What is post-traumatic stress disorder?

Post-traumatic stress disorder, or PTSD, is a debilitating mental disorder that follows experiencing or witnessing an extremely traumatic, tragic, or terrifying event.

People with PTSD usually have persistent frightening thoughts and memories of their ordeal and can also feel emotionally numb, especially with people they were once close to.

Types of event which can lead to PTSD include:

• military combat
• violent or sexual assaults
• terrorist attacks
• serious accidental injury
• serious transport accidents
• natural disasters
• witnessing violent deaths
• being in a fire

The onset of PTSD can happen immediately after someone experiences a disturbing event, or many years later, known as delayed onset PTSD. The main symptoms of PTSD are:

• Repeatedly re-living the trauma in the form of nightmares and disturbing recollections during the day. The nightmares or recollections (sometimes called flashbacks) may come and go. You may be free of them for weeks at a time, and then experience them daily for no particular reason
• Not wanting to think about or talk about what has happened
• Feeling unsafe
• Problems with sleeping, depression, feeling detached or numb, or being easily startled
• Losing interest in things you used to enjoy, and have trouble feeling affectionate
• Feeling irritable, more aggressive than before, or even violent
• Seeing things that remind you of the incident may be very distressing, which could lead you to avoid certain places or situations that bring back those memories. Anniversaries of the event are often very difficult

PTSD can occur at any age, including childhood. The disorder can be accompanied by depression, substance abuse, or anxiety.

Symptoms may be mild or severe. In severe cases, the individual may have trouble working or socialising. In general, the symptoms seem to be worse if the event that triggered them was initiated by a person, such as a murder, as opposed to a natural disaster (eg a flood).

How TF-CBT is used to treat post-traumatic stress disorder

You and your CBT therapist will discuss your specific difficulties and set goals for you to achieve. CBT is not a quick fix. It involves hard work during and between sessions. Your therapist will not tell you what to do. Instead they will help you decide what difficulties you want to work on in order to help you improve your situation. Your therapist will be able to advise you on how to continue using TF-CBT techniques in your daily life after your treatment ends.

Some of the aims of TF-CBT in treating PTSD are:

• Helping you understand how your PTSD symptoms have developed
• Gradually confronting situations which have been previously avoided until the anxiety subsides
• Gradually dealing with your memories of the trauma until there is a significant reduction in anxiety and other related symptoms
• Challenging unhelpful thoughts and beliefs which you have about yourself and others who may have been involved in the traumatic event
• Learning relaxation and confidence-building techniques to reduce the physical symptoms of PTSD
• Using CBT to treat the related symptoms of anxiety and depression

Listen to our podcasts

Let's Talk About CBT is a podcast about CBT: what it is, what it's not and how it can be useful. Dr Lucy Maddox interviews experts in the field including people who have experienced CBT for themselves. Each episode includes a mix of interviews, myth-busting and explains CBT jargon.

You can download our podcast - CBT for Post Traumatic Stress Disorder.

Other resources

You can download a pdf version of the information contained on this page here.

National Institute for Health and Care Excellence (NICE) guidelines for post-traumatic stress disorder