PTSD
PTSD is when the mind stays on high alert after a frightening event: flashbacks, nightmares, avoiding reminders, feeling on edge. It’s common, it’s not a sign of weakness, and trauma-focused therapy works well.
The PTSD ladder
Strong reactions in the first few weeks are normal and often ease. If they last beyond a month, trauma-focused therapy is the main treatment. Medicines help when therapy isn’t available, isn’t wanted or isn’t enough.
- Step 1 · Self-careSupport and watchful waiting (first month)Practical help, people you trust, routine, sleep, and a check-in with your GP if you’re struggling.
- Works
- Not tested as a treatment, but most people’s distress eases over the first weeks without one
- Cost
- Free
- How long
- About 4 weeks, then review if symptoms are still there
- Watch for
- Leaning on alcohol or drugs, or avoiding more and more of life
You don’t have to tell the story to everyone. Or anyone, yet.
- Step 2 · Self-careGP visit and guided online CBTYour GP checks for depression, sleep and alcohol problems, can write a mental health treatment plan, and can prescribe free online programs such as THIS WAY UP or MindSpot.
- Works
- Moderate drop in symptoms vs a waiting list in small trials; low-quality evidence, and works best with clinician support
- Cost
- GP visit often bulk billed or about $40–80 gap; online programs free with a clinician’s referral
- How long
- About 8 weeks for MindSpot; THIS WAY UP is 8 modules over a few months
- Watch for
- Some modules can stir up memories. Not designed for childhood or complex trauma
Therapy in your pyjamas, with someone checking you’re okay.
- Step 3 · Allied healthTrauma-focused therapyThe first-choice treatment: trauma-focused CBT, cognitive processing therapy, prolonged exposure or EMDR with a trained psychologist or therapist.
- Works
- About 2 in 3 no longer have PTSD after a course, vs about 1 in 8 on a waiting list. Around half in veterans
- Cost
- About $200–300 a session; Medicare pays back about $100–150 for up to 10 sessions a year with a GP mental health treatment plan. Free for eligible veterans through DVA or Open Arms
- How long
- Usually 8–12 weekly sessions, sometimes more
- Watch for
- Feeling worse for a session or two before it gets better. Ask your therapist about their trauma training
The memory doesn’t vanish. It just stops running the show.
- Step 4 · PrescriptionAntidepressant medicine (sertraline, paroxetine, fluoxetine or venlafaxine)When therapy isn’t available, isn’t wanted or isn’t enough, or when depression is also present.
- Works
- About 6 in 10 improve, vs about 3 to 4 in 10 on a dummy treatment
- Cost
- Generics under the $25 PBS co-payment, about $20–25, when PBS-listed for you (such as with depression); for PTSD alone it may be a private script, about $20–40 a month
- How long
- 4–8 weeks to work; if it helps, usually continued for at least 12 months
- Watch for
- Nausea, sleep changes, sexual side effects. Under 25s: watch for worsening mood early on. Don’t stop suddenly
Not a personality transplant. Just turns the alarm down a notch.
- Step 5 · SpecialistPsychiatrist or specialist trauma serviceFor severe or complex PTSD, when two treatments haven’t helped, or when there’s risk, psychosis or heavy substance use.
- Works
- Not a trial question: reviews the diagnosis and medicines and coordinates more intensive care
- Cost
- Private psychiatrist about $300–600 for a first visit, with partial Medicare rebates; public mental health services are free
- How long
- Waits can be weeks to months
- Watch for
- Long waitlists. Keep seeing your GP and therapist while you wait
Join the queue now. Future you will thank you.
- Step 6 · SpecialistDay programs and intensive treatmentStructured group programs over several weeks, such as PTSD treatment groups, STAIR (skills for emotions and relationships), CBT or ACT, often at private hospitals.
- Works
- Promising results in studies, but few fair comparisons with standard therapy
- Cost
- Often covered by private hospital cover that includes psychiatric care (check waiting periods and excess). DVA funds eligible veterans
- How long
- Usually 1–2 days a week for several weeks
- Watch for
- You need a referral from a GP or psychiatrist. Check eligibility and your fund cover first
Group therapy: harder to cancel, easier to keep going.
Save your money
Popular, heavily marketed or often asked about, but the evidence is weak or says no.
- Single-session debriefing straight after traumaGoing over the event in detail in one session doesn’t prevent PTSD, and one trial found more PTSD a year later. Practical support and kindness are fine.
- Benzodiazepines (such as diazepam or alprazolam)Don’t treat PTSD, may raise the chance of developing it after a recent trauma, and can cause dependence. Guidelines advise against them.
- Medicinal cannabis and CBDA large 2026 review found it no better than a dummy treatment for PTSD, and guidelines advise against it. Expensive, too.
- MDMA-assisted therapy (for now)Early trials look promising, but US regulators said in 2024 the data weren’t enough. In Australia it averages about $20,000 and very few psychiatrists can offer it. Watch this space.
- “Stress” and “trauma” supplementsNo good trials in PTSD. The label is calmer than the evidence.
What you can do
- Keep a routine: regular meals, movement and the same wake-up time, even after a bad night.
- Stay connected to people you trust. You don’t have to talk about the trauma to feel less alone.
- Go easy on alcohol and drugs. They numb things tonight and make PTSD worse over time.
- For a surge of panic: breathe in slowly, then out slowly while saying “calm”, for a few minutes.
- Supporting someone? Listen, don’t push for details, and help with the practical stuff.
See your GP if
- Flashbacks, nightmares, avoidance or feeling on edge last more than a month after a trauma
- Symptoms affect your sleep, work, study or relationships, at any stage
- You’re using alcohol, drugs or gambling to cope
- Low mood, anger or guilt won’t lift, or you feel cut off from people
- Childhood or past trauma is still affecting you now, even years later
If you’re thinking about suicide or are unsafe, call 000 (Australia) or your local emergency number. From a mobile, 112 works in most countries. For support any time, call Lifeline on 13 11 14 (24/7). Aboriginal and Torres Strait Islander people can call 13YARN on 13 92 76 (24/7). Veterans and their families can call Open Arms on 1800 011 046 (24/7). Outside Australia, find a free helpline at findahelpline.com.
Common questions
What are the symptoms of PTSD?
Unwanted memories, flashbacks or nightmares about the event; avoiding reminders; feeling numb, guilty, angry or cut off; and feeling on edge, jumpy or unable to sleep or concentrate. PTSD is considered when these last more than a month and get in the way of life.
Is PTSD only something soldiers get?
No. Anyone can develop PTSD after a frightening event, such as an assault, a car crash, a disaster, a difficult birth or abuse. About 5 to 10 in 100 Australians have PTSD at some point in their lives.
Can PTSD be treated years after the trauma?
Yes. Trauma-focused therapy and medicines can work even when the trauma happened long ago. It is never too late to get help.
Do I have to talk about the trauma in detail?
Trauma-focused therapy does involve working with the memory, because that is what helps it lose its power. You go at a pace agreed with your therapist, who helps you feel safe first. EMDR involves less talking than other therapies.
Helpful resources
- Phoenix Australia: Your recoveryAustralia’s national centre for posttraumatic mental health. Plain-English info on PTSD and treatments, self-help tips, and guides for family and friends. Free.
- THIS WAY UP Post-Traumatic Stress Program8-module online CBT course for trauma in adulthood. Free with a referral from your GP or psychologist, who keeps an eye on progress. Australia.
- MindSpot PTSD CourseFree 8-week online CBT course with optional weekly therapist support. Adults in Australia; good if face-to-face help is hard to reach.
- Blue Knot HelplineTrauma-specialist phone support for adults affected by childhood trauma or abuse, and the people supporting them. 1300 657 380, 9 am–5 pm, 7 days. Australia.
- Medicare Mental Health phone serviceFree advice and referral to local mental health services on 1800 595 212 (weekdays). Formerly Head to Health. Not a crisis line. Australia.
Evidence and more information
- Phoenix Australia: Australian PTSD Guidelines
- NICE: Post-traumatic stress disorder (NG116)
- VA/DoD PTSD guideline (2023): medicines summary
- Smolenski et al, JAMA Psychiatry 2025: loss of PTSD diagnosis with treatment
- Cochrane: Psychological therapies for chronic PTSD in adults (2013)
- Cochrane: Internet-based CBT for PTSD in adults (2018)
- Cochrane: Medicines for PTSD (2022)
- Cochrane: Psychological debriefing for preventing PTSD
- Guina et al 2015: Benzodiazepines for PTSD, systematic review
- University of Sydney: Lancet Psychiatry review of medicinal cannabis (2026)
- DVA: Free mental health care for veterans
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