PTSD

What is Posttraumatic Stress Disorder (PTSD)?

PTSD is a condition that can develop after experiencing or witnessing a traumatic or deeply distressing event. It happens when the brain’s normal recovery process becomes overwhelmed, leaving you feeling unsafe, on edge, or pulled back into moments from the past. It affects thoughts, mood, sleep, and the sense of safety. PTSD is not a personal failure — it’s a natural response to an overwhelming experience. With the right support and evidence-based treatment, people can heal, rebuild a sense of safety, and regain control of their lives. Loffty helps you understand your symptoms and connects you with pathways toward recovery.

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PTSD Symptoms

Core symptoms

• Re-experiencing: intrusive memories, nightmares, flashbacks; strong distress or body reactions to reminders.
• Avoidance & emotional numbing: steering clear of reminders, withdrawing from activities/people, feeling detached, guilt or hopelessness, memory gaps for parts of the event.
• Hyperarousal: feeling constantly “on edge,” jumpy or hyper-alert, sleep problems, irritability, poor concentration.

How it may feel day-to-day

• Trouble sleeping and focusing at work/school; conflict with partners/friends.
• Avoiding places/activities(e.g., driving after a crash), which can limit life and independence.
• Feeling unsafe and constantly scanning for danger; easily startled by noises or movements.

When to seek help:

• Symptoms last > 1 month or interfere with work, school, or relationships.
• You’re avoiding important parts of life due to fear or reminders.
• Alcohol/drug use increases to cope.
• Thoughts of self-harm or suicide - seek urgent help (see Throughline).

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How Do You Assess for PTSD?

Assessing for PTSD is difficult because there are so many overlapping symptoms with other mental health conditions. If you use a PTSD only assessment tool like a PCL-5 (PTSD Checklist), CAPS-5 (Clinician-Administered PTSD Scale), PC-PTSD-5 (Primary Care PTSD Screen), or IES-R (Impact of Event Scale-Revised), then you risk missing a differential diagnosis of other conditions with similar symptoms. Formal diagnosis should therefore involve a few steps:

• Start with a broad multi-condition mental health screen: Multi-condition tools, like Loffty, are better than single-disorder checklists at determining if your symptoms are related to another condition like Panic, Agoraphobia, or Social Anxiety, that have overlapping symptoms but without a qualifying traumatic event or without re-experiencing.
• Share your comprehensive assessment report with a psychologist who specialises in the condition(s) you have been assessed with. They will begin working with you to help with the specific challenges you are facing. They will also rule out Adjustment Disorder or Acute Stress Disorder (if timing and/or severity differ).
• Getting a formal diagnosis: In some countries, you can get a formal diagnosis from a primary care practitioner (GP, family physician, mental health nurse, psychologist); in others, you must be referred to a psychiatrist who can diagnose and prescribe. We recommend you follow the care pathway recommended in your country.

What to bring to an appointment:

• A brief timeline of the event(s) and current symptoms/triggers.
• Medications/substances used(including alcohol).
• How symptoms affect work/study/home life.
• Past treatments and what helped.
• Support people you’d like involved.

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How Do You Treat PTSD?

The good news is that PTSD is treatable. First-line care is trauma-focused talk therapy. Often care is multimodal, involving lifestyle changes, therapy and sometimes medication, depending on symptoms and preferences.

Lifestyle

• Sleep, movement, nutrition: regular routines, gentle exercise, and limiting caffeine/alcohol can reduce arousal.
• Social connection: lean on trusted people and peer support; avoid using substances to cope.
• Self-management tools: mood/sleep tracking, grounding/breathing exercises, psychoeducation resources. sleep/wake times, wind-down routine.

Talk Therapy

• Trauma-focused CBT: includes psychoeducation, exposure (imaginal & in-vivo), cognitive restructuring, de-arousal skills, and relapse prevention. Typical courses involve about 8–12 sessions; complex cases may need more.
• EMDR (Eye Movement Desensitisation and Reprocessing): structured recall of traumatic memories while tracking bilateral stimuli; effective in multiple trials and endorsed by US/UK/AU guidelines(often alongside in-vivo exposure).
• Skills-based options: stress inoculation/relaxation/anger control can help, but are generally less effective than CBT/EMDR when used alone.
• After mass trauma: brief CBT or“psychological first aid” may be offered early; single-session debriefing is not recommended.
• What a session may include: learning about trauma responses, gradual facing of reminders in a safe/structured way, skills for sleep/anger, and work on beliefs like guilt or shame.

Medication

Anxiety medications reduce anxiety while you build durable skills in therapy; they don’t “cure” anxiety.

Medication classes (generic examples, discuss locally with a prescriber):

• Antidepressants (SSRIs/SNRIs): can reduce core symptoms; often used when therapy isn’t available or as adjuncts. Guidelines note they’re helpful but, on average, less effective than trauma-focused therapy and relapse can occur after stopping. Typical courses may continue for approximately 12 months before slowly tapering off the medication.
• Benzodiazepines: not recommended for PTSD monotherapy as alone they don’t improve re-experiencing/avoidance, and there is a risk of dependence and symptom return after discontinuation.
• Combining therapy and meds: there is limited evidence for added benefit over CBT alone, though adding CBT can help those already on medication
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Prescribing pathways (who can prescribe anxiety medications) differ in different countries, so please follow local guidelines.

Other Treatments

• Group programs/peer support and guided e-therapy/tele-CBT can expand access, especially after mass trauma; early evidence is promising.
• Not recommended/limited evidence: single-session psychological debriefing; generic supportive psychotherapy alone; stand-alone relaxation without trauma focus.
  
  

PTSD Research

State of the evidence:
Trauma-focused CBT and EMDR produce the most consistent results. Antidepressants can help, but are generally less potent than therapy for core PTSD symptoms.

Key themes:

• Neurobiology: The amygdala (threat learning) and prefrontal cortex (safety learning/extinction; controllability of stress) are central; individual differences and gene–environment interplay likely shape risk.
• Memory processes: Research explores weakening fear memories and strengthening “safety” memories.
• ‍Personalised care: efforts to identify who benefits most from specific interventions and how to prevent PTSD after trauma.
• Digital delivery and early interventions: internet/phone-assisted CBT and improved screening after mass trauma show promise but need more trials.
  

Methodology caveats: many studies use select samples (e.g., veterans, clinic-referred), variable measures/timelines, and may not capture diverse cultural contexts, so real-world outcomes can differ.

Books and Resources about PTSD

• B. van derKolk (2014) The Body Keeps the Score. Trauma, body, and healing (read critically; complements, not replaces, evidence-based care).
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• P. Resick et al. (2016) Cognitive Processing Therapy for PTSD. Clinician-focused, helps patients understand CPT steps.

• M. Williams (2022) Getting Unstuck from PTSD. Workbook-style coping tools.
  
  

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