Post traumatic stress disorder develops after having or witnessing a traumatic experience. This could be an accident, an assault or some forms of abuse. You may experience anxiety with anything that reminds you of the trauma, memories or flashbacks, feeling sad or angry, feeling guilty, having problems concentrating or sleeping, things may feel unreal (called dissociation) and not feeling safe even in safe situations. Some people also have physical symptoms like nausea too.

People who have experienced long lasting trauma or multiple traumatic events (like abuse or neglect) may develop extra symptoms that we call complex PTSD (or just complex trauma). As well as the above you may have problems controlling your emotions, difficulty with social relationships due to fear of mistreatment or mistrust, you might feel bad about yourself in some way like thinking bad things that happened are your fault or that you are somehow abnormal. Sometimes people experience dissociative issues like feeling that things aren’t real or they are not themselves. Self-harm and self-neglect can also occur. Therapy can help you with both kinds.

PTSD is caused by experiencing or witnessing one or several traumatic events. Scientists have found several biological factors that explain why PTSD happens. It appears to be an evolutionary survival mechanism that gets out of control. Being able to reconsider events where we may be seriously injured or killed (through dreams or flashbacks) to try and prevent them happening again would have a survival benefit as would other symptoms such as hyper-arousal and anxiety might have helped us protect ourselves. Even symptoms like dissociation may help us get through the situation. They have found several biological mechanisms underpinning this like higher levels of stress hormones in the bodies of people with PTSD and differently sized areas in the brains limbic system (that deals with emotions and memories among other things). These mechanisms keep us safe at the time but may come to hold us back once we are not within the traumatic situation so can use therapy to help resolve them.

There are a number of ways therapy can help you with PTSD. We may help you learn relaxation techniques for meditation to help you manage anxiety or other self-soothing techniques to help yourself through. We may help you consider the thought processes and rules for living you have developed due to trauma and challenge them to make them more flexible and balanced. We can do this through talk therapy, cognitive techniques or behavioural techniques like graded exposure. We can help you work on lingering feelings with talk therapy, imaginal exposure or other methods. The exact treatment plan will be tailored and developed at a pace appropriate for you.

Some people can also be prescribed medication for PTSD, these may be used to help accompanying depression, anxiety or sleep issues. Some doctors believe that SSRI antidepressants also help PTSD symptoms when combined with therapy.

Another powerful technique is called eye movement desensitisation and reprocessing (EMDR). You move your eyes in a guided rhythm while remembering your trauma. This technique has good evidence for being helpful but it is unclear exactly how it works. One leading theory is that it tricks the brain into re-processing information the way you do when asleep in the REM stage. This re-processing seems to reduce PTSD symptoms.