PTSD and Trauma: Understanding What Happens After a Shocking Event
This article is general information published by the practice of Dr. Sholeh Toobaei, Specialist Psychiatrist, Dubai. It has not yet been individually reviewed by a clinician and is not a substitute for personal medical advice. Published: 1 September 2026.
Scope: This article is general information about trauma and PTSD. It is not a diagnosis. Only a proper clinical assessment can determine whether your experiences match PTSD or another trauma-related condition.
What is trauma?
Trauma is not a medical diagnosis — it is an experience. An event, or series of events, that overwhelms a person's ability to cope. The defining feature is not the event itself (though some events are more traumatic than others) but the person's response to it: feeling helpless, terrified, or powerless.
Traumatic events include: accidents, natural disasters, physical or sexual assault, war or combat, witnessing violence, serious medical events, childhood abuse or neglect, and prolonged exposure to distressing information (common in first responders and journalists).
Some trauma is a single event — a car crash, an attack. Some is chronic and repeated — ongoing abuse, living in a war zone, long-term domestic violence. Chronic trauma is generally more difficult to treat because the nervous system has had far longer to adapt to a state of constant alert.
There is also "complex trauma" — exposure to multiple traumatic events, especially in childhood, where the trauma affects the developing brain during critical periods. This is different from PTSD in important ways and often overlaps with what some call complex PTSD.
What happens to the brain during and after trauma?
When danger is imminent, the brain's alarm system activates. The amygdala — the threat-detection centre — fires. The prefrontal cortex — the rational part that can assess whether the threat is real — goes somewhat offline. Your body releases adrenaline and cortisol. Your heart rate increases. Your breathing quickens. Your muscles tense. Your vision narrows. All of this is adaptive — it is designed to help you fight, flee, or freeze in the face of genuine danger.
The problem with trauma is that the alarm system does not always switch back off after the danger has passed. For some people, the brain continues to process the environment as if the danger is ongoing. This is not a weakness. It is a biological adaptation that became stuck.
The person experiences this as: intrusive memories or flashbacks (feeling as if the event is happening again), nightmares, hypervigilance (constantly scanning for threats), being easily startled, avoidance of anything that reminds them of the event, numbing or detachment, difficulty sleeping, irritability, and difficulty concentrating.
What is PTSD?
Post-traumatic stress disorder is diagnosed when these symptoms last more than a month and cause significant impairment. If the symptoms last less than a month, it is called acute stress disorder — which is a normal initial reaction to trauma for many people. Not everyone who experiences trauma develops PTSD. The risk depends on the severity of the trauma, the person's previous experiences, their support system, and their biological vulnerability.
Some people develop PTSD gradually — the symptoms emerge weeks or months after the event, often when a trigger brings the memory to the surface. Some never develop full PTSD but live with milder symptoms for years. Some experience depression and anxiety alongside PTSD. The presentation is highly individual.
What is a flashback?
A flashback is not a memory in the ordinary sense. It is a dissociative state in which the person feels as if the traumatic event is happening right now. It may involve seeing, hearing, or feeling sensations from the event. The person may lose awareness of where they are in the present. Flashbacks can last seconds or hours. They are one of the most distressing symptoms of PTSD because the brain is not distinguishing past from present.
This is why certain smells, sounds, dates, or physical sensations can trigger intense reactions — the brain associated that sensory input with the trauma, and the alarm system fires as if the danger is present.
What treatments work for PTSD?
Trauma-focused psychotherapy is the first-line treatment. Two approaches have the strongest evidence:
Cognitive Processing Therapy (CPT) helps the person identify and challenge unhelpful beliefs related to the trauma — beliefs like "the world is completely dangerous," "I should have known better," or "I am permanently damaged." These beliefs are natural responses to trauma, but they maintain the symptoms by keeping the brain in a state of perceived threat.
Prolonged Exposure (PE) therapy involves gradually and repeatedly recalling the traumatic memory in a safe environment, and gradually approaching trauma-related situations that have been avoided. Over time, the memory loses its emotional charge, and the avoided situations become tolerable again.
Eye Movement Desensitisation and Reprocessing (EMDR) is another evidence-based therapy that involves recalling the trauma while following a therapist's moving finger with the eyes. The mechanism is not fully understood, but the evidence supports its effectiveness for many people.
Medications, particularly SSRIs, can help with PTSD symptoms, especially when combined with therapy. Prazosin, originally a blood pressure medication, is sometimes used to reduce trauma-related nightmares.
A note about debriefing: the old practice of immediately and forcefully processing a traumatic event with others (sometimes called Critical Incident Stress Debriefing) has been shown to potentially worsen outcomes for some people. The current guidance is to offer support without forcing narrative processing, and to let the person's own timeline guide recovery.
What can help in the first weeks after a trauma?
Rest, routine, social support, and time. Most people experience a range of normal reactions after a traumatic event — trouble sleeping, intrusive thoughts, irritability, avoidance — and these usually settle within a few weeks. If they do not, or if they are getting worse, professional help is worth seeking early.
Being kind to yourself matters. You do not need to be "strong." You do not need to process everything right now. But you also do not need to suffer in silence. Trauma affects the brain, and the brain responds to treatment.
When should I seek help?
If you have experienced a traumatic event and your symptoms have lasted more than a month, are getting worse, or are interfering with your ability to function, seek a professional assessment. If you are having flashbacks that make you feel unsafe, or if you are avoiding so many situations that your life has become very restricted, that is also a reason to reach out. Seek urgent help — call 999 (police) or 998 (ambulance) in the UAE, or go to the nearest emergency department — if you are having thoughts of self-harm, if you are feeling unable to keep yourself safe, or if you are experiencing severe dissociation. For non-urgent enquiries, use the appointment request form on this website. This practice does not operate a monitored telephone line, and a message sent through the form may not be read straight away.