What is PTSD and complex trauma?
Post-traumatic stress disorder (PTSD) can develop after a single frightening event such as an accident, assault or medical emergency. Complex PTSD (C-PTSD) usually follows prolonged or repeated trauma, often in childhood, and adds difficulties with emotional regulation, self-worth and relationships.
Trauma symptoms overlap with ADHD, borderline personality traits, anxiety and depression, so an accurate, trauma-informed assessment is the foundation of good treatment.
Signs and symptoms
Re-experiencing
- Flashbacks and intrusive memories
- Nightmares
- Intense distress at reminders
Avoidance & numbing
- Avoiding people, places or conversations
- Feeling detached or emotionally flat
- Memory gaps around the trauma
Hyperarousal
- Being constantly on guard
- Startling easily, irritability
- Difficulty sleeping and concentrating
Complex PTSD features
- Difficulty managing emotions
- Persistent shame, guilt or worthlessness
- Difficulty trusting others and sustaining relationships
How we assess PTSD and complex trauma
A 90-minute consultation with a consultant psychiatrist experienced in trauma. We go at your pace; you do not have to describe the trauma in detail to be assessed. We use validated measures such as the PCL-5 and ITQ, screen for dissociation and coexisting conditions, and consider your safety and support network.
You receive a written report within five working days and a treatment plan agreed with you.
How we treat PTSD and complex trauma
NICE recommends trauma-focused psychological therapy as the first-line treatment. Your plan may include:
- Eye movement desensitisation and reprocessing (EMDR)
- Trauma-focused cognitive behavioural therapy
- A stabilisation phase for complex PTSD before trauma processing
- Medication such as sertraline or venlafaxine to reduce symptoms, or prazosin for nightmares
- Treatment of coexisting depression, ADHD or sleep difficulties