Post-traumatic stress disorder (PTSD) - Treatment
The main treatments for post-traumatic stress disorder (PTSD) are psychological therapies and medication.
Traumatic events can be very difficult to come to terms with. But confronting your feelings and seeking professional help is the recommended way of treating PTSD.
It's possible to treat PTSD many years after the traumatic event occurred. This means it's never too late to seek help.
An assessment of your symptoms will be carried out to ensure treatment is tailored to your needs.
Your GP will often carry out an initial assessment. They'll refer you to a mental health specialist for further assessment and treatment if your symptoms are severe.
There are a number of mental health specialists you may see if you have PTSD. These could be a psychologist, a community psychiatric nurse or a psychiatrist.
If you have mild symptoms of PTSD or you've had symptoms for less than 4 weeks, an approach called watchful waiting may be recommended.
Watchful waiting involves monitoring your symptoms to see if they improve or get worse. 2 in every 3 people who develop problems after a traumatic experience improve within a few weeks without treatment.
If watchful waiting is recommended, you should have a follow-up appointment within 1 month.
If you have PTSD that requires treatment, psychological therapies are usually recommended first. A combination of a psychological therapy and medication may be recommended if you have severe or persistent PTSD.
Your GP can refer you to a community mental health team. Or you can refer yourself to primary care psychology.
There are 3 main types of psychological therapies used to treat people with PTSD:
Cognitive behavioural therapy
Cognitive behavioural therapy (CBT) helps you manage problems by thinking more positively. It frees you from unhelpful patterns of behaviour.
Trauma-focused CBT uses a range of psychological techniques to help you come to terms with the traumatic event.
For example, your therapist may ask you to confront your traumatic memories by thinking about your experience in detail. During this process your therapist helps you cope with any distress you feel. They will identify any unhelpful thoughts you have about the experience.
Your therapist can help you gain control of your fear and distress 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.
You may also be encouraged to gradually restart any activities you've avoided since your experience.
Eye movement desensitisation and reprocessing
Eye movement desensitisation and reprocessing (EMDR) is a relatively new treatment. Where it is available it can help to reduce the symptoms of PTSD.
It 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.
It's not clear exactly how EMDR works. It may help you to change the negative way you think about a traumatic experience.
Some people find it helpful to speak about their experiences with other people who also have PTSD. Group therapy can help you find ways to manage your symptoms and help you understand the condition.
Antidepressants are sometimes used to treat PTSD in adults.
They will only be used if:
- you choose not to have trauma-focused psychological treatment
- psychological treatment wouldn't be effective because there's an ongoing threat of further trauma
- you've gained little or no benefit from a course of trauma-focused psychological treatment
- you have an underlying medical condition, such as severe depression. This could affect your ability to benefit from psychological treatment
If medication for PTSD is effective, it will usually be continued for a minimum of 12 months. It may then be withdrawn over the course of 4 weeks or longer. If a medication isn't effective at reducing your symptoms, your dosage may be increased.
Before prescribing a medication, your doctor will let you know about possible side effects you may have while taking it. They will also let you know about any possible withdrawal symptoms when the medication is withdrawn.
Withdrawal symptoms are less likely if the medication is reduced slowly.
Children and young people
For children and young people with PTSD, trauma-focused CBT is usually recommended.
This normally involves individual sessions that will be adapted to suit the child's age, circumstances and level of development. Where appropriate, treatment includes consulting with and involving the child's family.
Treatment with medication isn't usually recommended for children and young people with PTSD.