Any situation that a person finds traumatic can cause PTSD. These can include:

• serious road accidents
• violent personal assaults, such as sexual assault, mugging or robbery
• serious health problems
• childbirth experiences

PTSD can develop immediately after someone experiences a disturbing event, or it can occur weeks, months or even years later. PTSD is estimated to affect about 1 in every 3 people who have a traumatic experience, but it’s not clear exactly why some people develop the condition and others do not.

Complex post-traumatic stress disorder (PTSD)

People who repeatedly experience traumatic situations, such as severe neglect, abuse or violence, may be diagnosed with complex PTSD. It’s often more severe if the trauma was experienced early in life, as this can affect a child’s development.

Signs and symptoms

Re-experiencing 

This is the most typical symptom of PTSD. This is when a person involuntarily and vividly relives the traumatic event in the form of:

• flashbacks
• nightmares
• repetitive and distressing images or sensations
• physical sensations, such as pain, sweating, feeling sick or trembling

Children may re-enact the traumatic event again and again through their play

Avoidance and emotional numbing

People with PTSD may avoid certain people or places that remind them of the trauma, or avoid talking to anyone about the experience. They try to push memories of the event out of their mind, often distracting themselves with work or hobbies. Some people try not to feel anything at all. This is known as emotional numbing. This can lead to the person becoming isolated and withdrawn, and they may also give up pursuing activities they used to enjoy.

Hyperarousal (feeling ‘on edge’)

Someone with PTSD may be very anxious and find it difficult to relax. They may be constantly aware of threats and easily startled. This state of mind is known as hyperarousal.

Hyperarousal often leads to: irritability, angry outbursts, sleeping problems (insomnia), and difficulty concentrating. PTSD sometimes leads to work-related problems and the breakdown of relationships.

Treatment

• monitoring your symptoms to see whether they improve or get worse without treatment
• antidepressant medicines such as paroxetine or mirtazapine
• trauma-focused cognitive behavioral therapy (CBT). A CBT practitioner helps a client to challenge unhelpful thoughts and behaviours by thinking and talking about them. 
• eye movement desensitization and reprocessing (EMDR). EMDR uses a patient’s own rapid, rhythmic eye movements. These eye movements dampen the power of emotionally charged memories of past traumatic events.