Health condition · Clinically reviewed
PTSD, post-traumatic stress disorder — trauma-focused evidence-based care.
A specific response to trauma with intrusion, avoidance, negative mood and hyperarousal. First-line treatments are trauma-focused CBT and EMDR — with medication as adjunct.
Why trust this guide
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Clinically reviewed
Written by our editorial team and reviewed by a registered UK clinician before publication.
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Sourced from guidance
Checked against NICE, Royal College of Psychiatrists and peer-reviewed sources you can see at the end.
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Current for 2026
Reflects current UK guidance on trauma-focused CBT, EMDR and stepped-care pathways.
Key facts
PTSD at a glance.
The essentials, in plain English — what PTSD is, when it’s diagnosed, and how it’s treated in the UK today.
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What it is
A specific response to trauma with four symptom clusters — intrusion, avoidance, negative mood and hyperarousal.
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When it’s diagnosed
Formally diagnosed when symptoms persist for at least one month after the traumatic event.
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Complex PTSD
A related diagnosis that follows repeated or prolonged trauma — with additional difficulties in emotion, self-concept and relationships.
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First-line treatment
Trauma-focused CBT (TF-CBT) and EMDR are first-line psychological therapies.
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The first month
Watchful waiting is appropriate in the first month after trauma — many people recover naturally.
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Role of medication
Medication is an adjunct — not a replacement for trauma-focused therapy.
Why this guide matters
Trauma isn’t the end of the story.
PTSD is treatable — with therapies that have decades of evidence. The three points below shape everything else on this page.
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PTSD is treatable
Trauma-focused CBT and EMDR help most people who complete a course — and many recover fully.
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The first month matters
Watchful waiting is right in the first month — many people recover naturally with support.
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Therapy comes first
Medication is an adjunct, not a substitute — trauma-focused therapy is the treatment PTSD actually responds to.
How the diagnosis is made
From first conversation to a clear plan.
The steps a UK GP or mental health service will normally follow, in order — so you know what to expect and why.
Phase 1 · Recognising
Trauma history and symptom score
Phase 2 · Confirming
Concurrent conditions and cultural context
Phase 3 · Managing
Trauma-focused referral and safety plan
- 01
Recognising
Trauma history
A sensitive, paced interview about the traumatic event or events — you set the pace and can stop at any point.
- 02
Recognising
PCL-5 questionnaire
A validated symptom checklist that maps onto the four PTSD symptom clusters.
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Confirming
Concurrent conditions
Screening for depression and substance use, which often travel with PTSD and shape the treatment plan.
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Confirming
Cultural context
Understanding how trauma, help-seeking and healing are viewed in your own context — this shapes what treatment will feel right.
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Managing
Trauma-focused referral
Referral to a therapist trained in TF-CBT or EMDR — the two evidence-based first-line therapies.
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Managing
Psychiatry input if severe
For severe symptoms, dissociation, or where medication is being considered alongside therapy.
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Managing
Structured safety plan
A written plan for managing crisis moments, flashbacks and suicidal thoughts — with named contacts and clear steps.
Typical timeline: 4–8 weeks from first appointment to a trauma-focused plan.
Symptoms
What PTSD actually feels like.
PTSD shows up in four clusters — intrusion, avoidance, negative mood and hyperarousal — plus common accompaniments. Here’s what to look for, and when to seek urgent help.
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Intrusion
Flashbacks, nightmares and unwanted memories — the trauma feels present, not past.
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Avoidance
Avoiding people, places, conversations or reminders linked to the trauma.
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Negative mood and beliefs
Persistent low mood, guilt, shame, or beliefs like ‘I can’t trust anyone’ or ‘the world isn’t safe’.
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Hyperarousal
Feeling constantly on edge, easily startled, irritable, or struggling to sleep.
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Dissociation
Feeling detached from yourself or your surroundings, or gaps in memory around the trauma.
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Substance use to cope
Using alcohol, drugs or other substances to numb symptoms — common, and treatable alongside PTSD.
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Suicidal ideation
Thoughts of suicide are more common in PTSD — please tell someone. See the red-flags section for support numbers.
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Red flag
Suicidal thoughts with a plan — please seek same-day help. Numbers are listed in the red-flags section.
Treatment
How PTSD is treated in the UK.
Trauma-focused therapy first, medication where it helps — what each option does, and when it fits.
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Trauma-focused CBT (TF-CBT)
A structured, time-limited therapy that processes the traumatic memory and reshapes the beliefs it created — first-line for PTSD.
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Eye Movement Desensitisation and Reprocessing (EMDR)
Uses guided eye movements alongside trauma recall to reduce the emotional charge of the memory — first-line, and often quicker than TF-CBT.
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Prolonged exposure therapy
A form of trauma-focused CBT that involves repeated, controlled retelling of the trauma to reduce its power.
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SSRI (sertraline, paroxetine)
The two SSRIs with the strongest evidence in PTSD — used as an adjunct to therapy, or where therapy is not accessible.
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Prazosin for nightmares (specialist)
An off-label option for trauma-related nightmares, prescribed by a specialist and monitored carefully.
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MDMA-assisted therapy (specialist trials only)
An emerging option available only within specialist clinical trials — not routine NHS care.
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Group therapy
For specific groups such as veterans or survivors of shared events — the shared context can be powerful.
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Substance-use co-treatment
Where alcohol or drug use is part of the picture, integrated treatment addresses both together rather than in sequence.
What this guide is based on
The sources behind every statement on this page.
UK national guidance and specialist society standards, current at the time of last review.
Key references
Guidelines and standards we relied on.
A quiet reminder
This guide is for information, not medical advice.
Your GP or a mental health professional knows your history and can tell you which parts apply to you. If you’re unsure, ask.
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NICE. Post-traumatic stress disorder (NG116).
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Royal College of Psychiatrists. Patient information on PTSD.
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UK Psychological Trauma Society. Guidance on trauma-focused care.
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Mind. Understanding PTSD and complex PTSD.
Red flags
When to reach out — and where.
These are the moments where PTSD needs prompt attention. If you are in crisis right now, the last item on this list has the numbers to call.
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Suicidal ideation
Any thoughts of suicide — please reach out. Support numbers are at the bottom of this list.
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Complex PTSD with self-harm
Complex PTSD with active self-harm needs prompt specialist input — contact your GP or crisis team.
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Post-partum trauma reactions
Trauma symptoms following birth are common and treatable — perinatal mental health services can help.
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Substance dependence
Where alcohol or drug use has become dependence, integrated support is available — ask for it.
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Dissociative crisis
Prolonged detachment, gaps in memory or feeling unreal — deserves prompt review.
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Postnatal PTSD
A distinct pattern following a traumatic birth — specialist perinatal support is available.
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Refugee or interpreter-dependent care
Trauma-focused therapy can be delivered with a trained interpreter — ask for one.
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Trauma re-experiencing during therapy
If therapy is destabilising rather than helping, tell your therapist — the plan may need adjusting.
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You are in crisis right now
Samaritans 116 123 (24/7, free). NHS 111 (mental health option). Text SHOUT to 85258. In an emergency, call 999 or attend A&E.
Living with it
Recoverable, with the right care.
Four things that make the biggest difference day to day — habits, approach, medication and reviews.
A quiet reminder
Pacing beats pushing, every time.
Trauma-focused work is deliberate — safety, stabilisation and then processing. A therapist you trust makes the pace right for you.
- 01 Habits
Sleep, movement, and steadiness
Regular sleep, gentle movement and predictable routines calm the nervous system and make therapy work better.
- 02 Approach
Pacing beats pushing
Trauma-focused work is deliberate and paced — your therapist will build safety before processing.
- 03 Medication
Adjunct, not replacement
SSRIs can steady mood and sleep enough to make therapy possible — they don’t replace the work of trauma-focused therapy.
- 04 Reviews
Track with PCL-5
Repeating the PCL-5 every few weeks shows progress you can see — and catches regression early.
Frequently asked
Everything we get asked about PTSD.
Quick answers on trauma-focused CBT, EMDR, medication and where to turn in crisis.
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What is PTSD?
PTSD is a specific response to trauma with four symptom clusters — intrusion (flashbacks, nightmares), avoidance, negative mood or beliefs, and hyperarousal — that persist for at least one month after the traumatic event.
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What’s the difference between PTSD and complex PTSD?
Complex PTSD follows repeated or prolonged trauma — often in childhood or captivity. Alongside the PTSD symptoms, there are lasting difficulties in emotion regulation, self-concept and relationships. Treatment is longer and phased.
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Why is watchful waiting recommended in the first month?
Many people recover naturally in the weeks after a trauma. UK guidance recommends watchful waiting and support in the first month, with formal treatment offered if symptoms persist.
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Are TF-CBT and EMDR really both first-line?
Yes — NICE recommends both trauma-focused CBT and EMDR as first-line psychological treatments for PTSD in adults. Your therapist will help you choose based on preference and availability.
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When is medication used?
Medication (usually sertraline or paroxetine) is an adjunct — offered alongside therapy, where therapy is not accessible, or where symptoms need to settle before trauma-focused work can begin. It doesn’t replace therapy.
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What do I do if I’m in crisis?
If you have suicidal thoughts with a plan, or you can’t keep yourself safe — call Samaritans on 116 123, NHS 111 (mental health option), text SHOUT to 85258, or in an emergency call 999 or attend A&E.