Living with PTSD



How to get help

Most medical services are accessed via your GP. If you haven't signed up with one, click here and then enter 'GP' and your postcode in the search boxes.

There are some organisations that can help you to get help by contacting your GP for you.

Please remember some basics:
If you are a disabled Veteran, you are supposed to receive priority care (apart from, clinically speaking, cases that are of a more urgent nature than yours).
Your prescriptions for your recognised conditions (if you're getting a War disablement Pension) should be free.

It can be extremely difficult to go and talk to a stranger about the cause of your problems where mental health problems are concerned (it can be the same for physical problems - who wants to get their piles examined?). If you have a friend that you trust, talk to them first and take them with you for some support.

Opening up your inner most pain is difficult ... but it's something that you need to do to take your first steps towards recovery (or being able to live with the condition). If you're a Veteran, chances are that you're used to being the dependable one. Your self expectations are higher than the average civvy. You need to go easy on yourself and realise something important ... we all need help from time-to-time ... and it's okay not to be strong all the time. So let someone help you.

If you're accessing or trying to access services that require you to wait in uncomfortable surroundings that just make you want to go home and lock the rest of the world out - phone them up first and explain to them how going out makes you feel and tell them that you're a Veteran. They should try to make allowances for you in some way.

If you don't have a GP that is empathetic towards your issues, find another one! Your relationship with your GP will affect which support services you will be referred to.

Not all GPs are clued up about Veterans issues, mental health in general or PTSD. You may meet a GP with the bedside manner of an inebriated warthog. Walk away and find someone else - you can ask to be seen by a different GP at the same practice or go to a different health centre.

When you start unscrewing that tight lid that's been keeping your memories and feelings of service hidden, be prepared in case the symptoms worsen temporarily. It's part of the process ... so please hang in there and don't give up.

Avoid booze, smoking, drugs and caffeine. Get yourself down to the gym, go for a run or take up a martial art (the discipline of a dojo is something that will feel familiar). Find other ways to relax when you're at home but don't develop warts on your palm ... I don't think they'll give you priority treatment for them.


What's available?

The NHS are using three main forms of treatment: Medication, CBT and EMDR. These therapies do not work for everyone ... BUT they may work for you. The medication can leave you feeling like a zombie - tread carefully. What works for me? Staying away from people, CBT, creativity and talking with a therapist. You have to find what works for you.

The NHS have to realise that they have to fund other options for treatment - eg just allowing someone to sit and talk, to unwind enough to get back on with living in the rat race for a while before coming back for more. Unfortunately the NHS like to sign off the patient within a prescribed number of sessions. This is partly a funding exercise and doesn't take into account the need of people suffering with PTSD. There are other therapies that need to be explored. You can find out about CBT and EMDR below.

CBT - Cognative Behavioural Therapy

Cognitive Behavioural Therapy  

.CBT leaflet

What is CBT?

It is a way of talking about:

  • how you think about yourself, the world and other people
  • how what you do affects your thoughts and feelings.
CBT can help you to change how you think ('Cognitive') and what you do ('Behaviour'). These changes can help you to feel better. Unlike some of the other talking treatments, it focuses on the 'here and now' problems and difficulties. Instead of focusing on the causes of your distress or symptoms in the past, it looks for ways to improve your state of mind now.

When does CBT help?

CBT has been shown to help with many different types of problems. These include: anxiety, depression, panic, phobias (including agoraphobia and social phobia), stress, bulimia, obsessive compulsive disorder, post-traumatic stress disorder, bipolar disorder and psychosis. CBT may also help if you have difficulties with anger, a low opinion of yourself or physical health problems, like pain or fatigue.

How does it work?

CBT can help you to make sense of overwhelming problems by breaking them down into smaller parts. This makes it easier to see how they are connected and how they affect you. These parts are:
  • A Situation - a problem, event or difficult situation. From this can follow:
  • Thoughts
  • Emotions
  • Physical feelings
  • Actions
Each of these areas can affect the others. How you think about a problem can affect how you feel physically and emotionally.
All these areas of life can connect like this: 5 Areas
What happens in one of these areas can affect all the others.
There are helpful and unhelpful ways of reacting to most situations, depending on how you think about it. The way you think can be helpful - or unhelpful.
An example:
The Situation
You've had a bad day, feel fed up, so go out shopping. As you walk down the road, someone you know walks by and, apparently, ignores you. This starts a cascade of:
Thoughts: He/she ignored me - they don't like me He/she looks a bit wrapped up in themselves - I wonder if there's something wrong?
Low, sad and rejected Concerned for the other person, positive
Physical: Stomach cramps, low energy, feel sick None - feel comfortable
Action: Go home and avoid them Get in touch to make sure they're OK
The same situation has led to two very different results, depending on how you thought about the situation.
How you think has affected how you felt and what you did. In the example in the left hand column, you've jumped to a conclusion without very much evidence for it - and this matters, because it's led to:
  • having a number of uncomfortable feelings
  • behaving in a way that makes you feel worse.
If you go home feeling depressed, you'll probably brood on what has happened and feel worse. If you get in touch with the other person, there's a good chance you'll feel better about yourself.
If you avoid the other person, you won't be able to correct any misunderstandings about what they think of you - and you will probably feel worse.
This 'vicious circle' can make you feel worse. It can even create new situations that make you feel worse. You can start to believe quite unrealistic (and unpleasant) things about yourself. This happens because, when we are distressed, we are more likely to jump to conclusions and to interpret things in extreme and unhelpful ways.
CBT can help you to break this vicious circle of altered thinking, feelings and behaviour. When you see the parts of the sequence clearly, you can change them - and so change the way you feel. CBT aims to get you to a point where you can 'do it yourself', and work out your own ways of tackling these problems.

What does CBT involve?

The sessions
You can do CBT individually or with a group of people, or even a self-help book or computer programme.
In England and Wales, two computer-based programmes have been approved for use by the NHS. Fear Fighter is for people with phobias or panic attacks; Beating the Blues is for people with mild to moderate depression.

If you have individual therapy:

  • You will usually meet with a therapist for between 5 and 20, weekly, or fortnightly sessions. Each session will last between 30 and 60 minutes.
  • In the first 2-4 sessions, the therapist will check that you can use this sort of treatment and you will check that you feel comfortable with it.
  • The therapist will also ask you questions about your past life and background. Although CBT concentrates on the here and now, at times you may need to talk about the past to understand how it is affecting you now.
  • You decide what you want to deal with in the short, medium and long term.
  • You and the therapist will usually start by agreeing on what to discuss that day.
The work
  • With the therapist, you break each problem down into its separate parts, as in the example above. To help this process, your therapist may ask you to keep a diary. This will help you to identify your individual patterns of thoughts, emotions, bodily feelings and actions.
  • Together you will look at your thoughts, feelings and behaviours to work out:
    • if they are unrealistic or unhelpful
    •  how they affect each other, and you.
  • The therapist will then help you to work out how to change unhelpful thoughts and behaviours.
  • It's easy to talk about doing something, much harder to actually do it. So, after you have identified what you can change, your therapist will recommend 'homework' - you practise these changes in your everyday life. Depending on the situation, you might start to:
  • question a self-critical or upsetting thought and replace it with a more helpful (and more realistic) one that you have developed in CBT
  • recognise that you are about to do something that will make you feel worse and, instead, do something more helpful.
  • At each meeting you discuss how you've got on since the last session. Your therapist can help with suggestions if any of the tasks seem too hard or don't seem to be helping.
  • They will not ask you to do things you don't want to do - you decide the pace of the treatment and what you will and won't try. The strength of CBT is that you can continue to practise and develop your skills even after the sessions have finished. This makes it less likely that your symptoms or problems will return.

How effective is CBT?

  • It is one of the most effective treatments for conditions where anxiety or depression is the main problem.
  • It is the most effective psychological treatment for moderate and severe depression.
  • It is as effective as antidepressants for many types of depression.

What other treatments are there and how do they compare?

CBT is used in many conditions, so it isn't possible to list them all in this leaflet. We will look at alternatives to the most common problems - anxiety and depression.

  • CBT isn't for everyone. Another type of talking treatment may work better for you.
  • CBT works as well as antidepressants for many forms of depression. It may be slightly better than antidepressants in helping anxiety.
  • For severe depression, CBT should be used with antidepressant medication. When you are very low, you may find it hard to change the way you think until the antidepressants have started to make you feel better.
  • Tranquillisers should not be used as a long term treatment for anxiety. CBT is a better option.

Problems with CBT

  • CBT is not a quick fix. A therapist is like a personal trainer that advises and encourages - but cannot 'do' it for you.
  • If you are feeling low, it can be difficult to concentrate and get motivated.
  • To overcome anxiety, you need to confront it. This may lead you to feel more anxious for a short time.
  • A good therapist will pace your sessions. You decide what you do together, so you stay in control.

How long will it last?

A course may be from 6 weeks to 6 months. It will depend on the type of problem and how it is working for you. The availability of CBT varies between different areas and there may be a waiting list for treatment.

What if the symptoms come back?

There is always a risk that the anxiety or depression will return. If they do, your CBT skills should make it easier for you to control them. So, it is important to keep practising your CBT skills, even after you are feeling better. There is some research that suggests CBT may be better than antidepressants at preventing depression coming back. If necessary, you can have a "refresher" course.

So what impact would CBT have on my life?

Depression and anxiety are unpleasant. They can seriously affect your ability to work and enjoy life. CBT can help you to control the symptoms. It is unlikely to have a negative effect on your life, apart from the time you need to give up to do it.

How can I get CBT?

  • Speak to your GP. They may refer you to someone trained in CBT - for example, a psychologist, nurse, social worker or psychiatrist.
  • The British Association for Behavioural and Cognitive Psychotherapies keeps a register of accredited therapists.
  • You can try 'self-help' - using a book, internet programme or computerised CBT. This is more likely to work if you also receive support from a professional.

What will happen if I don't have CBT?

It depends very much on the problem. You could:
  • Wait to see if you get better anyway - you can always ask for CBT later if you change your mind.
  • Talk over some alternatives with your doctor.
  • Read more about CBT and its alternatives. (see below). 
  • If you want to "try before you buy", get hold of a self-help book or CD-Rom and see if it makes sense to you.
CHANGE VIEW: 10 key facts about CBT

Change: your thoughts and actions

Homework: practice makes perfect

Action: don't just talk, do!

Need: pinpoint the problem

Goals: move towards them

Evidence: shows CBT can work

View: events from another angle

I can do it: self-help approach

Experience: test out your beliefs

Write it down: to remember progress


Useful CBT web links

Further reading

Reading Well Agency: Books on Prescription
Reading Well Books on Prescription helps you manage your well-being using self-help reading. The scheme is endorsed by health professionals, including the Royal College of Psychiatrists, and is supported by public libraries.
The 'Overcoming' series, Constable and Robinson
Self-help books which use the theories and concepts of CBT to help people overcome many common problems. Titles include: overcoming social anxiety and shyness, overcoming depression and overcoming low self-esteem.

Free online CBT resources

  • MoodGYM: Information, quizzes, games and skills training to help prevent depression
  • Living Life to the Full:  Free online life skills course for people feeling distressed and their carers.  Helps you understand why you feel as you do and make changes in your thinking, activities, sleep and relationships.
  • FearFighter: free access can only be prescribed by your doctor in England and Wales.


For further information contact:

Anxiety UK (formerly National Phobics Society)
Monday to Friday: 9.15 am to 9.00 pm: tel: 08444 775 774; 0161 227 9898; email:
A national registered charity formed 30 years ago by a sufferer of agoraphobia for those affected by anxiety disorders.
Depression Alliance
Helpline: 0845 123 23 20;
Information, support and understanding for people who suffer with depression, and for relatives who want to help. Self-help groups, information, and raising awareness for depression. 

RCPsych logo Produced by the RCPsych Public Education Editorial Board. Editor: Dr Philip Timms.

Main author: Dr Paul Blenkiron

Illustration by Lo Cole:

This leaflet reflects the best available evidence at the time of writing.


Eye Movement Desensitisation and Re-processing

EMDR is an approach to psychotherapy that has been practiced in the US and around the world for the past 20 years.   It integrates many of the successful elements of a range of therapeutic approaches, yet there are aspects of EMDR are unique:  In particular, the therapist leads a patient in a series of lateral eye movements while the patient simultaneously focuses on various aspects of a disturbing memory.  The left – right eye movements in EMDR are a form of “bilateral stimulation.” Other forms of bilateral stimulation used by EMDR therapists include alternating bilateral sound using headphones and alternating tactile simulation using a handheld device that vibrates or taps to the back of the patient’s hands.

EMDR is applicable for a wide range of psychological problems that result from overwhelming life experiences. During the processing of difficult memories, a person who has been abandoned by a spouse may come to realize that she is loveable and no longer be overwhelmed by negative feelings about herself or participate in unproductive behaviors stemming from those feelings. A person fearful of driving due to a terrible car accident in the past, may end the session feeling safe to drive again.

The therapeutic effects of bilateral stimulation were discovered by Francine Shapiro, Ph.D., who grasped their power in psychotherapy.  Dr. Shapiro found—quite by accident—that emotional and behavioral symptoms resulting from disturbing  experiences tend to resolve naturally when a person allows him/ herself to recall various elements of a memory while engaging in bilateral stimulation such as lateral eye-movements.  Dr. Shapiro and her associates developed a number of procedures for coordinating this “dual awareness.”  The procedures have been refined and validated through controlled research at several centers around the world.  Precise and careful use of these procedures can lead to a safe processing of memories, such that the negative thoughts and emotions disappear.

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