Treatment for PTSD usually begins with a detailed evaluation, and a treatment plan is then tailored to your individual needs. It is never too late to ask for help - PTSD is still treatable years after the traumatic event.

Your GP may feel that you would benefit from seeing a counsellor, a community psychiatric nurse, a psychologist or a psychiatrist. The health professionals that you see should always treat you with sensitivity and understanding, and should explain your treatment plan to you clearly. For treatment to be effective, it is important that you and your family understand that PTSD is a medically recognised anxiety disorder that happens to some people after an extremely traumatic experience.

PTSD is often treated with psychotherapy, medication, or a combination of the two.

• Cognitive-behavioural therapy (CBT) includes learning skills that help you to change negative thought processes. It also includes the use of mental imagery of the traumatic event to help you work through the trauma, and to gain control of the fear and distress.
• Eye movement desensitisation and reprocessing (EMDR) - this involves making several sets of side-to-side eye movements while recalling a traumatic incident. This appears to help reduce distress for many with PTSD. EMDR helps you to have more positive emotions, behaviour and thoughts.
• Medications - the most widely used drug treatments for PTSD are the selective serotonin reuptake inhibitor (SSRI) such as paroxetine. These medications may also be prescribed to help reduce associated symptoms of depression and anxiety and help ease sleep. SSRIs should not be prescribed to the under 18s, although fluoxetine can be used if specialist advice is obtained. Benzodiazepines are effective against anxiety, insomnia and irritability, but are now used with great caution because of the high incidence of substance dependence in people with PTSD. These medicines can, however, rapidly relieve any feelings of anxiety triggered by PTSD.

NICE (National Institute for Health and Clinical Excellence) published guidelines (2005) on the treatment of PTSD:

• Mild symptoms of less than four weeks - watchful waiting.
• Everyone else should be offered trauma-focused CBT or EMDR on an individual outpatient basis.
• Children and young people should be offered trauma-focused CBT adapted for their age and circumstances.
• Drug treatments should not be used as a routine first line treatment in preference to trauma-focused psychological treatment, but should be considered in adults who do not wish to take part in psychological treatment.
• Debriefing sessions (single sessions focusing on the traumatic incident) should NOT be routine practice. All disaster plans should have a planned psychological response to a disaster, with health care workers having clear responsibilities agreed in advance.