Post-traumatic stress disorder (PTSD)
Post-traumatic stress disorder (PTSD) is a mental health condition that can affect anyone. It can develop after a single traumatic event – one that is distressing or stressful. PTSD can also be triggered by repeated trauma such as abuse or bullying. There is some research that suggests that autistic people can develop PTSD symptoms from a wider range of experiences than non-autistic people. PTSD can be successfully treated and, with the right support, most people make a full recovery.
What is PTSD?
PTSD is a condition that anyone can experience, at any age. The NHS describe PTSD as:
'an anxiety disorder caused by very stressful, frightening or distressing events. Someone with PTSD often relives the traumatic event through nightmares and flashbacks. PTSD can develop immediately after someone experiences a disturbing event, or it can occur weeks, months or even years later. People who repeatedly experience traumatic situations, such as severe neglect, abuse or violence, may be diagnosed with complex PTSD.'
Read more about PTSD and complex PTSD on the NHS website.
How do I know if I have PTSD?
The symptoms of PTSD will often be similar for autistic and non-autistic people.
You might be experiencing PTSD if you are:
- reliving a distressing event(s), either awake (flashbacks) or during a nightmare
- avoiding people or places connected to the event(s)
- avoiding talking or thinking about the event(s)
- feeling more alert or on edge (also known as hyperarousal)
- feeling irritable or having angry outbursts.
Why might I experience PTSD?
Some experiences that could be traumatic include:
- physical, domestic and emotional abuse
- serious health problems
- death or harm of a parent or loved one
- severe accidents
- bullying or victimisation by peers
- witnessing or being a victim of a crime.
If you experience traumatic experiences more than once, you might be more likely to develop PTSD.
There is very little research exploring PTSD in autistic people, making it impossible to say how many people might experience it. However, there is some research that suggests autistic people can develop PTSD symptoms for a wider range of reasons than non-autistic people. These could be part of your everyday life, including:
- sensory differences, for example being over or under-sensitive to things such as lighting, noise, or smell
- differences in understanding social situations
- lack of appropriate support
- increased likelihood of mental health issues
- relationship breakdowns.
These wider experiences may not be recognised within the usual signs and symptoms for PTSD. This means some autistic people might not get a PTSD diagnosis and the help they need.
Some research suggests autistic people may experience difficulties in their daily lives, such as social isolation, bullying and not being accepted by their peers. These may be traumatic experiences for autistic people, which could lead or contribute to PTSD symptoms.
How might PTSD affect me?
If you have PTSD you may find it more difficult to manage day-to-day tasks such as cooking, cleaning and looking after yourself. Friendships, relationships and work might also be more challenging and you may be more likely to experience depression.
There is some research to suggest that having PTSD can heighten autistic characteristics and you may feel an increased need for structure and consistency.
Complex PTSD can lead to behaviour that is harmful to you, such as alcohol or drug misuse, self-harm and suicidal thoughts.
PTSD is treatable. If you are experiencing symptoms of PTSD it is important to get support.
How do I get help and support?
If you think you might be experiencing PTSD then speak to your GP. If your symptoms persist for more than four weeks the GP should then refer you to a community mental health team, who can assess what support you may need.
Treatment for PTSD
The treatment for PTSD is the same for autistic and non-autistic people. The NHS and National Institute for Health and Care Excellence (NICE) recommend the following approaches for PTSD:
- trauma focused cognitive behavioural therapy (TF-CBT)
- eye movement desensitization and reprocessing (EMDR) - a psychological treatment that involves recalling the traumatic event in detail, while making eye movements. EMDR is a relatively new treatment - find out more on the NHS website.
There is currently no research into whether these PTSD treatments work for autistic people. Ideally, all treatments should be delivered by a professional with a good understanding of autism. Most importantly, to be accessible and effective, support should be adapted to your specific needs. Visit our Seeking help with mental health page for more advice.
Medication
NICE do not recommend the use of medication for the treatment of PTSD in children or young people. Adults might be prescribed antidepressants such as Paroxetine or Sertraline but only if:
- trauma-focused psychological treatment has not been successful or if you do not want this type of therapy
- psychological treatment would not be effective because there is an ongoing threat of more trauma (such as domestic violence).
Read more about autistic people’s experience of PTSD:
- Laina Eartharcher (2016): Asperger’s / autism + PTSD
- Erin Clements (2020): Recovering From PTSD After Being Bullied as Someone on the Autism Spectrum
- Pooky Knightsmith (2018): My mental health journey – the ups and downs of recovery (personal video)
- Pooky Knightsmith (2018): A hard day – anxiety and flashbacks (personal video)
- Pooky Knightsmith (2018): My experience of EMDR (personal video)
- Pooky Knightsmith (2020): EMDR | The impact of EMDR on my PTSD 18 months later
-
- Campaigns
- Policy
- Training and conferences
- Autism Services Directory: for services and support
- Branches: offering support, information and social activities for autistic adults, children and their families in their local areas
- Community: our online community is a place for autistic people and their families to meet like-minded people and share their experiences
- Good practice guide: for professionals delivering talking therapies for autistic adults and children.
- Guide to asking for reasonable adjustments
-
ResearchAuthor: Haruvi-Lamdan, Nirit et al. (2020)
Title: PTSD and Autism Spectrum Disorder: Co-Morbidity, Gaps in Research, and Potential Shared Mechanisms, (2018)Author: Rumball, Freya et al. (2020)
Title: Experience of Trauma and PTSD Symptoms in Autistic Adults: Risk of PTSD Development Following DSM-5 and Non-DSM-5 Traumatic Life Events, (2020)Author: Jessica Peterson et al. (2019)
Title: Trauma and Autism Spectrum Disorder: Review, Proposed Treatment Adaptations and Future Directions, (2019)Author: Carrigan, Neil & Allez, Kate, (2017)
Title: Cognitive Behaviour Therapy for Post‐Traumatic Stress Disorder in a person with an Autism Spectrum Condition and Intellectual Disability: A Case Study, (2017)Author: Haruvi-Lamdan, Nirit et al. (2020)
Title: Autism Spectrum Disorder and Post-Traumatic Stress Disorder: An unexplored co-occurrence of conditions, (2020)Author: Lobregt-van Buuren, Ella, et al. (2018)
Title: Eye Movement Desensitization and Reprocessing (EMDR) Therapy as a Feasible and Potential Effective Treatment for Adults with Autism Spectrum Disorder (ASD) and a History of Adverse Events, (2018)Author: Hoover, Daniel W. & Kaufman, Joan, (2018)
Title: Adverse childhood experiences in children with autism spectrum disorder, (2018)Author: Kerns, Connor et al. (2015)
Title: Traumatic Childhood Events and Autism Spectrum Disorder, (2015)Author: Kildahl, Arvid Nikolai et al (2020)
Title: “If we do not look for it, we do not see it”: Clinicians' experiences and understanding of identifying post‐traumatic stress disorder in adults with autism and intellectual disabilityAuthor: Rumball F, Antal K, Happé F, Grey N (2021).
Title: Co-occurring mental health symptoms and cognitive processes in trauma-exposed ASD adultsAuthor: Hoover, D., & Romero, E. (2019).
Title: The Interactive Trauma Scale: A Web-Based Measure for Children with AutismAuthor: Rumball, F. (2019).
Title: A Systematic Review of the Assessment and Treatment of Posttraumatic Stress Disorder in Individuals with Autism Spectrum DisordersAuthor: Stack A, Lucyshyn J. (2019)
Title: Autism Spectrum Disorder and the Experience of Traumatic Events: Review of the Current Literature to Inform Modifications to a Treatment Model for Children with AutismProfessional resources
Author: Nice (2019)
Title: Autism spectrum disorder in adults: diagnosis and management, (2019)Author: Nice (2013)
Title: Autism spectrum disorder in under 19s: support and managementAuthor: Nice (2018)
Title: 1.6 Management of PTSD in children, young people and adultsAuthor: Mental Health Foundation,
Title: Post-traumatic stress disorder (PTSD)Author: Mind (2017)
Title: Post-traumatic stress disorderAuthor: Young Minds,
Title: Post-Traumatic Stress DisorderAuthor: Rethink Mental Illness,
Title: Post Traumatic Stress DisorderAuthor: NHS (2018)
Title: Post-traumatic stress disorder, (2018)Author: NHS Inform
Title: PTSD and CPTSD self-help guidePersonal accounts
Author: Laina Eartharcher
Title: Asperger’s / autism + PTSD, (2016)
Source: The Silent WaveAuthor: Erin Clements 05/2020
Title: Recovering From PTSD After Being Bullied as Someone on the Autism Spectrum
Source: The MightyAuthor: Pooky Knightsmith (2018)
Title: My mental health journey – the ups and downs of recovery (personal video)
Source: YouTubePooky Knightsmith (2018)
Title: My experience of EMDR (personal video)
Source: YouTubeAuthor: Pooky Knightsmith (2020)
Title: EMDR | The impact of EMDR on my PTSD 18 months later
Source: YouTube
Related advice and support
Last reviewed and updated: July 2021
You are not alone
Join the community
Our online community is a place for autistic people and their families to meet like-minded people and share experiences.
Visit the community