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Post Traumatic Stress Disorder (PTSD): How to recognise symptoms and manage them

1 in 3 people experience Post Traumatic Stress Disorder (PTSD):
How to recognise the symptoms – and how to manage them

Yes, you read that right; shockingly, one-third of us suffer from PTSD or a trauma at some point in our lives. And yet, worryingly, many people either know very little about it or have misconceptions about who, and how, it impacts. I often see people in my clinic who are totally unaware that they have PTSD.

Most commonly, post-traumatic stress disorder (PTSD), is a term we associate with soldiers who have been at war. Indeed, a huge number of veterans sadly do suffer horrifically with the illness. However, PTSD can and does, effect absolutely any person who has experienced a traumatic event. A traumatic event can be defined as an experiencing a situation where you fear for your safety or the safety of someone you love. So if you see a loved one trip down a step and have an automatic though they could be seriously injured this could lead to some trauma symptoms even if they are perfectly fine. A difficult childbirth is another common situation that can leave mum or dad with some symptoms of trauma.

It is reported that 50% of people experience a trauma at some point in their lives. However, I would argue that everybody experiences some form of traumatic event at some point in their life. And any single harrowing experience can cause PTSD.

Psychological health like physical health – needs to be taken care of in the same way, if you broke your leg you would allow time for it to heal, adjust your lifestyle, get more support, rest and allow nature to take its course. After a psychological trauma we need to do the same our brain has had a shock and needs time to heal:

  • it’s not a weakness
  • will improve
  • you need care and support
  • allow time for healing.

How we respond to trauma depends on our interpretation of the event at the time and just afterwards. It also depends on our previous experiences of trauma, our support networks, current life stressors, and the things we do to cope. The symptoms of PTSD can start immediately or there may be a delay of weeks or months.

Examples of traumatic events

• Road traffic accidents
• Verbal, physical or sexual abuse
• Bullying
• Falls, accidents or injury
• Terrorist attacks
• Witnessing the death of a loved one
• Military combat
• Natural disasters
• Being stuck in lifts or confined spaces
• Dog bites or attacks
• Robbery or muggings
• Difficult experience of giving birth

The first four weeks after a traumatic event

In the few weeks following trauma, it is common to experience a number of symptoms which are consistent with PTSD. However, in many people, these symptoms will naturally reduce after the first month.

This period of time is called ‘watchful waiting’. It’s very important to look after yourself and to keep an eye on your symptoms, but you may not need any treatment. Some people find it helpful to talk event through to help them process it and others don’t want to talk it through and if this type of person is encouraged to talk when they are not ready it can be unhelpful. It’s important to try to follow what you feel you need initially.

Symptoms during the first month are generally at their worst and can be clustered into three main categories:
• Intrusive symptoms: Flashbacks of the event, nightmares, intrusive images or memories.
• Avoidant symptoms: The trauma feeling ‘unreal’, dream state, blunted emotions, shut down, low in mood, not wanting to talk about the event, being unable to talk about it, avoiding any reminders of the trauma, loss of interest in things, loss of enjoyment.
• Arousal symptoms: Anxiety, palpitations, feeling on high alert, heightened sensitivity to noise and/or light, anger, irritability, feeling scared, sense of impending doom, poor sleep, unable to concentrate, bad memory, loss of appetite.

These symptoms are a normal part of recovery and are the mind’s way of trying to make sense and come to terms with what happened.

Top ten ways to self-manage your symptoms

1. Self-compassion: Care for yourself in the same way that you would a friend. 2. Mindfulness: Use this technique to settle your mind and relax your body
3. Find your ‘safe place’: Use relaxation techniques and imagery to create a ‘safe place’ in your mind that you can go to whenever you feel the need.
4. Create a narrative of the event: Write down what happened – with a start, a middle and an end. Our brain likes things in order and often traumatised memories can be disorganised.
5. Remind yourself it’s over: Keep doing this and telling yourself that you are totally safe now.
6. Look after your physical health: Eat well, stay hydrated, avoid alcohol and drugs, exercise, and make sure you get enough sleep.
7. Stay connected: See and speak to friends and family as much as possible. Share your experiences with others and talk about what happened.
8. Try not to avoid reminders of the event: The exception to this is if they will totally overwhelm you.
9. Reduce rumination: Whilst you should talk about what happened and try not to avoid reminders of the event, it’s equally important to try not to constantly think about it. Where possible, turn your attention to other things.
10. Routine: Maintain a good routine and daily structure

Seeking professional help

After four to six weeks, if you are still experiencing symptoms then I would strongly advise you to seek the help of a professional to enable you to process your experience and move forward. This advice especially applies if you have any of the following symptoms:
• Feeling upset and fearful most of the time
• Constantly feeling emotionally overwhelmed
• Acting very differently to before the trauma
• Not being able to work or look after the home and family
• Deterioration of relationships
• Using drugs or drinking too much
• Feeling very jumpy
• Being unable to stop thinking about the incidents
• Not enjoying anything
• Impaired day-to-day functioning
• Poor sleep

The most important thing to remember with PTSD is that it is treatable. We can’t erase difficult traumatic memories from our minds – but we can store them in a way that doesn’t impact our lives, relationships and emotional well-being.

The most effective psychological treatment for PTSD is trauma-focused EMDR and CBT both of which are in the NICE guidelines for the treatment of trauma.

Cognitive Behavioural Therapy (CBT) 

CBT is based on the concept that your thoughts, feelings, physical sensations and actions are interconnected, and that negative thoughts and feelings can trap you in a vicious cycle. CBT aims to help you deal with overwhelming problems in a more positive way by breaking them down into smaller parts. You’re shown how to change these negative patterns to improve the way you feel. CBT  looks for practical ways to improve your state of mind on a daily basis.

Find Out More Here: About CBT

Eye Movement Desensitisation and Reprocessing (EMDR) 

EMDR is a form of therapy, which integrates many of the successful elements of a range of therapeutic approaches such as cognitive behavioural therapy, and combines them with eye movements or other forms of bilateral stimulation in ways which stimulate the brain’s information processing system.

Normally, people process traumatic experiences naturally. However, sometimes an overwhelming event or when you are repeatedly subjected to distress, this healing process may become overloaded, leaving the original disturbing experiences unprocessed. These unprocessed memories can be stored in the brain in a “raw” form where they can be continually re-evoked when experiencing events that are similar to the original experience.

EMDR utilises the body’s natural healing ability and allows the brain to heal psychological problems at the same rate as the rest of the body heals physical ailments. Because EMDR allows the mind and body to heal at the same rate, treatment can be rapid. The number of sessions required for EMDR treatment, however, will vary according to the complexity of the issues being dealt with. In general, the more isolated the traumatic memory being treated, the shorter the treatment tends to be.

Find Out More Here: About EMDR

Further Information can be found in the main section of my website.

I hope you have found this blog helpful if you have any questions please comment below and I will be happy to answer them. Sarah


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Sarah Rees

Sarah is a fully accredited Cognitive Behavioural Therapist and mental health writer delivering Modern Mental Health for you and with you in Mind. Sarah is the author of ‘The CBT Journal’ which helps you write for your wellbeing incorporating CBT techniques. For more information and to keep in touch have a look at