Baseer Maroof, LCSW · Raleigh, NC · Adults 21+
PTSD
Trauma can leave the alarm system stuck on: memories that won’t stay in the past, a body braced for danger, a life that keeps shrinking. Here’s how PTSD works and the treatments with the strongest evidence.
In short
- PTSD is what happens when the body’s alarm system stays switched on after a trauma: memories that intrude, avoidance, a darker view of yourself and the world, and feeling constantly on guard, for more than a month.
- Most people who go through trauma don’t develop PTSD. About 70% of people worldwide report at least one traumatic event; about 6.8% of U.S. adults have PTSD at some point.
- It’s very treatable. Both the VA/DoD (2023) and APA (2025) guidelines put trauma-focused therapies first: cognitive processing therapy and prolonged exposure, plus EMDR.
- The stuck point worksheet on this planet is built on CPT. Use it alongside a therapist.
At a glance
Tap a card to open it.
What it isThe alarm that stays on
After a trauma, nightmares, jumpiness and avoidance are normal for a while. In PTSD they don’t settle. It means symptoms in four areas (intrusion, avoidance, negative changes in thoughts and mood, and arousal) lasting more than a month and getting in the way of life. The four clusters → (National Center for PTSD)
Why it sticksAvoidance and stuck beliefs
Reminders set off the alarm, so you avoid them. Avoidance brings relief, but it also stops the brain from learning that the memory isn’t the event. Beliefs bend too: “it was my fault”, “nowhere is safe”. See the response →
What worksTherapy first
Trauma-focused therapy. VA/DoD strongly recommends CPT, PE and EMDR, and recommends them over medication. APA’s first-line picks are CPT, PE and trauma-focused CBT. (VA/DoD 2023; APA 2025)
When to check with a doctorMedication and sleep
If you’re considering medication, or sleep, alcohol or pain are part of the picture, bring it to your doctor. Sertraline and paroxetine are the two medications FDA-approved for PTSD.
Explore
Seven short pages. If you’re already in CPT, start with the worksheet.
By the numbers
NIMH (National Comorbidity Survey Replication); Kessler et al. 2017 (WHO World Mental Health Surveys, 68,894 people).
Myths
MythMost people who go through trauma end up with PTSD.
Resilience is the most common path. Pooled across 54 studies, about two-thirds of people showed steady functioning after a potentially traumatic event.
Galatzer-Levy et al. 2018
MythIf you froze, you must have gone along with it.
Freezing and shutting down are automatic defence responses, wired in and shared with other mammals. They’re what bodies do when fighting or escaping isn’t possible.
Kozlowska et al. 2015
MythTherapy means retelling every detail, over and over.
Not always. CPT focuses on the beliefs the trauma left behind; writing an account of the event is optional, and outcomes are similar either way.
National Center for PTSD
MythBenzodiazepines are a good treatment for PTSD.
The VA/DoD guideline recommends against them, and APA suggests against alprazolam.
VA/DoD 2023; APA 2025
Sources
All sources, linked9 references⌄
- National Center for PTSD. PTSD and DSM-5. www.ptsd.va.gov/professional/treat/essentials/dsm5_ptsd.asp
- National Institute of Mental Health. Post-Traumatic Stress Disorder (NCS-R statistics). www.nimh.nih.gov/health/statistics/post-traumatic-stress-disorder-ptsd
- Kessler RC et al. (2017). Trauma and PTSD in the WHO World Mental Health Surveys. European Journal of Psychotraumatology, 8(sup5), 1353383. pmc.ncbi.nlm.nih.gov/articles/PMC5632781/
- Galatzer-Levy IR, Huang SH, Bonanno GA (2018). Trajectories of resilience and dysfunction following potential trauma: a review and statistical evaluation. Clinical Psychology Review, 63, 41–55. pubmed.ncbi.nlm.nih.gov/29902711/
- Kozlowska K, Walker P, McLean L, Carrive P (2015). Fear and the defense cascade: clinical implications and management. Harvard Review of Psychiatry, 23(4), 263–287. pmc.ncbi.nlm.nih.gov/articles/PMC4495877/
- Schnurr PP et al. (2024). The Management of Posttraumatic Stress Disorder and Acute Stress Disorder: synopsis of the 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline. Annals of Internal Medicine (2024). doi:10.7326/M23-2757. www.healthquality.va.gov/guidelines/MH/ptsd/PTSD-in-Annals-2024.pdf
- American Psychological Association (2025). Clinical Practice Guideline for the Treatment of Posttraumatic Stress Disorder (PTSD) in Adults. www.apa.org/ptsd-guideline
- National Center for PTSD. Cognitive Processing Therapy for PTSD (for providers). www.ptsd.va.gov/professional/treat/txessentials/cpt_for_ptsd_pro.asp
- National Center for PTSD. Clinician’s Guide to Medications for PTSD. www.ptsd.va.gov/professional/treat/txessentials/clinician_guide_meds.asp
Related on this site