Post-traumatic stress disorder (PTSD)

Post-traumatic stress disorder (PTSD) is mental health disorder that can occur after experiencing a traumatic event.

It's common to have feelings of fear and anxiety after a traumatic event. In some cases, these feelings can last for a long time and affect how you cope with everyday life. If these symptoms continue to persist more than a month after traumatic event, they may be a sign of PTSD.

About 12 in every 100 Australians will experience PTSD at some time in their lives.

PTSD can be caused by experiencing or witnessing a traumatic event. This could involve serious injury, sexual violence, a potentially life-threatening situation or death. It can also be caused by hearing about a traumatic event that happened to someone close to you.

Experiences that can potentially lead to PTSD include:

• serious accidents
• natural disasters such as bushfires, floods and earthquakes
• living in a war zone, or experiencing war in the military
• sexual or physical assault
• torture or terrorism
• seeing people hurt or killed

Although a relationship break-up or losing a job can feel devastating, these are not the type of events that cause PTSD.

Risk factors for PTSD

Anyone can develop PTSD, but some people are at a greater risk. Females are more likely to develop PTSD than males.

You are more likely to develop PTSD if you:

• experienced a traumatic event where someone caused harm intentionally
• experienced repeated trauma, such as living in a war zone or suffered repeated episodes of abuse
• work in a job that exposes you to repeated trauma, such as a soldier, paramedic or firefighter
• have had a mental illness in the past, such as anxiety or depression
• did not have enough support afterward the traumatic event
• experienced additional life stressors after the trauma, such as the loss of loved ones, a home or a job

PTSD is not the only mental health disorder caused by experiencing traumatic events. Depression, psychosis, anxiety or eating disorders can also result from experiencing traumatic events.

Everyone is affected differently by PTSD. Symptoms of PTSD usually start soon after the traumatic event, but sometimes they take several months to appear.

There are 4 types of PTSD symptoms.

Re-experiencing the trauma

Symptoms of this type include:

• repetitive memories (or flashbacks) that are hard to control and intrude into everyday life
• nightmares
• extreme distress caused by reminders of the trauma
• physical symptoms such as a racing heartbeat, difficulty breathing, sweating or panic attacks when reminded of the trauma

Avoidance

Symptoms of this type include:

• avoiding places, people or objects that may trigger memories of the traumatic event
• not wanting to talk or think about the event

Negative thoughts and mood

Symptoms of this type include:

• blaming yourself or others for the traumatic event
• feeling numbness, depression, anger or guilt
• not being able to remember the traumatic event
• no longer enjoying favourite activities
• becoming emotionally detached from others

Increased alertness

Symptoms of this type include:

• frequently scanning the environment for signs of danger
• being easily startled
• irritable or aggressive behaviour
• difficulty sleeping
• poor concentration

PTSD in children and adolescents

Children and teenagers with PTSD may have similar symptoms to adults, but there can be some differences.

After experiencing trauma, children may:

• lose skills they had previously mastered, such as speaking
• develop bedwetting (Opens in new tab) after previously been dry at night
• become scared of the dark or of going to sleep
• become unusually clingy (Opens in new tab) with parents or carers
• act out the event during play
• have distressing dreams (Opens in new tab) or trouble sleeping (Opens in new tab)
• have extreme temper tantrums (Opens in new tab)

Adolescents with PTSD may experience similar symptoms to adults, but they may also be more likely to:

• increase risk-taking behaviour
• engage in self-harm
• use alcohol or other substances

If you or someone you know appears to be experiencing symptoms of PTSD that are affecting work, school or day-to-day activities for longer than 2 weeks after a traumatic event, it's important to talk to a doctor or other health professional. If you or someone you know are at a high risk of developing PTSD after a traumatic event, getting help early may help reduce this risk.

Your doctor will ask you about your symptoms and whether you have experienced any trauma, and if necessary, work with you to build a mental health treatment plan. This is a plan that maps out your treatment goals and includes the services and resources available to you.

Your doctor may refer you to a psychiatrist or psychologist, who will ask you more about how your symptoms are affecting your life and how much support you have from family and friends. Fees may be higher than the Medicare rebate so it's a good idea to ask about fees and out-of-pocket costs when you book your appointment.

PTSD may be diagnosed if you have a number of symptoms that are severe enough to interfere with your ability to function at work, socially or at home.

Many people have some symptoms of PTSD in the first couple of weeks after a traumatic event, but most recover on their own or with the help of family and friends.

For people whose symptoms last longer, PTSD can be treated with psychological therapies and sometimes medicines. Everyone experiences PTSD differently. Talk to your doctor or mental health professional to decide which treatment options might work best for you.

Psychological therapies for PTSD

Psychological therapies can help teach you how to deal with the traumatic memories and calm your anxiety. There are different types of therapies, including:

• Trauma-focused cognitive behaviour therapy (TF-CBT) — This involves working through memories of the trauma in a safe and structured environment, trying to change unhelpful beliefs and thoughts and gradual exposure to triggers that make you anxious.
• Prolonged exposure (PE) — A type of talking therapy, which involves retelling your trauma memories until they become less distressing.
• Cognitive processing therapy (CPT) — A type of CBT, which focuses on people who are stuck in their thoughts about trauma.
• Eye movement desensitisation and reprocessing (EMDR) — This involves working through memories of the trauma while going through a series of eye movements.

It may take between 8 and 12 sessions to get relief from symptoms.

You can also find an online PTSD treatment course at THIS WAY UP (Opens in new tab).

Medicines for PTSD

Medicine for PTSD may be recommended if your symptoms are more severe. It is often used together with psychological treatment.

The most useful medicines for PTSD are antidepressants. It can take time before they start to work. It's important to be aware of the possible side effects and to maintain regular contact with a doctor or mental health practitioner while you're taking these medicines.

If you or someone you know has experienced a traumatic event, you can help yourself or your loved one cope with the experience and recover from negative feelings.

Strategies which may be helpful:

• Rest, eat a healthy diet and get some exercise.
• Avoid alcohol, smoking and stimulants such as coffee.
• Gradually return to your usual activities.
• Take time to do things you enjoy.
• Spend time with family and friends.
• Talk or write about how you are feeling.
• Limit how much time you spend looking at media coverage of the traumatic event.

Without treatment, PTSD may become chronic and lead to other mental health problems such as depression and anxiety. The sooner treatment begins, the better.

Some people use alcohol or other substances to cope with traumatic memories, which can lead to substance abuse.

PTSD can make people isolated from relatives and friends. It can put great stress on families.

Lifeline (Opens in new tab) is a 24-hour counselling, suicide prevention and mental health support service. Call 13 11 14 for crisis support.

If you need to talk to someone about your mental health, call Beyond Blue (Opens in new tab) on 1300224636. They also offer information on PTSD behaviours, treatments and associated conditions.

Call Medicare Mental Health on 1800 595 212 for advice and to get connected to local mental health services. You can also visit the Medicare Mental Health website for information on trauma and PTSD (Opens in new tab).

Headspace (Opens in new tab) provides mental health assistance for individuals aged 12 to 25 and provides fact sheets specific to young people.

The Australia Government offers resources and contacts (Opens in new tab) for members of the Australian Defence Force (ADF), veterans or their families to access support.

Other languages

You can find information about trauma (Opens in new tab) in plain English and in languages other than English (Opens in new tab) at Blue Knot.

Witness to War (Opens in new tab) is a national multilingual telephone hotline for people affected by overseas conflicts. Anyone across Australia can call for free, on 1800 845 198.