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 confronting your feelings and seeking professional help is the recommended way of treating PTSD.

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

Assessment

Your GP will often carry out an initial assessment. They'll refer you to a mental health professional for further assessment and treatment.

There are a number of mental health specialists you may see if you have PTSD. These could be a psychologist, a community mental health nurse or a psychiatrist.

Watchful waiting

You may have symptoms of PTSD for less than 4 weeks. If so, you may be recommended 'watchful waiting'.

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.

Psychological therapies

If you have PTSD that requires treatment, psychological therapies are usually recommended first. A combination of a psychological therapy and medicine 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 (CBT)

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

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

For example, your therapist may ask you to engage with 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. 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.

You may also be encouraged to gradually restart any activities you've avoided since your experience.

Find out more about cognitive behavioural therapy (CBT)

Eye movement desensitisation and reprocessing

Eye movement desensitisation and reprocessing (EMDR) is a relatively new treatment. 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.

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 also have PTSD. Group therapy can help you find ways to manage your symptoms and understand the condition.

Find out more about talking therapies

Medicine

Antidepressants are sometimes used to treat PTSD in adults.

They will only be used if:

• you find the idea of having a trauma-focused psychological intervention too overwhelming
• there's a possibility the effectiveness of psychological treatment might be limited because there's an ongoing threat of further trauma
• a previous course of trauma-focused psychological treatment did not achieve the goals you'd hoped for
• you have an underlying medical condition, such as severe depression - this could limit the effectiveness of psychological treatment

Find out more about antidepressants

If medicine for PTSD is effective, you'll normally take it for a minimum of 12 months. It may then be withdrawn over the course of 4 weeks or longer. If a medicine is not effective at reducing your symptoms, the dose may be increased.

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.

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. Sometimes the child's family can be involved in the treatment.

Treatment with medicine is not usually recommended for children and young people with PTSD.