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Birmingham and Solihull Mental health NHS Foundation Trust
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Post-traumatic stress disorder (PTSD)

What is a traumatic incident?

A traumatic incident can be anything that is out of the ordinary range of daily events and is deeply distressing to someone. Many things can have this impact. It could be a fire, an accident, a robbery or burglary, an attack, being a witness to a traumatic event such as a death. It can be large scale such as a major disaster involving many people or a personal event involving yourself, friends or family members.

How do people react after a traumatic incident?

The following are some of the reactions you may experience after a traumatic event. 

  • Re-experiencing the trauma in your mind and body.
  • Avoiding things to do with or related to the trauma.
  • Feeling more tense, irritable or over-alert than usual.
  • Feeling depressed, crying.


Post-traumatic stress reactions can affect you in at least four different ways thoughts, emotions, physical sensations and behaviours.

Why do we react so strongly to trauma?

There are many reasons why trauma leaves such a strong impact on us emotionally.

Firstly, it often shatters the basic beliefs we have about life: that life is fairly safe, secure and predictable, that life for us has a particular form, meaning and purpose. It may be that the image that we have of ourselves is shattered, we may have responded differently in the crisis from how we expected or wanted to behave.

Secondly, trauma usually occurs suddenly and without warning. We have no time to adjust to this new experience. It will usually be outside our normal range of experience and we are faced with not knowing what to do or how to behave. You may have felt you were going to die, people around you may have died, you are shocked. In the face of this danger your mind holds on to the memory of the trauma very strongly, probably as a natural form of self-protection to ensure you never get into that situation again. The result of this is that you are left with the posttraumatic reactions described above.

For most people the reactions will have reduced or disappeared within a few weeks but for some people they can continue. For others the reaction does not start immediately after the traumatic event but begins after delay. 

  • Experiencing flashbacks – pictures of the trauma coming into your mind
  • Struggling to concentrate
  • Worrying constantly
  • Blame yourself for all or part of the trauma.
  • Struggling to make decisions
  • Having critical or angry thoughts
  • Racing thoughts
  • Having nightmares
  • Thinking back over the event in particular having “what if…” and “why…” thoughts
  • Isolated and lone
  • Anxious, nervous, terrified or frightened.
  • Feeling guilt or shame about what has happened
  • Tense, uptight, on edge, unsettled
  • Unreal, strange, woozy, detached
  • Depressed, low, at a loss
  • Feeling angry
  • Feeling jumpy and restless
  • Easily startled/on guard
  • Heart races and pounds
  • Chest feels tight
  • Muscles are tense/stiff.
  • Feel tired/exhausted
  • Body aching
  • Feel dizzy, light headed
  • Feel panicky
  • Cry often
  • Stomach churning
  • Unable to sleep
  • Pace up and down
  • Avoid things that remind you of the trauma
  • Struggle to sit and relax.
  • Avoid people.
  • Avoid being alone
  • Are snappy and irritable
  • Spoil relationships
  • Drink/smoke more
  • Depend on others too much