Trauma is a deeply personal experience, whilst some people recover naturally following a distressing event other develop long lasting psychological symptoms that can significantly affect their day to day lives.
One of the most well-known trauma related conditions is Post Traumatic Stress Disorder (PTSD), which is a complex mental health condition that can develop after experiencing or witnessing a traumatic event.
Not everyone who experiences trauma will develop PTSD, by understanding why this happens, can help us appreciate the complexity of trauma and the importance of getting early support, compassionate care, and evidence-based treatments.
Trauma is not defined solely by the event itself but by how the individual experiences it. Events such as serious accidents, military combat, physical or sexual assault, domestic abuse, childhood neglect, natural disasters, medical emergencies, or the sudden loss of a loved one, a pet or a job can all be traumatic.
During a traumatic event the brain activates its survival response, which is often described as fight, flight, freeze, or fawn. This automatic response prepares the body to respond to danger by releasing stress hormones such as adrenaline and cortisol. For many people, these responses settle down once the danger has passed. However, when the brain continues to perceive the threat long after the event has ended, symptoms of PTSD may develop.
PTSD is a mental health condition that can occur following exposure to actual or threatened death, severe injury or sexual violence. Symptoms usually fall into four broad categories:
These symptoms can interfere with relationships, employment, education, and everyday activities often leaving people feeling as though they are on constant alert.
Research has shown that trauma can affect several areas of the brain involved in memory, emotion, and threat detection. The amygdala, which is often described as the brains alarm system, may become overactive, causing individuals to remain highly alert to potential danger. At the same time, the prefrontal cortex, which helps regulate emotions and make rational decisions, may become less effective during periods of stress. The hippocampus which plays a vital role in organising memories may also function differently, contributing to fragmented or intrusive memories commonly experienced in PTSD.
These neurological changes help explain why traumatic memories can feel as though they are happening in the present rather than remaining safely stored as events from the past.
Experiencing trauma does not automatically lead to PTSD; most people will experience at least one traumatic event during their lifetime, yet only a proportion will develop the disorder. Several factors influence vulnerability including:
Protective factors such as supportive relationships, timely interventions, and access to appropriate mental health care can reduce the likelihood of developing persistent symptoms.
Trauma is not always a single event; some individuals can experience repeated or prolonged trauma, particularly during childhood or within abusive relationships.
This type of trauma can contribute to Complex PTSD (C-PTSD) which includes the core symptoms of PTSD alongside persistent difficulties with emotional regulation, self-worth, interpersonal relationships and identity.
Recognising the impact of complex trauma is essential for developing effective person-centred treatment plans that can address both the traumatic memories and their wider psychological effects.
Over recent years, mental health services have increasingly adopted trauma informed approaches, rather than asking "what is wrong with you?" Trauma informed care encourages professionals to ask, "what has happened to you?" This shift recognises that many behaviours, emotional responses, and coping strategies develop as understandable adaptations to overwhelming experiences.
Trauma informed care prioritises safety, trust, collaboration, empowerment, and cultural sensitivity. These principles can help individuals feel more understood rather than feeling judged and help to create an environment where recovery is more likely.
PTSD is a treatable condition, and many people recover with the right support. Evidence-based treatments include trauma focused Cognitive Behavioural Therapy (CBT), Eye Movement Desensitization and Reprocessing (EMDR), medication where appropriate and supportive psychological interventions are. Maintain good sleep, regular physical activity, social connection, and healthy daily routines can also support recovery.
There are emerging treatments which continue to be explored, including Repetitive Transcranial Magnetic Stimulation (rTMS). Research suggests that rTMS may help reduce symptoms such as hyperarousal, intrusive thoughts, and depression in some individuals with PTSD by modulating activity within the brain networks involved in emotion regulation. While evidence is encouraging, further large-scale clinical trials are needed before rTMS becomes a routine treatment for PTSD and is currently considered emerging rather than first line intervention.
Trauma can have a profound effect on the brain, body, and emotional wellbeing, but developing PTSD is not inevitable. Understanding the role trauma plays in shaping psychological responses allows both professionals and the public to approach PTSD with greater knowledge, empathy, and compassion. Recovery is possible, with early recognition, evidence-based treatments and trauma informed support, may individuals are able to process traumatic experiences, rebuild resilience and regain a sense of safety and control over their lives.
Written by Nikki, Birmingham Smart TMS Practitioner
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NHS. (n.d.). PTSD (post-traumatic stress disorder). NHS.
World Health Organization. (2026). ICD-11: Complex post traumatic stress disorder (6B41). International Classification of Diseases, 11th Revision.
International Society for Traumatic Stress Studies. (2018). ISTSS prevention and treatment guidelines. ISTSS.
Kan, R. L. D., Zhang, B. B. B., Zhang, J. J. Q., & Kranz, G. S. (2020). Non-invasive brain stimulation for posttraumatic stress disorder: A systematic review and meta-analysis. Translational Psychiatry, 10, 168.