Treatment - Post-traumatic stress disorder (PTSD)

The main treatments for post-traumatic stress disorder (PTSD) are:

• psychological therapies
• medicine

Traumatic events can be very difficult to come to terms with. But the way to treat PTSD is to seek professional help and confront your feelings.

It is possible to treat PTSD many years after the traumatic event happened. This means it is never too late to seek help.

Assessment

Your GP will often do an assessment. They may refer you to a mental health specialist for assessment and treatment if they feel it will help.

The mental health specialist may be:

• a psychologist
• a community mental health nurse
• a psychiatrist

Watchful waiting

You may have symptoms of PTSD for less than 4 weeks. If so, your mental health specialist or GP may recommend 'watchful waiting'.

Watchful waiting is when you monitor your symptoms to see if they improve or get worse. 2 in 3 people improve in a few weeks without treatment.

You usually have a follow-up appointment within 1 month.

Psychological therapies

If you have PTSD, your mental health specialist will usually recommend psychological therapies.

If you have severe PTSD or it does not go away they may recommend psychological therapy and medicine. Your GP can refer you to a community mental health team for this.

There are 3 main types of psychological therapies used to treat people with PTSD:

Cognitive behavioural therapy (CBT)

Cognitive behavioural therapy (CBT) helps you manage difficulties by thinking in a more balanced way. It can free you from unhelpful patterns of behaviour.

Trauma-focused CBT uses psychological techniques to help you come to terms with what happened.

Your therapist can help you gain control of your fear and distress. They can do this by changing the negative way you think about your experience. For example, feeling you're to blame for what happened or fear that it may happen again.

They may ask you to think about your experience in detail. They will help you cope with any distress you feel while you are doing this.

They will help you identify any unhelpful thoughts you have about the experience.

They may also encourage you to begin doing any activities you've avoided since your experience.

Cognitive behavioural therapy (CBT)

Eye movement desensitisation and reprocessing

Eye movement desensitisation and reprocessing (EMDR) can help to reduce the symptoms of PTSD.

EMDR involves making side-to-side eye movements. You follow the movement of your therapist's finger, while recalling the traumatic incident. Other methods may include the therapist tapping their finger or playing a tone in your ears.

EMDR can help you to change the negative way you think about a traumatic experience.

Group therapy

Some people find it helpful to speak about their experiences with other people who have PTSD. Group therapy can help you find ways to manage your symptoms and understand PTSD.

Talking therapies

Medicine

Antidepressants are sometimes used to treat PTSD in adults.

They will only be used if:

• you choose not to have trauma-focused psychological treatment
• there's an ongoing threat of further trauma (such as domestic violence)
• previous trauma-focused psychological treatment did not work as well as you'd hoped
• you have another mental health difficulty such as depression that makes psychological treatment less effective

If medicine works for your PTSD you usually take it for at least 12 months. If your doctor decides to stop your medicine, they'll reduce the dose over 4 weeks or longer.

If a medicine does not work well at reducing your symptoms, your doctor may increase the dose.

Before prescribing a medicine, your doctor will tell you about any possible side effects. They will also tell you about any possible withdrawal symptoms you might have when you stop taking it.

Withdrawal symptoms are less likely if the medicine is reduced slowly.

Antidepressants

Children and young people

Trauma-focused CBT is usually the recommended treatment for children and young people with PTSD.

A child or young person usually has a number of 1-to-1 sessions with a therapist.

The sessions are adapted to suit the child's age, circumstances and level of development. Sometimes the child's family can be involved in the treatment.