Post-traumatic stress disorder (PTSD)
Help for the lasting effects of frightening or traumatic experiences — flashbacks, nightmares, feeling on edge and avoidance — mainly using trauma-focused talking therapies, with medication where needed.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- PTSD is the lasting effect of trauma — flashbacks, nightmares, avoidance and feeling on edge — and it is a treatable condition, not a weakness.
- The main treatments are trauma-focused talking therapies (trauma-focused CBT and EMDR); medication, usually an antidepressant, can help where therapy is not enough or you are not yet ready for it.
- Trauma-focused therapy can stir up difficult feelings before it helps, so a safe, well-paced approach with a skilled therapist matters — improvement builds over a course of treatment.
- If you ever have thoughts of suicide or self-harm or feel unable to keep yourself safe, get help now: call 999 or go to A&E anywhere in the UK. For urgent mental health support you can call Samaritans free on 116 123 (24/7) or text SHOUT to 85258. In England, Scotland or Wales you can also call 111 and select the mental health option; in Northern Ireland call Lifeline free on 0808 808 8000, or contact your GP or GP out-of-hours service.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your psychiatrist will give you advice for your situation.
Fewer and less intense flashbacks and nightmares for many people
Jumping straight into trauma processing may not be suitable if you are in crisis, very unstable, or do not yet feel safe enough — stabilisation usually...
You and your clinician build trust and safety, agree a plan, and work on stabilising symptoms if needed. If starting medication, early side effects are...
A clear safety plan and a named contact for difficult moments and crises
You and your clinician build trust and safety, agree a plan, and work on stabilising symptoms if needed. If...
As you process the memory, symptoms may briefly intensify before easing. Flashbacks, nightmares and avoidance...
The memory tends to feel less raw and more like the past. For medication, benefit often builds over several weeks...
You consolidate gains, plan for triggers and anniversaries, and prepare to handle setbacks. Complex PTSD often...
What is treatment for post-traumatic stress disorder (PTSD)?
PTSD can develop after a frightening, overwhelming or life-threatening experience — such as an accident, assault, abuse, serious illness, violence, military combat or a traumatic birth. It is the mind and body staying stuck in a state of threat long after the danger has passed.
Common experiences include reliving the event through flashbacks or nightmares, avoiding reminders, feeling constantly on edge or easily startled, and changes in mood and how you see yourself and the world. Some people develop these after a single event; others, after repeated or prolonged trauma, especially in childhood, may have a more complex picture sometimes called complex PTSD.
PTSD is a recognised condition, not a weakness, and it is treatable. The main treatments are trauma-focused talking therapies — trauma-focused CBT and EMDR (eye movement desensitisation and reprocessing) — which help your mind process the memory so it loses its grip. Medication, usually an antidepressant, can help, particularly where therapy alone is not enough or you are not ready for it.
Treatment helps most people reduce flashbacks, nightmares and avoidance, and feel safer in daily life. It usually means the memory becomes something you can live with rather than being erased, and going at the right pace, with the right support, matters a great deal.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Trauma-focused therapy vs medication for PTSD
| Point | Trauma-focused therapy | Medication (antidepressant) |
|---|---|---|
| First choice | Yes — recommended before medication | Usually if therapy is not enough or not yet possible |
| How it works | Processes the traumatic memory | Reduces symptoms over weeks |
| Main downsides | Can stir up distress before it helps | Side effects, especially early on |
| After stopping | Skills and processing stay with you | Stop slowly with advice; relapse possible |
NICE recommends trauma-focused psychological therapy before medication for PTSD. Medication can be added or used where therapy is not possible or not enough. Your clinician should explain what suits you.
Preparing for your treatment
- Before an appointment, note your main symptoms — flashbacks, nightmares, avoidance, feeling on edge — and how long you have had them.
- You do not need to write out the trauma in detail before you are ready; a clinician will go at your pace.
- Note anything that helps or worsens symptoms, including alcohol and drug use, which often rise after trauma.
- Bring a list of medicines and supplements, and any treatments you have tried.
- Mention any low mood, self-harm or thoughts of suicide, so you can be supported safely.
- NHS talking therapies are reached through your local psychological-therapies service. In England (often called NHS Talking Therapies) adults can usually refer themselves; in Scotland, Wales and Northern Ireland the service names and referral routes differ, so your GP can point you to the right one. Some areas have specialist trauma or veterans' services.
- Think about practical support during therapy, as trauma-focused work can be tiring and emotional.
What happens
Treatment usually starts with an assessment — a conversation about your symptoms, how trauma is affecting your life now, your safety, and your use of alcohol and drugs. You will not be forced to describe the trauma in detail before you are ready; building trust and safety comes first.
The main treatments are trauma-focused: in trauma-focused CBT you gradually process the memory and the beliefs that came from it, reduce avoidance and learn to manage reminders; in EMDR you recall aspects of the memory while doing guided eye movements, which helps your brain process it. For complex PTSD, therapy is often phased, starting with stabilisation before processing the trauma.
If medication is used, you will usually be started on an antidepressant, told what to expect, and reviewed for benefit and side effects. NICE recommends trauma-focused therapy ahead of medication, with specialist services for complex or treatment-resistant PTSD. Throughout, your safety and pace guide the plan.
Is this treatment right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- Jumping straight into trauma processing may not be suitable if you are in crisis, very unstable, or do not yet feel safe enough — stabilisation usually comes first.
- Trauma-focused therapy alone may not be enough for complex PTSD, which often needs longer, phased, specialist care.
- Medication may not be the preferred first step, as NICE recommends trauma-focused therapy first, and should be discussed carefully in pregnancy.
- If heavy alcohol or drug use is dominating the picture, that often needs support before or alongside trauma work.
Delay or rearrange if…
- You are in crisis or having thoughts of suicide or self-harm — urgent help and safety come first.
- You feel too unstable or unsafe to begin processing the trauma — stabilisation and support are needed first.
- You are misusing alcohol or drugs heavily, which can make trauma-focused therapy harder until addressed.
- You are pregnant, breastfeeding or planning a pregnancy and medication is being considered — discuss this carefully first.
- Your circumstances are currently too unsafe or chaotic, such as ongoing abuse, where safety planning takes priority.
Alternatives to discuss
- Stabilisation, grounding and coping-skills work before or instead of immediate trauma processing
- Medication (an antidepressant) where therapy is not possible or not enough
- Guided self-help and support while waiting for therapy, for less severe symptoms
- Treating linked depression, sleep problems or substance use where these are the priority
- Referral to a specialist trauma or complex-PTSD service
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Benefits
- Fewer and less intense flashbacks and nightmares for many people
- Less need to avoid reminders, places or people
- Feeling less on edge, with better sleep and concentration
- A memory that feels more like the past than something happening now
- Improvement in linked low mood, guilt or shame
- For many people, being able to rebuild relationships, work and daily life
Risks & complications
- Trauma-focused therapy can temporarily stir up distressing memories and strong feelings before it helps
- Sessions can be tiring, and symptoms may briefly increase as you process the trauma
- Antidepressants can cause early side effects such as nausea, headache, restlessness or disturbed sleep, which often settle
- It can take a course of therapy, or several weeks of medication, before clear benefit
- Feeling worse, or dropping out, if therapy moves faster than feels safe
- Sexual side effects or reduced sex drive with antidepressants
- Needing to try more than one therapy or medication before finding what helps
- Withdrawal-type symptoms if medication is stopped suddenly rather than reduced slowly
- A small increase in thoughts of self-harm in some people, especially in the first weeks or in younger adults starting an antidepressant
- Serious medication reactions, which are uncommon but need urgent attention
- Strong dissociation or being overwhelmed during therapy, which a skilled therapist plans for and manages
The main 'risk' of trauma-focused therapy is that facing the memory can stir up distress in the short term — which is why a skilled therapist, the right pace, and feeling safe enough to start all matter so much. With medication, the usual antidepressant cautions apply. Ask how the therapy will be paced, what to do if it feels too much between sessions, and — if on medication — what side effects to expect and how to stop it safely. If mood or self-harm thoughts worsen, contact your clinician promptly.
Published figures to discuss
There are no surgical-style complication rates for PTSD treatment. How well treatment works, and how long it takes, depends on the type of trauma, whether it was a single event or repeated, other conditions, and how safe and ready a person feels to engage. Trauma-focused therapies are effective for many people, but complex PTSD often needs longer, phased care. Because reliable, comparable individual outcome figures are limited and easily misread, this guide describes benefits and risks in words rather than quoting precise percentages. The usual antidepressant cautions apply, including the small early risk of increased agitation or self-harm thoughts, especially in younger adults.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Trauma-focused therapy response | Often helpful, but not instant | Trauma-focused CBT and EMDR require careful pacing, stabilisation and attention to dissociation and safety. | Guide sourcesClinical context |
| Temporary symptom worsening during therapy | Recognised | Nightmares, distress and avoidance can flare when trauma is processed; a safety plan matters. | Guide sourcesClinical context |
| Comorbid depression, substance use or self-harm | Common enough to assess explicitly | These can change therapy timing and risk management. | NHS — Post-traumatic stress disorder (PTSD)nhs.ukSource-linked context |
| Misdiagnosis or missed complex trauma | Recognised | PTSD can overlap with anxiety, depression, personality disorder diagnoses, psychosis-like symptoms and neurodivergence. | Guide sourcesClinical context |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
There is no physical recovery from PTSD treatment. What matters is the course of therapy and the time around it: processing the memory at a safe pace, looking after yourself between sessions, and — if on medication — giving it time to work. Recovery from PTSD is often gradual, with ups and downs, rather than a single turning point.
- A temporary increase in distress, dreams or memories while processing the trauma in therapy
- Feeling drained or emotional after sessions
- Uneven progress, with difficult days around reminders or anniversaries
- Waiting several weeks for medication to help
- Wanting to avoid the work — going at a safe, agreed pace is how recovery happens
Aftercare
- Look after yourself between sessions — rest, routine and gentle activity help while processing trauma.
- Use grounding techniques your therapist teaches you for flashbacks or feeling overwhelmed.
- Try not to use alcohol or drugs to cope, as they can worsen PTSD and interfere with treatment.
- If you take medication, take it as prescribed and do not stop suddenly.
- Tell your clinician if distress, mood or self-harm thoughts worsen, especially early in treatment.
- Plan for triggers and anniversaries, which can briefly bring symptoms back.
- Know who to contact if things get worse, and keep crisis numbers easy to find.
- A note of your main symptoms and triggers
- A list of current medicines and past treatments
- Questions written down for your clinician
- Grounding techniques and a plan for difficult moments
- Crisis numbers saved: 999, Samaritans 116 123, SHOUT to 85258, and either the 111 mental health option (England, Scotland, Wales) or Lifeline 0808 808 8000 (Northern Ireland)
- Practical support arranged for tiring or emotional therapy days
⚠ Get urgent help if…
- Thoughts of suicide or self-harm, or feeling you cannot keep yourself safe — call 999 or go to A&E now
- An immediate crisis at any time of day or night — call Samaritans free on 116 123 or text SHOUT to 85258; in England, Scotland or Wales you can also call 111 and select the mental health option, and in Northern Ireland call Lifeline free on 0808 808 8000 or contact your GP out-of-hours service
- Distress, flashbacks or nightmares becoming overwhelming and unmanageable
- Low mood or hopelessness worsening, particularly in the first weeks of an antidepressant
- A sudden lift into an unusually 'high', overactive or irritable mood, which should be reviewed
- Drinking much more alcohol, or using drugs, to cope
- Feeling disconnected from reality or losing time in a way that frightens you or puts you at risk
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your psychiatrist gives you.
Results & realistic expectations
A good outcome usually means fewer and less intense flashbacks and nightmares, less avoidance, feeling safer and less on edge, and a memory that feels more like the past — rather than the experience being erased. Many people improve substantially with trauma-focused therapy, and medication can add to this.
Treatment cannot undo what happened, and symptoms can flare at reminders or anniversaries. What it can do is help your mind process the trauma so it intrudes less and you regain control of your life. Complex PTSD may take longer and need phased, specialist care. If one approach does not work, that helps guide the next step rather than meaning recovery is not possible.
Many people make lasting gains from trauma-focused therapy, especially when they have learned skills to manage reminders. Symptoms can return at stressful times or anniversaries, but the skills can be reused and a top-up course can help. If medication is helping, it is usually continued for a period after improvement, then reduced slowly, because stopping early raises the chance of relapse. Complex PTSD is often managed over a longer period. Plans should be reviewed as your situation changes.
Related tests, treatments or support
PTSD often comes with depression, anxiety, sleep problems, chronic pain or alcohol and drug use, and treatment may need to address these together. Heavy alcohol or drug use may need support first, as it can make trauma-focused therapy harder. Sleep problems and nightmares can sometimes be helped specifically. For complex PTSD, therapy is often phased, with stabilisation before trauma processing. Practical, social and, where relevant, legal or safety support sit alongside formal treatment.
Follow-up & long-term care
Therapy includes regular sessions with a planned ending and often a follow-up to check progress holds, particularly around known triggers or anniversaries. If you are on medication, you should be reviewed for benefit and side effects, with attention to mood early on. Complex cases may have longer-term follow-up in a specialist service. You should always know how to get back in touch sooner if symptoms or mood worsen.
- Keep using grounding and coping skills, especially around triggers and anniversaries
- Use your setback plan if symptoms start to return
- Refresher or top-up therapy if PTSD flares
- If on medication, regular review and a slow, planned reduction when stopping
- Ongoing support from a specialist service for complex PTSD where needed
Repeat, follow-on and what comes next
- Some people need to switch between trauma-focused CBT and EMDR, or change medication, before finding what helps.
- Therapy may need re-pacing or a return to stabilisation if processing feels overwhelming.
- Symptoms can return at triggers or anniversaries, and a top-up course may be needed.
- Complex or treatment-resistant PTSD may be referred for longer, specialist input.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- A clear safety plan and a named contact for difficult moments and crises
- Grounding and coping skills to use between sessions and after therapy
- A plan for triggers, anniversaries and possible setbacks
- If on medication, advice on how long to continue and how to reduce it slowly
- Written crisis information, including 999/A&E, Samaritans 116 123, SHOUT to 85258, and either the 111 mental health option (England, Scotland, Wales) or Lifeline 0808 808 8000 (Northern Ireland)
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether you have trauma-focused therapy, medication, or both
- The type and length of therapy (trauma-focused CBT, EMDR, or longer phased work for complex PTSD)
- Who provides care — accredited trauma therapist, psychologist, or consultant psychiatrist
- The number of sessions and how often you are seen
- Whether a specialist trauma or complex-PTSD service is involved
- Ongoing medication reviews where relevant
- Follow-up appointments and how long support continues
- The therapist's or clinician's fee and their training in trauma-focused therapy or EMDR
- How many sessions are included and the cost of further sessions
- What an initial assessment covers and costs
- Whether stabilisation work, if needed, is included
- Whether medication reviews are included, if relevant
- The cancellation policy
- What happens, and what it costs, if you need longer or specialist complex-trauma treatment
On the NHS? PTSD treatment is available on the NHS across the UK. Access is through your local NHS/HSC psychological-therapies service — in England this is often called NHS Talking Therapies and may allow self-referral, while service names and referral routes differ in Scotland, Wales and Northern Ireland; in some areas there are specialist trauma services. Private care may be used for faster access or particular therapists.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Being pushed into describing or reliving the trauma before you feel safe or ready
- Not being told that symptoms can briefly worsen while processing trauma, and what to do if they do
- Being offered medication as the first or only treatment without mention of recommended trauma-focused therapy
- Not being warned about the small early risk of worsening mood or self-harm thoughts on antidepressants, or how to stop medication safely
- No clear safety plan or named contact for crises
Marketing red flags
- Claims of a quick or permanent 'cure' for PTSD, or that a single session will erase the trauma
- Unproven or unregulated 'trauma' techniques sold as guaranteed fixes
- Pushing expensive programmes without mentioning effective, often free NHS and specialist options
- Trauma processing offered with no attention to safety, stabilisation or crisis planning
- No mention of risks, pacing or what happens if you feel worse
Choosing a specialist safely
- Check the psychiatrist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the psychiatrist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good psychiatrist will welcome every one of these.
- Would you suggest trauma-focused CBT, EMDR, medication, or a combination for me?
- How will we make sure therapy goes at a pace that feels safe?
- What can I do between sessions if distress or flashbacks become overwhelming?
- If I have complex PTSD, will treatment be phased, and is a specialist service involved?
- If I take medication, how long before I should notice benefit, and how would I stop it safely?
- What should I do, and who should I contact, if my mood or self-harm thoughts get worse?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the psychiatrist who carries out my treatment, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this treatment not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Will I have to describe the trauma in detail straight away?
Can I get PTSD treatment on the NHS?
Does EMDR really work, and how?
Do I need medication for PTSD?
What is complex PTSD?
What if therapy makes me feel worse?
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Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — Post-traumatic stress disorder (PTSD) NICE NG116 — Post-traumatic stress disorder NICE NG116 — Recommendations PTSD UK NHS — Where to get urgent help for mental health nidirect — urgent and emergency care services nidirect — GP out-of-hours service NHS England — 111 mental health crisis support NHS inform Scotland — urgent mental health help NHS 111 Wales — mental health and wellbeing nidirect — mental health emergency (Lifeline) NHS — Find NHS Talking Therapies (England) NHS inform Scotland — psychological therapies NHS 111 Wales — counselling nidirect — mental health care professionals
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
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