years later.
The main symptom of PTSD is reliving the event through distressing thoughts and images you can't switch off. Symptoms can start straight away, or many months or even years later.
Signs and symptoms of PTSD
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flashbacks
vivid or intrusive images and thoughts
recurring dreams or nightmares
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avoiding people or places that bring it back
not being able to fully remember what happened
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negative thoughts or beliefs about yourself
losing interest in things you used to enjoy
low mood, or feeling more irritable or angry than usual
finding your emotions hard to control, or feeling numb
feeling disconnected from yourself and the world around you
communicating less and finding relationships harder
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feeling very anxious and constantly looking out for danger
difficulty sleeping
repeated headaches, stomach problems or pain with no physical cause
Not everyone has all of these. If low mood has become a large part of your experience, our guide to depression may also help.
What causes PTSD?
Any situation that a person finds traumatic can cause PTSD. Some of the most common routes are below.
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PTSD can follow a serious or life-threatening accident, such as a road traffic collision, or a physical or sexual assault.
Some jobs bring repeated exposure to traumatic events, including police officers, paramedics and healthcare workers, for whom critical incidents can be part of the role. Serious health problems, such as a stay in intensive care, can also lead to PTSD.
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You don't have to be harmed yourself to develop PTSD. It can also follow seeing something traumatic happen to someone else, or hearing that it happened to someone you're close to.
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A difficult birth, or the death of a baby, can cause PTSD too. Our perinatal mental health support is designed for this stage of life.
How is PTSD diagnosed?
If you see a GP about possible PTSD, they'll ask about your symptoms and can refer you to a mental health specialist, such as a talking therapies service or a psychiatrist. The specialist will ask about your mood, behaviour, health and family history.
You can also arrange an assessment directly with a Clinical Psychologist at Regal, with no long waiting lists.
There isn't a single test that confirms PTSD. Clinicians use structured questions and validated questionnaires to assess your symptoms. NICE also advises asking directly about traumatic events, which may have happened many months or years before.
PTSD treatment: what NICE recommends
NICE guideline NG116, Post-traumatic stress disorder, sets out how PTSD should be treated in England. Psychological therapies with a trauma focus are the recommended first approach. NICE reviewed the guideline in 2025 and again in 2026 and found no reason to change it.
Trauma-focused CBT
For PTSD lasting more than a month, NICE recommends offering individual trauma-focused CBT. This includes cognitive processing therapy, cognitive therapy for PTSD, narrative exposure therapy and prolonged exposure therapy, which all involve working through and processing the memories of what happened. NICE says courses typically run for 8 to 12 sessions, or more if you've experienced several traumas.
EMDR
Eye movement desensitisation and reprocessing (EMDR) uses guided eye movements to help you process traumatic memories. NICE recommends offering EMDR when PTSD follows non-combat-related trauma and has lasted more than three months, and it can be considered from one month if you prefer it. In studies comparing EMDR directly with trauma-focused CBT, NICE found no significant difference between them.
Other options
If you prefer, NICE says supported computerised trauma-focused CBT can be considered for PTSD lasting more than three months. For people who can't or don't want to engage with trauma-focused therapy, CBT targeted at specific symptoms such as poor sleep or anger is an option.
Medication can also be considered if you prefer it, prescribed by a GP or psychiatrist rather than a psychologist and reviewed regularly.
| Treatment | What it involves | When NICE recommends it |
|---|---|---|
| Trauma-focused CBT | A structured therapy that works through the memories of what happened | First month for acute stress disorder; offered for PTSD lasting over a month; typically 8 to 12 sessions |
| EMDR | Guided eye movements while processing traumatic memories | Offered after 3 months for non-combat trauma; considered from 1 month if preferred |
| Supported computerised trauma-focused CBT | Online trauma-focused CBT with practitioner support | Considered after 3 months if preferred to face-to-face therapy |
| Symptom-targeted CBT | CBT focused on a specific problem, such as sleep or anger | Considered after 3 months if trauma-focused therapy isn't possible |
| Medication | Venlafaxine or an SSRI such as sertraline, prescribed by a GP or psychiatrist | Considered if you prefer medication |
Therapy for PTSD at Regal Private Therapy Practice
We support adults with PTSD through our adult therapy service, offering the approaches recommended in NICE guidance, including EMDR and trauma-focused CBT. You can meet our team of Clinical Psychologists and therapists.
Your first appointment is a 50 to 60 minute assessment, in person in London or online across the UK, where you'll agree a personalised treatment plan together. For children and teenagers, our child and adolescent therapy service can help.
Get in touch with our team to talk through what's been happening.
If you need urgent support
If you are struggling to cope or worried about your safety, help is available now. Call 111 and select the mental health option, or contact your GP. Samaritans are available 24 hours a day on 116 123. In an emergency, call 999 or go to your nearest A&E.
If you are eating very little, or a child is, speak to a GP. This can affect physical health and should be looked at properly.
Frequently asked questions about PTSD
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Yes. The NHS states that PTSD can develop after seeing a traumatic event happen to someone else, or even hearing that it happened to someone you're close to. You don't need to have been hurt yourself. If what you saw is still affecting you around four weeks later, it's worth speaking to your GP or a Clinical Psychologist.
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It varies. Most people's reactions to a trauma ease over a few weeks, but for some, symptoms are more severe and last longer, sometimes for years. PTSD can still be treated successfully when it develops many years after the event, and NICE-recommended trauma-focused CBT typically runs for 8 to 12 sessions.
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Yes. A serious or life-threatening accident, including a road traffic collision, is a recognised cause of PTSD. You might notice flashbacks, avoid situations that remind you of the accident, or feel constantly on edge. NICE recommends trauma-focused CBT and EMDR for PTSD, including after accidents.
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There isn't a single test that confirms PTSD. A GP or mental health specialist asks about your symptoms and experiences, often using validated questionnaires to gauge how severe they are. An online quiz can't diagnose PTSD, but if one prompts you to seek help, a professional assessment is the right next step.
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References
National Institute for Health and Care Excellence (2018, reviewed 2025). Post-traumatic stress disorder (NG116)
NHS England (2025). Adult Psychiatric Morbidity Survey 2023/4, Chapter 3: Posttraumatic stress disorder