PTSD Care Pathway

Post-traumatic stress disorder (PTSD) can develop after exposure to a traumatic event — something involving actual or threatened death, serious injury, or sexual violence. Not everyone who experiences trauma develops PTSD, but those who do often experience the world as persistently unsafe. The DSM-5-TR defines four symptom clusters: intrusion (flashbacks, nightmares), avoidance (of reminders), negative changes in thinking and mood (guilt, detachment, inability to feel positive emotions), and hyperarousal (hypervigilance, exaggerated startle, sleep disturbance).

PTSD can follow a single event (an accident, assault, or disaster) or result from prolonged or repeated trauma (combat, childhood abuse, domestic violence). Symptoms must persist for more than one month and cause significant distress or functional impairment. Many people experience acute stress reactions after trauma that resolve naturally; PTSD is diagnosed when those reactions don't resolve and instead become entrenched.

Effective, evidence-based treatments for PTSD exist. Prolonged Exposure (PE), Cognitive Processing Therapy (CPT), and EMDR all have strong research support. Medication — primarily SSRIs (sertraline, paroxetine) — can also help. New Hampshire has trauma-informed providers across the state, and the community mental health centers all offer trauma services.