Post-Traumatic Stress Disorder (PTSD): A Doctor’s View, Without the White Coat

Naz Hernandez
1 day ago
12 min read

Trigger Warning — Discussion of Trauma triggers, child loss

I had never experienced true grief before my son died. I had never experienced Post-Traumatic Stress Disorder (PTSD) either. Then suddenly, I had both and could not understand what was happening to me. I began to feel like a mad-woman when hours of time began to disappear. I could not understand how the clock had moved 2 hours in what felt like the space of 20 minutes - my professional doctor brain kicked in. I started to mull it over and the only answer that came to me was I had PTSD.

What causes PTSD?

No, its not only war veterans that get PTSD. Yes, living in a war zone and seeing conflict is a well recognised cause, as is going through or witnessing any traumatic event, such as a car accident, being a victim of violence, difficult child-birth, or going through health problems. Did you know you can suffer from secondary trauma too? First-hand trauma is where you experienced it yourself and second-hand trauma is where a loved one has gone through the experience and you experience it by proxy.

Either can leave you feeling alone, terrified and 'in danger'.

It's important for you to know that although there may be a clearly traumatic 'event', it doesn't have to be. It may seem innocuous to those outside of it, but to you it was a trauma.. After mulling it over endlessly for the past 4 years and asking myself 'why me?' I read that it can stem from a loss of control - this really resonated with me.

My trauma was linked to the sudden diagnosis of a life-threatening heart condition in my 3 month old twin boys, leading to the death of one of them in a short space of time. I remember walking around the hospital crying 'I came with two car seats and now I'm going home with an empty one' (The disbelief will always floor me.) But what specifically made the week's events traumatic for me, was how fast they unfolded and the lack of control I had over everything.

When someone feels trapped, powerless, or unable to escape what’s happening, the brain records the event differently.

As a human, perceived control gives us safety, a sense of purpose and grounding on which we build our self-esteem. When that sense of control is compromised our brain enters an altered state. There is a school of evidence that supports this theory. Research suggests that those who lose a sense of control during a difficult event are more likely to develop PTSD symptoms and interestingly those with perfectionist traits combined with loss of control appear to have more severe PTSD symptoms.

When someone feels trapped, powerless, or unable to escape what’s happening, the brain records the event differently. The survival system switches on full force. Until we can rationalise it and process the events we remain in this survival mode, stuck in a time loop. Or rather, this is how I have rationalised the data for myself.

Put simply PTSD is how the brain reacts when a person is overwhelmed and loses their sense of safety and control. And that can happen to anyone.

So why can two people can live through the same event and only one develops PTSD? A perfect example being my husband and I who lived through the events side by side and lost our son at the end of it. It’s not because one is stronger (he'll be disappointed to know). It’s usually because:

Their sense of control was different
They had different support afterward
They’d already lived through earlier trauma
Their nervous system processed the threat differently

PTSD is not about what “should” be traumatic. It’s about what was traumatic to that person.

Typical vs. Non-Typical PTSD Symptoms

Typical symptoms are the ones that most people would readily recognise. They include flashbacks and nightmares, intrusive thoughts, avoidance of triggers to the event, being jumpy, poor sleep, being angry, feeling detached, the list goes on.

People often describe it as feeling like the danger is still happening, even when they know logically that it’s over. In my own experience, an unexpected repercussion of this sensation was the sudden fear of driving. When I say fear, I mean it was visceral! When in the car, I spent the whole time praying, triple checking before moving, braking needlessly...all unsafe driving practises but borne out of this impending sense that I was at actual risk of dying because someone (who's behaviour I could not control) was going to crash into me.

There are also less typical symptoms that can be overlooked - even doctors sometimes miss them and people find it hard to link it to their trauma directly. These symptoms include emotional numbness, memory gaps around the trauma, physical symptoms such as nausea, digestive problems, headaches, chronic pain. Our behaviours are also changed as people find ways to cope, including addiction or compulsive behaviours, perfectionism and an intense need for control. Then of course we have the really debilitating silent killers, shame and self-blame, feeling 'different' or broken and social withdrawal.

In my own story it was the 'typical' list that sent alarm bells ringing for me to get some help. Now in hindsight I can give a multitude of examples where I had most of the non-typical symptoms listed. In actuality, it was these that truly affected my daily life, quality of interactions and my sense of self. As having practised clinical medicine in the past, I can't stress enough that you need to first consult a doctor to consider the medical causes before putting it down to just trauma. Severe stress and trauma can also trigger a host of other medical problems, including autoimmune conditions, nutritional deficits and hormonal imbalances - these should be excluded first by your GP.

It's important to also know the pattern of your symptoms - anniversaries/milestones related to the events may cause temporary worsening of symptoms or seemingly unrelated life-events such as illness can also worsen symptoms. I find that now, even after treatment anything that triggers an adrenaline response causes me significant panic symptoms and I have had to adjust my threshold for taking part in these activities.

Complex PTSD

Some trauma doesn’t come in a single event — it happens repeatedly or over long periods, often in relationships where the person feels powerless. This can lead to complex or C-PTSD. Symptoms include many of the classic PTSD signs — flashbacks, hypervigilance, avoidance — but also:

Persistent feelings of shame or guilt
Difficulty managing emotions
Trouble trusting others or forming close relationships
Feeling permanently “different” or damaged

C-PTSD is often linked to prolonged abuse or neglect and it can be harder to treat than single-incident PTSD. Recovery is still possible, but it usually requires longer-term therapy, strong support networks, and strategies to help regulate emotions and rebuild trust.

The diagnosis of C-PTSD can become incredibly challenging for doctors, especially as it can be mistaken or overlap with borderline personality disorders (BPD). Also, as our conscious eye opens to the extent and prevalence of neurodiversity in our population, it also brings into question whether those with undiagnosed neurodiversity are more at risk of trauma or being misdiagnosed with BPD due to behavioural coping mechanisms from autistic traits. The current data suggests this is an ongoing area of understanding and development in psychiatry - no conclusions to be made, but many questions.

I can't stress enough that you need to first consult a doctor to consider the medical causes before putting it down to just trauma.

Is PTSD treatable?

Yes yes yes - even decades later.

Not all trauma needs treatment and most traumatic events are often processed appropriately. The sense of danger tends to resolve naturally - a ball-park period of 6-8 weeks was given to me but I think it can take up to a year. If symptoms go on longer or feel unmanageable then there are effective treatments that will help reduce the burden of symptoms.

As unique as humans are, no two people with PTSD will have the same profile of symptoms - nor the same capacity to deal with or process the memories. Reflecting back on my own treatment journey, it took a lot out of me mentally and physically - I needed to schedule time off to get the therapy done and do the work to put 'it' back in the box; enough to allow me to function for my kids and be present at work. Not everyone has the luxury for time off. Sometimes, it takes years to diagnose or simply be ready to face your story. As doctors we see all stages and I would encourage you not to let the 'when' bog you down too much. Take one step, speak to someone you trust about it and see where it goes.

Trauma-Focused Talking Therapies

These are the mainstay of treatment:

Trauma-focused Cognitive Behaviour Therapy (CBT)
EMDR (eye movement desensitisation therapy)

These therapies can help the brain process the memory so it no longer feels like a present danger.

My personal reflection of having experienced EMDR is that it was effective in stopping the uncontrollable symptoms. The dissociations, the out of nowhere desire to leave a room, time blanks etc. Over time I have learnt what happens to my body during stressful situations . Therapy helped me realise why my responses are so heightened. It gives me the knowledge I need to make the right life decisions and reduce the stress on my body. I had to make lifestyle changes and that's a relief now to me.

Medication

Medication is not to be sniffed at. Antidepressants can help reduce anxiety, flashbacks, sleep disturbance and emotional intensity to help you cope with therapy sessions or symptoms in general. It may reduce the likelihood of using other substances, such as alcohol, to calm your nervous system and help you reset. It doesn't mean you take them forever, but it can support you.

Body-Based Approaches

Trauma lives in the nervous system, not just thoughts. Or rather your thoughts trigger your nervous system to react and it becomes like a reflex - your heart rate jumps, you shake, you feel like something terrible will happen. Although we feel we can't control these things, we can help relax our nervous system. Some people benefit from:

Breathing work
Yoga
Grounding techniques

These help teach the body that it is safe again and reduce how strongly the nervous system fires. I like to fill my house with smelling candles and during stressful events it creates a cue to my body that all is OK. Note to self 'If you have time to light a candle you are not in danger (!)'

No treatment works without stability. If someone is still living in danger, recovery is extremely difficult. Safety always comes first. If you are in immediate danger call 999 and press 55 if you don't feel it is safe to talk. I have included a list of helplines for possible trauma situations at the end of this blog.

Maslow's hierarchy of needs is a great way to visualise why getting your GP involved and making sure you are out of danger is so important. I have explained this a little including a diagram in my previous blog

Where do I get this type of therapy?

If you feel immediately overwhelmed and are having dangerous thoughts that put you or others in actual danger call NHS 111 or Samaritans for support. (Call 116 123)

If you live in the England and Wales there are NHS talking therapy lines that you can self-refer to or speak to your GP who can support with referrals. In Scotland there is a NHS telephone CBT service and Northern Ireland there is no universal NHS provision for talking therapies, however your GP may be able to recommend where to find Trauma CBT or EMDR therapy. Ask specifically for Trauma based therapy.

From my own experience, EMDR was life-changing. EMDR does not require you to talk in depth about what happened, which is helpful when things are difficult to voice. The therapy uses eye movements to re-process events and the sessions work on giving you coping mechanisms so you can manage the sense of overwhelm.

There is likely to be a waiting list. So even if you're not sure whether you're ready, it may be worth getting on the list and then rethinking it when you get allocated a therapist.

How to Support Someone With PTSD

As family and friends I can imagine it must be difficult to know how to support someone with PTSD. Perhaps they themselves have not told you they have PTSD but you recognise the symptoms. I have several stories of 'offending' family members when I was trying hard to cope with my own symptoms and behaving out of character. I was never in a state to explain myself and I desperately sought their understanding without having the words. It can be incredibly isolating. Here are some thoughts on what those around us could do to support, whilst acknowledging it is challenging to do so at times.

What Helps

I caveat that we are all individual, but here are some things that would have helped us as a young family having experienced something traumatic.

Listen. Silence is OK and sometimes that is the safety someone needs to feel. The ability to not say anything is a skill. If they do say something that doesn't seem to make sense to you, or feels an overreaction, believe them. Offer patience, it takes a long time to face things so let them set the pace towards recovery. We all want to feel better but if they feel in danger the overwhelm will make things worse, so you can't do anything but be patient. Following on from this, learn their triggers and respect them however silly they appear. Try to recognise when they're overwhelmed and if you know what helps them cope, action it.

Forgive easily. Remember that certain behaviours are out of character, gently encourage them to seek help but do not force it - its a fine balance.

For others such as friends and acquaintances, offering time to talk, sending gifts and food parcels in the immediate and occasional milestone aftermath can be supportive. Gifts for children to help distract them and give the parents space to rest is a great way to support too.

What Often Hurts (Even if Said Kindly)

“You should be over this by now”
“Others have been through worse”
“Just think positively"
“It was years ago”
"You are so strong to survive"

PTSD doesn’t respond to logic. It responds to safety, patience, and trust.

Supporting someone with PTSD is not about fixing them. It’s about standing beside them while they heal.

Its OK if you can't understand it, but do give the person space to figure it out by themselves. Offer them a pause on expectations until they are ready to be subject to them again.

Life After PTSD?

This is one of the hardest questions, and one of the most hopeful. Does PTSD always disappear completely? Not always. Does life still get better? Very often — yes.

Many people reach a point where they can control their symptoms.

Flashbacks stop
Sleep improves
Anxiety quietens
Relationships feel possible again
Joy returns in small, real ways

Some carry scars — certain sensitivities, limits, or triggers. But they no longer live inside the trauma. The trauma becomes part of their story, not the whole story.

Recovery doesn’t always mean going back to who you were before. The grief that comes with losing your former self will happen too. Sometimes it means becoming someone new — shaped by survival, not defined by it.

I know you wouldn't have chosen this for yourself but it can get better and you will go further than you think.

References

Posttraumatic stress, uncontrollability, and emotional distress tolerance. (n.d.). PubMed Central. https://pmc.ncbi.nlm.nih.gov/articles/PMC6161595/
Perfectionism and perceived control in posttraumatic stress disorder symptoms. (n.d.). PubMed.
Psychological and environmental correlates of locus of control and post-traumatic stress symptoms: A latent profile analysis. (n.d.). PubMed Central.
Relationships between neurodivergence status and adverse childhood experiences, and impacts on health, wellbeing, and criminal justice outcomes: Findings from a regional household survey in England. (n.d.). BMC Medicine.
Kushner, M. G., Riggs, D. S., & Foa, E. B. (1993). Perceived controllability and the development of PTSD in crime victims. Journal of Traumatic Stress, 6(4), 507–517.
Hancock, J. T., & Bryant, R. A. (2018). Perceived control and avoidance in post-traumatic stress. Journal of Behavior Therapy and Experimental Psychiatry, 60, 57–63.
Maier, S. F., & Seligman, M. E. P. (1976). Learned helplessness: Theory and evidence. Journal of Experimental Psychology.
Lewis, C. et al. (2020). Dropout rates from psychological therapies for PTSD. Journal of Anxiety Disorders.
Van der Kolk, B. (2014). The Body Keeps the Score. Penguin Books.
American Psychiatric Association. (2022). DSM-5-TR: Diagnostic criteria for PTSD.
NHS. (2024). Post-traumatic stress disorder (PTSD): Overview, symptoms, causes and treatment. https://www.nhs.uk/mental-health/conditions/post-traumatic-stress-disorder-ptsd/
NICE. (2018, updated). Post-traumatic stress disorder (NG116): Diagnosis and management. https://www.nice.org.uk/guidance/ng116
Oxford Health NHS. (n.d.). Specialist Psychological Interventions Centre – PTSD and trauma treatment services. https://www.oxfordhealth.nhs.uk/ohspic/problems/ptsd/
Mind UK. (2023). Understanding PTSD and Complex PTSD. https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd/

Immediate Danger / Emergencies

999 – Police, Ambulance, Fire. Use if life is at risk.
Silent Solution – If you cannot speak safely when calling 999, press 55 to alert police.

Mental Health Crisis

Samaritans (24/7, free) – 116 123
NHS 111 (England, Wales, Scotland) – urgent health/mental health support (press 2 for mental health in Wales).
Samaritans Scotland / Breathing Space – 0800 83 85 87 (Mon–Thu 6 pm–2 am, Fri–Mon 6 pm–6 am)
Shout Crisis Text Line – text SHOUT to 85258 (24/7, free)

Domestic Abuse / Sexual Violence

National Domestic Abuse Helpline (Refuge) – 0808 2000 247 (24/7)
Men’s Advice Line – 0808 801 0327
Rape Crisis UK – 0808 802 9999

Child & Young Person Support

Childline – 0800 1111 (under 19, 24/7, free)
NSPCC Helpline – 0808 800 5000

Other Specialised Supports

CALM (men’s mental health, 5 pm–midnight) – 0800 58 58 58
Frank (substance misuse help) – 0300 123 6600

About Naz

I’m a former doctor with a background in palliative care, geriatrics and general medicine. I am now exploring life through writing and reflection. I write about grief, loss, healing, and living life with two children and a husband. I share my personal journey in the hope it helps others feel seen, understood, and a little less alone.

We started our not-for-profit, Cafelias, in memory of Elias, our son. Our aim is to help reduce the isolation of being a special needs parent, child loss and being a disability family. Did you know we also run weekly groups for SEND children in partnership with OXFSN? click the link to find out more.