What post-traumatic stress disorder is, how it develops after disasters and emergencies, how to recognise it in yourself and others, and what treatment options are available.
Post-traumatic stress disorder (PTSD) is a recognised psychiatric condition that develops in some people after experiencing or witnessing traumatic events. Disasters, emergencies, and life-threatening events are significant causes of PTSD, but it is important to understand that PTSD develops in a minority of people who experience trauma — most people recover with time and social support.
Understanding what PTSD is, how to recognise it, and what helps is essential for both self-awareness after a crisis and for supporting others who may be struggling.
PTSD is not:
PTSD is:
The distinction between normal stress response and PTSD is primarily time and impairment:
| Response | Normal Stress | PTSD |
|---|---|---|
| Duration | Days to weeks | Months to years without treatment |
| Flashbacks | Vivid memories that fade | Intrusive, involuntary re-experiencing |
| Avoidance | Temporary avoidance of reminders | Significant and sustained avoidance |
| Function | Maintained with some difficulty | Significantly impaired |
| Social | Some withdrawal | Marked isolation |
| Onset | Immediately following event | Can be months after event |
Acute Stress Response (within the first month) is expected and normal. Symptoms that persist beyond one month and significantly impair daily function meet the criteria for PTSD.
PTSD is characterised by symptoms in four clusters:
Intrusive, involuntary re-experiencing of the traumatic event:
Persistent efforts to avoid anything associated with the trauma:
| Symptom | Examples |
|---|---|
| Negative beliefs | "I am damaged"; "The world is completely dangerous"; "I cannot trust anyone" |
| Distorted blame | Self-blame or blaming others for the event |
| Persistent negative emotions | Fear, horror, anger, guilt, shame |
| Loss of interest | Activities that were previously meaningful |
| Feeling detached | From other people; emotionally numb |
| Inability to feel positive emotions | Joy, love, satisfaction absent |
⚠️ If you or someone you know has thoughts of self-harm or suicide, seek immediate help. UK: Samaritans 116 123. US: 988 Suicide and Crisis Lifeline. These thoughts are a medical emergency and are treatable.
Not everyone who experiences trauma develops PTSD. Risk is higher with:
| Risk Factor | Notes |
|---|---|
| Direct exposure | Being personally in the event vs. witnessing from distance |
| Repeated trauma | Cumulative traumatic experiences increase risk |
| Injury during the event | Physical injury is associated with higher PTSD rates |
| Prior mental health history | Previous anxiety, depression, or trauma |
| Low social support | Isolation after trauma is a major risk factor |
| Peritraumatic dissociation | Feeling detached or unreal during the event |
| High-intensity response during event | Extreme fear, helplessness, or horror at the time |
Protective factors that reduce risk:
| Do | Don't |
|---|---|
| Listen without pressure to share | Demand they "process" or "talk it through" |
| Acknowledge that their responses are real | Say "you're overreacting" or "it was a long time ago" |
| Stay present even when they withdraw | Disappear when their behaviour is difficult |
| Encourage professional support | Diagnose them or tell them they have PTSD |
| Stay patient when they are irritable | Take anger personally |
| Offer practical help (tasks, company) | Pretend nothing happened |
Avoid pushing someone with PTSD to repeatedly talk about the traumatic event. This can reinforce the traumatic memory rather than process it. Trauma-focused therapy with a trained professional, not informal re-living, is what produces recovery.
PTSD is among the most treatable mental health conditions. First-line treatments:
| Treatment | Notes |
|---|---|
| Trauma-focused CBT (TF-CBT) | High evidence base; recommended first-line treatment |
| EMDR (Eye Movement Desensitisation and Reprocessing) | Strong evidence; NICE-recommended in UK |
| Prolonged Exposure Therapy | Systematic approach to confronting avoided memories and reminders |
| Medication (SSRIs) | Sertraline, paroxetine; moderate evidence; useful when therapy alone insufficient |
Accessing treatment:
Early intervention matters — professional support sought within weeks of a traumatic event produces better outcomes than waiting months or years.
| Category | Key Point |
|---|---|
| Normal vs PTSD | Normal stress fades in weeks; PTSD persists and impairs function for months |
| Four symptom clusters | Re-experiencing; avoidance; negative cognition/mood; hyperarousal |
| Most important risk factor | Low social support after the event |
| Most important protective factor | Strong social support after the event |
| Self-harm thoughts | Emergency — call Samaritans (116 123) or 988 immediately |
| Supporting others | Listen; stay present; do not push them to relive the event |
| Treatment | TF-CBT and EMDR are first-line; highly effective |
| Access (UK) | GP referral to Talking Therapies |
| Access (US) | VA services; SAMHSA Helpline 1-800-662-4357 |
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