Summary
Post-Traumatic Stress Disorder (PTSD) can affect your thoughts, emotions, body and behaviour. People can experience PTSD in different ways, and symptoms do not always appear immediately after a traumatic event. They can develop weeks or months later, and sometimes become more noticeable after a reminder or another stressful experience.
PTSD symptoms can include unwanted memories, flashbacks or nightmares about what happened. You might feel as though the event is happening again or experience strong physical or emotional reactions when something reminds you of it. You may feel constantly alert, anxious, irritable or on edge, have difficulty concentrating or experience changes in your sleep. Some people experience physical sensations such as pain, nausea, a racing heart or feeling shaky when reminded of the event.
You might also avoid thoughts, feelings, people, places or activities that remind you of what happened. This could involve staying away from certain places, keeping yourself constantly busy or trying not to think about the event. Some people experience changes in how they see themselves, other people or the world, such as feeling unsafe, guilty, ashamed, disconnected or unable to experience positive emotions.
PTSD can also occur alongside other mental health difficulties, including anxiety and depression. Experiencing unusual perceptions or psychotic symptoms can have different causes and does not automatically mean that someone has PTSD.
PTSD in children and young people
PTSD can look different in children and young people, particularly depending on their age and stage of development. They may have nightmares or distressing dreams, become more clingy or find it difficult to sleep alone. Some children may repeatedly act out or play through parts of what happened, such as recreating an accident with toys. Younger children may show changes in behaviour, toileting, eating or play rather than being able to explain how they are feeling.
Children and young people may also become more withdrawn, lose interest in activities they usually enjoy, become more irritable or have physical symptoms such as headaches or stomach aches. They may ask repeated questions about death or safety or become particularly worried that something bad will happen again.
Complex PTSD
Complex Post-Traumatic Stress Disorder (CPTSD) can develop following repeated or prolonged traumatic experiences, particularly when it has been difficult or impossible to escape from the situation. CPTSD includes the core symptoms of PTSD alongside additional difficulties with emotional regulation, self-concept and relationships.
Acute Stress Disorder
Acute Stress Disorder can develop after someone experiences or witnesses a traumatic event. Symptoms can include intrusive memories or nightmares, feeling as though the event is happening again, avoiding reminders, feeling on edge or easily startled, difficulty sleeping or concentrating, and feeling numb or disconnected from yourself or your surroundings. Some people may also experience changes in mood, anxiety or distressing physical reactions. Acute stress disorder is diagnosed when these symptoms occur from 3 days to 1 month after the traumatic event and cause significant distress or affect everyday life. If symptoms continue beyond this period, a professional may consider whether another trauma-related condition, such as PTSD, is present.
Emotional regulation
You may experience emotions very intensely or find them difficult to manage once they start. Small situations might sometimes lead to very strong feelings of anger, sadness, fear or distress. You may also feel emotionally numb or disconnected from yourself or the world around you, particularly when you have experienced overwhelming stress.
Self-worth
You may have very negative beliefs about yourself and feel worthless, broken, damaged or responsible for what happened. Strong feelings of shame or guilt can also occur, even when what happened was not your fault.
Relationships
Trauma can affect how safe it feels to be close to other people. You might find relationships exhausting, struggle to trust others or find it difficult to be vulnerable. You may withdraw from people or find yourself becoming very reliant on particular relationships. These difficulties can affect friendships, family relationships and intimate relationships.
Causes of PTSD and trauma
Traumatic experiences can take many forms. They can include experiencing or witnessing a serious accident, physical or sexual violence, abuse, domestic abuse, serious illness, the death of someone close to you, natural disasters or living in an unsafe or unstable environment. Experiences of bullying, racism, discrimination and hate crime can also have a significant psychological impact.
You do not have to experience an event directly for it to affect you. Witnessing someone being seriously harmed or experiencing the death or serious injury of someone you care about can be deeply distressing. People can also respond differently to similar experiences, so there is no simple checklist that determines whether something will be traumatic for an individual.
A person may develop significant trauma-related symptoms following an experience that other people do not understand or consider serious. Telling someone to “get over it” or suggesting that their experience was not serious enough can make it harder for them to seek support.
Trauma and neurodivergence
Autistic and other neurodivergent people can experience trauma and trauma-related distress, and some experiences may be particularly distressing because of sensory, communication or environmental differences. Research has highlighted experiences reported as traumatic or highly distressing by some autistic people, including the loss or abandonment of important people or pets, overwhelming sensory experiences, significant changes or transitions, difficulties being understood by others, and distress associated with mental health experiences.
Examples might include a fire alarm or other overwhelming sensory event, moving between schools, sudden changes to routines, repeated experiences of being misunderstood or excluded, or experiencing a severe mental health episode. These experiences can have a significant emotional impact, although experiencing one of them does not automatically mean that someone will develop PTSD or CPTSD.
If you have experienced something that continues to affect how you feel, think, behave or relate to other people, you can seek support even if you are unsure whether what happened “counts” as trauma. A professional can help you understand your experiences and decide what support may be appropriate.
How to help myself
If you experience a flashback, intrusive memory or feel as though the traumatic event is happening again, try to remind yourself that you are in the present. Look around your surroundings and notice what is happening right now. You could use the 5-4-3-2-1 grounding technique by naming five things you can see, four things you can touch, three things you can hear, two things you can smell and one thing you can taste. This can help bring your attention back to your current surroundings.
Remind yourself that the traumatic event has already happened and that you are safe in the present moment, if this is true. You could say to yourself, “I am here now,” “I am safe right now”, or “That happened in the past; it is not happening now.” You might also find it helpful to look at the date, check where you are or name the people and objects around you to help your brain recognise that you are in the present.
Use your senses to help you feel grounded and comforted. You could hold something soft such as a blanket, cushion or favourite toy, squeeze a stress ball or soft object, wrap yourself in a blanket or hold something with an interesting texture. Some people find firm pressure or movement helpful, while others prefer a quieter and softer sensory experience. Try different things and notice what works for you.
When you notice your body becoming tense or overwhelmed, try slowing your breathing. You could practise box breathing by breathing in gently for four seconds, holding for four seconds, breathing out slowly for four seconds and holding for another four seconds before repeating. If holding your breath feels uncomfortable or makes you more anxious, simply focus on taking slow, comfortable breaths instead.
You do not have to manage trauma-related feelings on your own. Tell someone you trust when you are struggling, even if you do not feel ready to explain everything that has happened. You could ask them to sit with you, help you feel grounded or simply listen. Speaking to a GP or mental health professional can also help you explore longer-term support for trauma symptoms.
Try to notice what situations, places, sounds, smells or experiences tend to trigger your symptoms. You do not need to avoid everything that reminds you of the trauma, but understanding your triggers can help you prepare for difficult situations and identify what support you might need. If reminders are having a significant impact on your everyday life, trauma-focused therapy can help you work through these experiences safely and gradually.
Recovering from trauma takes time. You might experience the feelings coming in waves, and some days could be easier than others.
How to help a loved one
Offer opportunities to talk when they feel ready, without pressuring them to share more than they want to. Let them know you are available to listen and give them space if they do not want to talk. When they do talk, use their own words when referring to what happened or how they feel. This can help them feel heard and understood rather than making assumptions about their experience.
Remember that everyone responds differently to difficult or traumatic experiences. Avoid comparing their response with someone else’s or expecting them to recover in a particular way. Involve them in decisions about their support and ask what would be helpful. This can give them a greater sense of control when other parts of life may feel unpredictable.
Establishing a predictable routine can provide a sense of normality, stability and control. Where possible, support regular sleep, meals, school or work, exercise and enjoyable activities. If they are struggling with everyday tasks, break things down into smaller, manageable steps and offer practical help without taking over completely.
Help them rebuild a sense of safety by being patient, consistent and reassuring. You can help them identify situations, places or experiences that make them feel more unsettled and explore coping strategies together. This might include breathing exercises, grounding techniques, spending time somewhere quiet, listening to music, going for a walk or having access to a trusted person. If they experience reminders or become overwhelmed, calmly help them focus on the present and remind them that they are safe now.
Spend quality time together, even if you are not talking about what happened. Watching a film, going for a walk, cooking together, playing a game or doing another familiar activity can provide connection and a sense of normality. Continue to include them in everyday activities while being mindful that they may sometimes need time alone or additional rest.
Be mindful of changes in their behaviour, mood, sleep, eating, relationships or usual activities. They may become more withdrawn, irritable, worried or avoidant, or may find it harder to concentrate. Try to respond with curiosity and patience rather than punishment or criticism. If you are concerned about their wellbeing, encourage them to seek additional support from their GP, school, college or a mental health professional. You can offer to help them arrange an appointment or go with them if they would find this useful.
Recovery takes time and is rarely completely straightforward. There may be better and more difficult days, and reminders of the experience may temporarily increase distress. Continue offering consistent support and recognise small steps forward rather than expecting everything to return to normal straight away.
Myth Buster
Myth: “Only veterans get PTSD.”
Truth: PTSD can affect anyone who has experienced or witnessed a traumatic event. This can include serious accidents, abuse, violence, natural disasters, serious illness, the death of someone close to you or other experiences that cause significant fear, helplessness or distress. PTSD is not limited to people who have served in the military.
Myth: “PTSD is untreatable and never gets better.”
Truth: PTSD can be treated, and many people experience an improvement in their symptoms with appropriate support. Evidence-based treatments include Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) and Eye Movement Desensitisation and Reprocessing (EMDR). Treatment can help people process traumatic memories, develop coping strategies and reduce the impact of symptoms on everyday life.
Myth: “Symptoms of PTSD appear immediately after a traumatic event.”
Truth: Some people experience symptoms soon after a traumatic event, while for others symptoms may develop weeks, months or sometimes longer afterwards. Symptoms can also become more noticeable following reminders of the event or another stressful experience.
Myth: “Everyone who experiences trauma develops PTSD.”
Truth: Experiencing a traumatic event does not automatically mean that someone will develop PTSD. People respond to traumatic experiences in different ways, and many people recover without developing PTSD. Support from trusted people, coping strategies and access to appropriate help can be useful during recovery.
Myth: “You have to experience an event yourself to develop PTSD.”
Truth: PTSD can develop after witnessing a traumatic event or learning that something traumatic has happened to someone close to you. The impact of an experience depends on the individual and their circumstances.
Myth: “Talking about trauma will always make PTSD worse.”
Truth: Talking about a traumatic experience can feel difficult, and people should not be pressured to discuss things before they are ready. However, avoiding reminders of trauma completely can sometimes maintain PTSD symptoms. Trauma-focused therapies provide a structured and supported way to work through traumatic experiences at a manageable pace.
Support
If trauma-related symptoms are affecting your everyday life, relationships, sleep, school, work or wellbeing, it may be helpful to seek additional support. You do not need to wait until things become overwhelming before asking for help.
Start by talking to someone you trust, such as a family member, friend, teacher or another trusted adult. A GP can also help you understand what you are experiencing and discuss appropriate support or referrals. For children and young people, support may also be available through school, college or Child and Adolescent Mental Health Services (CAMHS).
A mental health professional can help you understand your symptoms, identify triggers and develop coping strategies. Support may focus on feeling safer, managing distress, improving sleep and reducing avoidance before or alongside trauma-focused therapy.
If you feel unable to keep yourself safe or are experiencing thoughts of suicide or serious self-harm, seek urgent support. You can contact NHS 111 for urgent mental health support, call 999 or go to A&E if there is an immediate risk of serious harm.
Therapy interventions
Different types of therapy can support people experiencing PTSD or trauma-related difficulties. Treatment can help you understand your responses to trauma, develop coping strategies and gradually reduce the distress associated with traumatic memories. The approach used will depend on your individual needs, circumstances and what feels manageable for you.
- Eye Movement Desensitisation and Reprocessing (EMDR) – EMDR involves bringing traumatic memories to mind while completing bilateral stimulation, such as moving your eyes from side to side. The aim is to reduce the emotional distress linked to traumatic memories and help them feel less overwhelming over time.
- Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) – TF-CBT involves learning about trauma responses, developing coping strategies and gradually working through traumatic experiences in a structured and supported way. For children and young people, parents or carers may also be involved.
- Narrative Exposure Therapy (NET) – NET involves working with a practitioner to develop a life story that includes traumatic experiences. This can help organise memories and place traumatic experiences within the wider context of your life.
- Art and Creative Therapies – Art, music, drama or movement can provide alternative ways to express and explore feelings when talking about experiences feels difficult.
- Stabilisation and Phase-Based Work – This focuses on developing coping and safety skills before processing traumatic memories. This may include grounding, emotional regulation and safety strategies to help reduce distress and increase coping.
Helplines
YoungMinds
YoungMinds is a national charity supporting the mental health and wellbeing of children and young people. They provide information, advice and support for parents and carers who are concerned about a young person’s mental health, and help people understand mental health difficulties, find appropriate support and access useful resources. Their Parents Helpline can provide information, advice, emotional support and signposting to other services.
Parent helpline: 0808 802 5544 (9:30 am – 4 pm on Mondays, Thursdays and Fridays, and from 9:30 am – 6 pm on Tuesdays and Wednesdays)
Email: parents@youngminds.org.uk
Webchat: https://www.youngminds.org.uk/parent/parents-helpline/5544
Place2Be
Place2Be is a children’s mental health charity that provides emotional and mental health support in schools. They support children and young people with issues including anxiety, low mood, bullying, family difficulties, bereavement, neglect and other challenges affecting their wellbeing.
Phone: 020 7923 5500
Opening times: 9 am–5 pm, Monday–Friday
Website: http://www.place2be.org.uk
Email: enquiries@place2be.org.uk
Shout
Shout is a free, confidential text messaging service that provides support to anyone who is struggling to cope. It can help with a wide range of issues, including stress, anxiety, low mood, loneliness, relationship difficulties, bullying, self-harm, suicidal thoughts, feeling overwhelmed and other mental health challenges.
Text: SHOUT to 85258
Opening times: Available 24 hours a day, 7 days a week, 365 days a year
Website: www.giveusashout.org
Childline
Childline is a free service for young people to talk to a counsellor about anything. The service is available 24 hours a day, 7 days a week. Childline is available to anybody who is 18 years old or younger.
Phone: 0800 1111
Opening times: Available 24 hours a day, 7 days a week, 365 days a year
You can also find helpful resources, speak to a counsellor online or send a message on their site.
Website: www.childline.org.uk
For adults concerned about a child, the NSPCC can be contacted
NSPCC
NSPCC is a children’s charity that works to protect children and prevent abuse and neglect. They provide support and advice for adults about child abuse, neglect, child safety, online safety and children’s mental and emotional wellbeing.
Phone: 0808 800 5000
Opening times: 10 am–4 pm, Monday–Friday
Email: help@nspcc.org.uk
Email opening times: 11 am–4 pm, 7 days a week
Website: www.nspcc.org.uk
