Summary

• Trauma is an experience and a response. PTSD, which means post-traumatic stress disorder, is a defined mental health condition. They are not interchangeable.
• Common PTSD symptoms include intrusive memories, nightmares, avoidance, feeling detached, hypervigilance, sleep disruption and strong physical reactions to reminders.
• Complex PTSD includes the core features of PTSD plus persistent difficulties with emotional regulation, self-worth and relationships.
• Trauma can overlap with anxiety, panic, depression, obsessive thoughts, addictions, emotional eating, disordered eating, gut symptoms, chronic pain, fatigue and relationship distress. Association does not mean that trauma is the only cause.
• Effective care begins with safety, assessment and collaborative pacing. Nobody should be pushed into detailed trauma processing before they are ready.
• Guidelines recommend trauma-focused psychological therapies as first-line treatment for diagnosed PTSD. Counselling, Psychotherapy, Clinical Hypnotherapy, Clinical Medical Hypnotherapy, RTT and Registered Nutritionist Services may each have different roles within an individual care plan.
• Recovery is possible, including when symptoms have been present for years.

Immediate safety: If you or someone else is at immediate risk of harm, phone 112 or 999, or go to the nearest emergency department. The HSE urgent mental health guidance explains the options available in Ireland.

1. Trauma, PTSD and Complex PTSD Are Not the Same

After something frightening, violating, overwhelming or life-threatening, your mind and body may react strongly. In the early days, disturbed sleep, jumpiness, tearfulness, anger, numbness, poor concentration and repeated thoughts about the event can be understandable stress responses. Many people gradually improve without developing PTSD.

A large World Mental Health Survey analysis found that 70.4 per cent of respondents had experienced at least one potentially traumatic event, while lifetime PTSD affected 3.9 per cent of the total sample and 5.6 per cent of people exposed to trauma.⁵ The important message is that trauma exposure is common, but PTSD is not inevitable. Risk is shaped by the type and duration of the event, earlier experiences, current safety, social circumstances, physical health and access to appropriate care.

The HSE description of PTSD symptoms groups common difficulties into re-experiencing, avoidance and emotional numbing, and hyperarousal.² The HSE also explains that complex PTSD may follow repeated experiences such as violence, neglect or abuse and may involve shame, emotional regulation difficulties, dissociation and relationship problems.³

You do not have to decide which label fits. A competent assessment looks at what happened, what you experience now, how long it has been present, how it affects your life and whether another physical or mental health condition could better explain part of the picture.

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2. PTSD Symptoms Can Be Emotional, Cognitive, Physical and Behavioural

Some trauma symptoms are unmistakable. Others look like insomnia, anger, perfectionism, people-pleasing, workaholism, digestive distress or a sudden reliance on alcohol, food, gambling, smoking, vaping, drugs, pornography, sex, shopping or constant scrolling.

Re-experiencing and trauma triggers

• Unwanted memories, images or sensations
• Flashbacks or moments when the event feels present again
• Nightmares or fear of going to sleep
• Intense distress after a smell, voice, date, message, location, medical setting or interpersonal conflict
• Racing heart, nausea, trembling, sweating, pain or breathlessness in response to reminders

Avoidance and disconnection

• Avoiding people, places, conversations, news, appointments or intimacy
• Staying constantly busy to avoid thinking
• Emotional numbness or loss of interest
• Feeling detached from your body or surroundings
• Memory gaps that require sensitive professional assessment

Hypervigilance and a persistent sense of threat

• Scanning rooms, faces, messages or your body for signs of danger
• Being easily startled or unable to relax
• Irritability, anger, panic or sudden defensive reactions
• Checking locks, phones, symptoms or a partner’s behaviour
• Difficulty concentrating, making decisions or trusting reassurance

If being constantly on edge is your main concern, read our detailed guide to hypervigilance symptoms, causes and treatment in Ireland. Where fear has spread into panic, health anxiety, social anxiety or persistent worry, our flagship anxiety disorders guide explains the differences.

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3. Experiences That Can Lead to Trauma-Related Difficulties

PTSD can follow a single event, repeated events or ongoing exposure. The HSE lists serious accidents, violent assault, sexual assault, abuse, severe neglect, witnessing violent death, disasters, life-threatening illness and an unexpected severe injury or death among recognised causes.²

Trauma-related difficulties may follow:

• Childhood abuse, neglect, bullying, instability or having to take on adult responsibilities too early
• Domestic abuse, coercive control, stalking or sexual violence
• Road traffic accidents, workplace accidents, fires or sudden emergencies
• Medical trauma, cancer treatment, intensive care, surgery, chronic illness or frightening symptoms
• Traumatic childbirth, emergency procedures, pregnancy loss or distressing perinatal care
• Relationship betrayal, spouse betrayal, family betrayal, sibling betrayal or repeated deception
• Workplace bullying, employer betrayal, harassment, redundancy handled abusively or repeated exposure to distressing incidents
• Sudden bereavement, witnessing death or discovering a loved one after death
• Military service, emergency work, frontline care or repeated exposure to other people’s traumatic material
• Migration, displacement, community violence or living through a disaster

Not every painful experience meets formal diagnostic trauma criteria, yet it can still cause serious anxiety, grief, low mood, loss of trust, compulsive checking, sleep disruption or relationship distress. The clinical task is not to compete over whether an experience was “bad enough”. It is to understand the pattern accurately and decide what care is appropriate.

Birth-related trauma deserves particular attention. A 2022 systematic review and meta-analysis estimated PTSD after childbirth in 4.7 per cent of mothers and clinically significant post-traumatic stress symptoms in 12.3 per cent.¹⁷ Symptoms can coexist with postnatal depression, anxiety, feeding difficulties, sleep deprivation, grief or relationship strain. These presentations need compassionate assessment and, where necessary, coordination with a GP, maternity service or specialist perinatal mental health team.

For relationship-based experiences, see our articles on the effects of living with a manipulative person and narcissism, antisocial traits and their impact. Claire’s focused resource on betrayal trauma explores trust, shock and relationship injury in more depth.

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4. Why Your Brain and Body May React When Danger Has Passed

Trauma can change what your nervous system predicts. If a cue was once connected with danger, the brain may later treat a similar cue as a warning before your thinking mind has had time to assess it. A slammed door, a delayed text, a hospital smell or an angry facial expression can therefore produce a real surge of fear in a situation that is not identical to the past.

This is not a character flaw. It is threat learning. The problem is not that your protective system reacted. The problem is that it may now react too often, too strongly or in situations where the response costs you sleep, closeness, health, freedom or work.

People often describe fight, flight, freeze or appease responses. These are useful plain-English descriptions, not diagnoses. Your pattern may also change with context. You might become forceful at work, silent in conflict and restless at night.

PTSD can be associated with changes beyond mood. Meta-analyses link PTSD symptoms with poorer physical health, disrupted sleep and altered inflammatory markers.¹¹¹²¹³ These findings do not prove that PTSD directly causes a particular disease. Genetics, medication, sleep, alcohol, smoking, nutrition, activity, socioeconomic conditions and existing illness also matter.

A 2018 meta-analysis found that people with PTSD were 31 per cent more likely to have obesity and 22 per cent more likely to be current smokers than people without PTSD.¹⁶ That is an association, not a judgement. It helps explain why trauma care may need to include sleep, appetite, cravings, smoking, metabolic health and realistic daily routines rather than focusing on memory alone.

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5. Trauma Rarely Sits in One Neat Clinical Box

In clinical work, the important question is often not “Is this trauma or something else?” It is “Which processes are present, which need medical investigation and what should be addressed first?”

Research supports several of these connections. A meta-analysis found a bidirectional association between ADHD and PTSD, with a relative risk of PTSD of 2.9 among people with ADHD and a relative risk of ADHD of 1.7 among people with PTSD.¹⁸ Recent systematic review evidence also suggests elevated PTSD prevalence in autistic children, young people and adults.¹⁹ This does not mean ADHD or autism is caused by trauma. It means assessment should be developmentally informed and should not force every symptom into one explanation.

PTSD and substance misuse also commonly coexist.¹⁴ If you use alcohol or another behaviour to switch off, the immediate relief makes sense, even when the later cost is high. Our resources on addiction and how change can begin, drug addiction and the brain, and porn and sex addiction therapy explain these cycles without shame.

For digestive symptoms, see the gut-brain connection and IBS, anxiety and gut health. A Registered Nutritionist can help investigate dietary adequacy, meal pattern, blood sugar stability and digestive triggers, but nutrition is not a stand-alone treatment for PTSD.

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6. How Trauma May Look in Children and Teenagers

Children do not always describe fear directly. A child may become clingy, angry, withdrawn, controlling, tearful or unusually compliant. A teenager may avoid school, lose confidence, sleep all day, stay awake at night, self-isolate, become highly reactive or rely on food, nicotine, alcohol, drugs, gaming or social media to change how they feel.

Possible signs include:

• New bedwetting, nightmares, tummy aches or headaches
• Regression in skills or a sudden need to stay close to a trusted adult
• Repetitive play or drawings connected with danger
• School avoidance, falling grades or difficulty concentrating
• Aggression, shutdown, risk-taking or sudden changes in friendships
• Food restriction, bingeing, body distress or rapid weight change
• Self-harm, hopelessness, substance use or talk of not wanting to live

The same sign can have several explanations. Bullying, learning difficulty, ADHD, autism, depression, anxiety, sleep disorders, family stress, pain, nutritional deficiency and physical illness can overlap. A child should not be repeatedly questioned for detail or asked to prove what happened. Safeguarding and an age-appropriate professional assessment come first.

Trauma-focused psychological therapies have evidence for reducing PTSD symptoms in children and young people, with individual trauma-focused cognitive behavioural approaches among the better-supported options.⁹ Parents can learn more through our pages on child and adolescent counselling, anxiety in children and teenagers, and Claire’s resource on overstimulation and sensory overload.

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7. A Careful Assessment Prevents the Wrong Problem Being Treated

A screening questionnaire can identify possible symptoms, but it does not replace diagnosis. A good assessment explores current safety, the nature and timing of events, intrusive symptoms, avoidance, threat responses, dissociation, sleep, mood, substance use, physical health, medication, relationships, neurodevelopmental history and daily functioning.

Questions that change the treatment plan

• Is the threat over, or is abuse, coercion, stalking or workplace danger continuing?
• Are there suicidal thoughts, self-harm, psychosis, severe dissociation or risk to another person?
• Is alcohol or drug withdrawal a medical risk?
• Are eating disorder symptoms causing fainting, dehydration, rapid weight change or cardiac risk?
• Could thyroid disease, anaemia, menopause, medication effects, sleep apnoea, chronic pain or another condition be contributing?
• Are intrusive thoughts trauma memories, OCD obsessions, depressive rumination or another process?
• Were attention, sensory or social differences present before the traumatic events?
• Does the person have enough stability, privacy and consent for trauma processing now?

Your GP can help assess physical symptoms, medication, risk and referral needs. A psychiatrist or clinical psychologist may be appropriate where diagnosis is unclear, symptoms are severe, there is significant comorbidity or specialist treatment is required. Counselling and Psychotherapy can begin with present-day distress, functioning and safety without demanding a complete narrative.

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8. What Effective PTSD and Trauma Treatment Can Include

The HSE states that PTSD can be treated with psychological therapy, medication or a combination, and that it is never too late to seek help.²⁴ NICE guidance recommends trauma-focused psychological therapy for adults, children and young people with clinically important PTSD symptoms, with the exact method, timing and number of sessions adapted to age, complexity and need.¹ The 2023 VA and Department of Defense guideline also places evidence-based individual psychotherapies at the centre of care.⁴

What safe trauma work should never require

• Being forced to disclose every detail at the first appointment
• Reliving an event without consent, preparation or a clear clinical reason
• Accepting a therapist’s interpretation as fact
• Using hypnosis to claim that a memory has been recovered as objective evidence
• Stopping prescribed medication without speaking to the prescriber
• Remaining in a dangerous environment while being told to regulate your reactions
• Promises that one session will erase complex symptoms for everyone

If you would like to understand the services more fully, visit Counselling and Psychotherapy, Clinical Hypnotherapy and Clinical Medical Hypnotherapy, ONLINE Counselling, and Registered Nutritionist Services. Claire also provides a detailed evidence-aware resource on the history, science and clinical uses of hypnotherapy.

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9. The Counselling Experts SAFE PATH Framework

Claire Russell and Shane Murphy use a joined-up clinical reasoning process so that treatment is not reduced to one symptom or one technique. The SAFE PATH framework is a practical way to describe that process.

The order is not rigid. Safety may need revisiting. Sleep may improve before memories become less intrusive. A relationship decision may change the whole formulation. Good care responds to the person in front of the clinician, not to a template.

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10. Two Irish Composite Clinical Illustrations

The following illustrations combine features seen across clinical work in Ireland. Details are altered and combined to protect confidentiality. They do not predict any individual’s result.

“I thought it was anxiety, but my whole life had narrowed”

A woman in her forties from County Cork sought help for panic, poor sleep, reflux, repeated checking and fear when her partner was late home. She had survived a serious road collision several years earlier and had never connected the event with her current reactions.

Assessment showed trauma triggers, avoidance, health anxiety and severe sleep disruption. Work began with understanding the alarm cycle, improving sleep and eating regularity, reducing repeated reassurance, and establishing ways to orient to present safety. Direct trauma work was introduced only when she understood the plan and agreed to it. Progress was measured through daily functioning, driving, sleep, checking and ability to stay present in relationships, not through a promise that she would never feel anxious again.

“I was coping, but alcohol, anger and distance were doing the coping for me”

A man in his fifties from County Limerick described irritability, emotional distance, weekend drinking and explosive reactions to criticism. A history of childhood violence had taught him to scan for disrespect and act before he could be hurt.

The plan prioritised alcohol risk, current safety, sleep and responsibility for behaviour. Psychotherapy explored threat interpretations, shame and relationship patterns. Couples sessions were considered only after individual assessment confirmed that joint work was safe. The work did not excuse harmful behaviour because of trauma. It helped him understand the pattern, take responsibility and develop alternatives.

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11. What You Can Try Over the Next Fortnight

These suggestions are educational and are not a substitute for personal assessment. Choose one or two. Consistency matters more than intensity.

1. Name the present. When a trigger hits, say the date, where you are and what is different from the past. Look around slowly and identify several ordinary objects. This helps the brain update context.
2. Lengthen the exhale. If slow breathing feels comfortable, breathe out a little longer than you breathe in for one or two minutes. Stop if it increases dizziness, panic or disconnection.
3. Track the loop, not every memory. Note the trigger, body reaction, action and short-term result. This can reveal whether checking, avoidance, alcohol, food or arguing is maintaining distress.
4. Protect sleep timing. Keep waking time reasonably steady, reduce late caffeine and seek GP advice for persistent insomnia, nightmares, snoring, pain or medication concerns.
5. Eat regularly. Long gaps without food can amplify shakiness, irritability and poor concentration. Consider regular meals containing protein, fibre and carbohydrates that suit your digestion and medical needs.
6. Reduce avoidable amplifiers. Alcohol, cannabis, nicotine, high caffeine intake and sleep loss can intensify anxiety or disturb sleep. If dependence is possible, seek medical guidance before stopping suddenly.
7. Choose one safe connection. Tell a trusted person what helps, such as listening without pressing for detail, sending a message after an appointment or sitting nearby during a difficult evening.
8. Book an assessment. You can begin with the present-day symptoms. You do not need to tell the whole story during the first contact.

If anticipatory fear takes over before appointments, travel or difficult conversations, read our guide to anticipatory anxiety. If food has become the quickest route to relief, see emotional eating therapy and rebuilding a steadier relationship with food.

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12. A Note for Partners, Parents and Trusted People

You do not have to become the therapist. Your role is to be steady, respectful and clear.

• Believe distress without demanding details or deciding the diagnosis yourself.
• Ask, “What would help right now?” rather than assuming.
• Do not touch, block an exit or raise your voice during a trigger unless immediate safety requires action.
• Encourage professional help, but allow the person choice wherever safety permits.
• Keep reasonable boundaries. Trauma can explain behaviour without excusing intimidation, violence, coercion or repeated harm.
• Seek urgent help if there is suicidal intent, severe self-harm, psychosis, dangerous substance use or risk to another person.

Trauma may affect communication, trust, intimacy and conflict. Couples Counselling and Marriage Counselling may help when both people can speak freely and the relationship is safe. Individual therapy and safety planning take priority where there is abuse or coercive control.

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13. When to Seek Urgent or Specialist Help

Phone 112 or 999, or attend the nearest emergency department, if you or someone else is at immediate risk of harm. In Ireland, you can also call Samaritans on 116 123 free of charge, or contact Pieta’s 24-hour crisis line on 1800 247 247 or text HELP to 51444. These contacts do not replace emergency services where danger is immediate.

Prompt GP, psychiatric or specialist assessment is important if you experience:

• Suicidal thoughts, self-harm, violent impulses or an inability to stay safe
• Psychosis, severe confusion, prolonged loss of awareness or marked dissociation
• Alcohol, benzodiazepine or other drug dependence where sudden withdrawal may be dangerous
• Rapid weight loss, fainting, purging, dehydration or other serious eating disorder signs
• New chest pain, neurological symptoms, severe breathlessness or unexplained physical decline
• Ongoing domestic abuse, stalking, sexual violence or safeguarding concerns involving a child or vulnerable adult
• Severe depression, mania, marked agitation or several nights with almost no sleep
• Symptoms following a head injury, intensive care admission, new diagnosis or medication change

If you have Parkinson’s disease, an autoimmune condition, cancer, a cardiac condition, epilepsy, diabetes, pregnancy-related concerns or another complex health condition, psychological care should be coordinated with the medical team where appropriate. Therapy can address fear, loss, adjustment and trauma-related symptoms, but it must not delay necessary medical treatment.

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14. Why Work With Claire Russell and Shane Murphy

Counselling Experts offers two experienced clinicians with complementary strengths. The purpose is not to fit every person into every service. It is to identify the most appropriate starting point and work within professional scope.

Read more about Claire Russell and Shane Murphy, view client testimonials, or explore the full range of Counselling Experts services.

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15. ONLINE and In-Person Trauma Therapy Appointments

Counselling Experts provides ONLINE Counselling and Psychotherapy across Ireland and internationally. In-person appointments are available through the practice in Cork City, Youghal, East Cork, Newcastle West and Limerick.

Claire also works online and in person with adults, teenagers and children in Adare, Newcastle West, Limerick, Abbeyfeale, Charleville, Kanturk, Midleton, Youghal, Cork, Lismore, Dungarvan and Dublin. Service availability varies by clinician and location, so the first contact helps match you with the appropriate option.

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16. Related Services and Clinical Articles

Use the links below to continue with the part of the problem that feels most relevant. These pages form the Counselling Experts clinical knowledge pathway around trauma, anxiety, relationships, addictions, eating, sleep and physical symptoms.

Start with a service

• Counselling Experts home
• Counselling and Psychotherapy
• Anxiety Counselling
• ONLINE Counselling across Ireland
• Couples Counselling and Marriage Counselling
• Child and Adolescent Counselling
• Clinical Hypnotherapy, Clinical Medical Hypnotherapy and Hypnosis
• Registered Nutritionist Services
• Meet Claire Russell and Shane Murphy
• Testimonials
• Mind Matters podcast
• Counselling Experts clinical articles
• Contact Counselling Experts

Understand connected symptoms and patterns

• Hypervigilance symptoms, causes and treatment
• Anxiety disorders in Ireland
• Anxiety Counselling and Hypnotherapy in Ireland
• Fears and phobias treatment
• Why the brain fixates on negativity
• How to tell the difference between ADHD and anxiety
• Stress, immune health and disease risk
• Stress, gut health and the gut-brain connection
• IBS, anxiety and gut health
• Emotional eating therapy
• A healthier relationship with food
• Food and mental health
• Addiction, why it develops and how change can begin
• Drug addiction in Ireland
• Porn and sex addiction therapy
• Living with a manipulative person
• Narcissism, NPD and antisocial personality disorder
• Anxiety in children and teenagers

Claire Russell Therapy specialist resources

• Trauma Therapy and Trauma Hypnotherapy in Ireland
• Hypnotherapy for trauma-related symptoms
• Betrayal trauma
• Chronic stress, inflammation, hormones and autoimmune symptoms
• Clinical Hypnotherapy history, science and evidence
• Claire Russell Therapy consultation

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17. Frequently Asked Questions About Trauma, PTSD and Complex PTSD

1. What is the difference between trauma, PTSD and complex PTSD?

Trauma describes an overwhelming experience and its impact. PTSD is a condition involving re-experiencing, avoidance and a persistent sense of threat that causes significant distress or impairment. Complex PTSD includes those core symptoms plus persistent difficulties with emotional regulation, self-worth and relationships.

2. How do I know if I have PTSD?

Flashbacks, nightmares, avoidance, emotional numbing, hypervigilance, strong startle responses and continuing impairment can indicate PTSD, but a questionnaire or article cannot diagnose you. A GP or suitably qualified mental health professional should assess symptoms, duration, risk, physical health and overlapping conditions.

3. Can PTSD develop months or years after trauma?

Yes. Symptoms can begin immediately or emerge weeks, months or years later. Sometimes a later loss, medical event, relationship rupture, hormonal transition or period of reduced coping brings an older pattern into clearer view.

4. Can childhood trauma cause complex PTSD in adults?

Repeated or inescapable childhood trauma can increase the risk of complex PTSD, especially when safety, attachment and development were affected. It does not determine a person’s future, and diagnosis should be based on current symptoms and functioning rather than history alone.

5. Can emotional abuse or betrayal cause trauma symptoms?

Yes. Emotional abuse, coercive control, repeated deception and betrayal can lead to anxiety, hypervigilance, sleep problems, shame, intrusive thoughts and loss of trust. Whether formal PTSD criteria are met requires assessment, but serious distress deserves appropriate care regardless of the label.

6. What does PTSD feel like in the body?

It may feel like a racing heart, tight chest, trembling, nausea, pain, numbness, dizziness, sweating, jaw tension, disturbed sleep, exhaustion or being unable to settle. New, severe or unexplained physical symptoms should still be medically assessed.

7. What is the best treatment for PTSD?

Clinical guidelines recommend structured trauma-focused psychological therapy as first-line care for PTSD. The best plan depends on age, safety, preference, symptom pattern, physical health and coexisting difficulties. Medication may also be considered by a prescriber.

8. How long does trauma therapy take?

There is no honest universal number. A focused presentation may need a defined course, while complex PTSD, ongoing danger, dissociation, addictions, eating disorders or severe depression can require longer and more coordinated care. Progress and fit should be reviewed rather than leaving treatment open-ended without goals.

9. Is ONLINE trauma therapy effective?

ONLINE psychological therapy can be effective and improves access for many people. Suitability depends on privacy, technology, clinical risk, dissociation and the type of intervention. Some clients prefer their own space, while others need in-person or specialist care.

10. Can hypnotherapy help PTSD or complex PTSD?

Hypnotherapy may help selected clients with anxiety regulation, sleep, pain, gut-brain symptoms, habits and some trauma-related responses. The PTSD evidence base is limited compared with guideline-recommended trauma-focused therapies, so it should be presented as a carefully assessed adjunct rather than a guaranteed replacement.

11. Can trauma cause anxiety, panic attacks or obsessive thoughts?

Trauma can contribute to threat scanning, panic, intrusive thoughts, checking and rumination. OCD, panic disorder, health anxiety and PTSD can also coexist. Distinguishing them matters because the treatment emphasis may differ.

12. Can trauma affect sleep, digestion and inflammation?

PTSD is associated with disturbed sleep, IBS and altered inflammatory markers in research. Association does not prove that trauma is the sole cause. Digestive, immune, hormonal and sleep symptoms deserve medical assessment alongside psychological care.

13. Is trauma linked with addiction or emotional eating?

Alcohol, drugs, nicotine, gambling, food, sugar, pornography, sex, shopping and technology can provide short-term escape from trauma-related distress. Treating both the coping behaviour and the underlying symptoms is often more useful than addressing either in isolation. Dependence or withdrawal risk may require medical care.

14. When is PTSD an emergency?

It is an emergency when there is immediate risk of suicide, self-harm, serious violence, overdose, severe withdrawal, psychosis or inability to stay safe. Phone 112 or 999 or go to the nearest emergency department. In Ireland, Samaritans is available on 116 123 and Pieta’s 24-hour crisis line is 1800 247 247.

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18. About the Authors

Claire Russell

Claire Russell, MSc, BSc, DipNT, is a Counsellor, Psychotherapist, Registered Nutritionist, Clinical Medical Hypnotherapist, Clinical Hypnotherapist, RTT Practitioner and Advanced Rapid Transformational Therapy Practitioner with more than 20 years of clinical experience across Ireland, the UK and Europe. She works with adults, teenagers and children experiencing trauma-related difficulties, PTSD and complex PTSD symptoms, anxiety, depression, addictions, eating disorders and disordered eating, gut and digestive issues, hormonal concerns, chronic inflammation, autoimmune symptoms, sleep problems, pain, fatigue and relationship difficulties.

Claire’s integrative assessment considers psychological, behavioural, nutritional, gut-brain, hormonal and physical contributors without implying that every symptom has one root cause. Where appropriate, she brings an evidence-informed functional medicine perspective to the wider assessment of symptoms and daily health behaviours. She works ONLINE and in person across her Irish clinic locations. Phone 087 716 8844.

Shane Murphy

Shane Murphy, BSc (Hons) Counselling and Psychotherapy, BA (Hons), is an Anxiety Expert, Counsellor and Psychotherapist. He trained through Middlesex University, is an accredited member of IACP and is Garda vetted. Shane works with adults and couples experiencing anxiety, panic, trauma-related distress, childhood difficulties, depression, attachment patterns, low self-esteem, anger, relationship problems and the emotional impact of cancer.

His style is empathic, practical and non-judgemental, with careful attention to the person’s pace, strengths and current life. Phone 086 894 7322.

Editorial transparency

This article was written for education and informed by current Irish health information, clinical guidelines and systematic reviews. Composite illustrations are used to protect confidentiality. The article does not diagnose, prescribe or promise a particular result. Claire Russell and Shane Murphy should complete and approve the final clinical review before publication. It should then be reviewed whenever major guidelines change and, at minimum, annually.

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19. Clinical Guidelines and Academic References

1. National Institute for Health and Care Excellence. Post-traumatic stress disorder: NICE guideline NG116. 2018, surveillance reviewed 2025. https://www.nice.org.uk/guidance/ng116
2. Health Service Executive. Symptoms – Post-traumatic stress disorder (PTSD). https://www2.hse.ie/conditions/ptsd/
3. Health Service Executive. Complex PTSD. https://www2.hse.ie/conditions/ptsd/complex-ptsd/
4. Department of Veterans Affairs and Department of Defense. VA/DoD Clinical Practice Guideline for Management of Posttraumatic Stress Disorder and Acute Stress Disorder. Version 4.0, 2023. https://www.healthquality.va.gov/guidelines/mh/ptsd/
5. Kessler RC, Aguilar-Gaxiola S, Alonso J, et al. Trauma and PTSD in the WHO World Mental Health Surveys. European Journal of Psychotraumatology. 2017;8(sup5):1353383. https://pubmed.ncbi.nlm.nih.gov/29075426/
6. Fung HW, et al. Prevalence of ICD-11 post-traumatic stress disorder (PTSD) and complex PTSD in the general populations: a systematic review and meta-analysis. Asian Journal of Psychiatry. 2025;110:104610. https://pubmed.ncbi.nlm.nih.gov/40652792/
7. Lewis C, Roberts NP, Andrew M, Starling E, Bisson JI. Psychological therapies for post-traumatic stress disorder in adults: systematic review and meta-analysis. European Journal of Psychotraumatology. 2020;11(1):1729633. https://pubmed.ncbi.nlm.nih.gov/32284821/
8. Bisson JI, Roberts NP, Andrew M, Cooper R, Lewis C. Psychological therapies for chronic post-traumatic stress disorder in adults. Cochrane Database of Systematic Reviews. 2013. https://pubmed.ncbi.nlm.nih.gov/24338345/
9. Mavranezouli I, Megnin-Viggars O, Daly C, et al. Psychological and psychosocial treatments for children and young people with post-traumatic stress disorder: a network meta-analysis. Journal of Child Psychology and Psychiatry. 2020. https://pubmed.ncbi.nlm.nih.gov/31313834/
10. Hughes K, Bellis MA, Hardcastle KA, et al. The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis. The Lancet Public Health. 2017;2(8):e356-e366. https://pubmed.ncbi.nlm.nih.gov/29253477/
11. Pacella ML, Hruska B, Delahanty DL. The physical health consequences of PTSD and PTSD symptoms: a meta-analytic review. Journal of Anxiety Disorders. 2013;27(1):33-46. https://pubmed.ncbi.nlm.nih.gov/23247200/
12. Peruzzolo TL, Pinto JV, Roza TH, et al. Inflammatory and oxidative stress markers in post-traumatic stress disorder: a systematic review and meta-analysis. Molecular Psychiatry. 2022;27(8):3150-3163. https://pubmed.ncbi.nlm.nih.gov/35477973/
13. Zhang Y, Ren R, Sanford LD, et al. Sleep in posttraumatic stress disorder: a systematic review and meta-analysis of polysomnographic findings. Sleep Medicine Reviews. 2019. https://pubmed.ncbi.nlm.nih.gov/31518950/
14. Debell F, Fear NT, Head M, et al. A systematic review of the comorbidity between PTSD and alcohol misuse. Social Psychiatry and Psychiatric Epidemiology. 2014. https://pubmed.ncbi.nlm.nih.gov/24643298/
15. Ng QX, Soh AYS, Loke W, Venkatanarayanan N, Lim DY, Yeo WS. The association between post-traumatic stress disorder and irritable bowel syndrome: a meta-analysis. Journal of Gastroenterology and Hepatology. 2019. https://pubmed.ncbi.nlm.nih.gov/30144372/
16. van den Berk-Clark C, Secrest S, Walls J, et al. Association between posttraumatic stress disorder and lack of exercise, poor diet, obesity, and co-occurring smoking: a systematic review and meta-analysis. Health Psychology. 2018;37(5):407-416. https://pubmed.ncbi.nlm.nih.gov/29698016/
17. Heyne CS, Kazmierczak M, Souday R, et al. Prevalence and risk factors of birth-related posttraumatic stress among parents: a comparative systematic review and meta-analysis. Clinical Psychology Review. 2022. https://pubmed.ncbi.nlm.nih.gov/35584590/
18. Spencer AE, Faraone SV, Bogucki OE, et al. Examining the association between posttraumatic stress disorder and attention-deficit/hyperactivity disorder: a systematic review and meta-analysis. Journal of Clinical Psychiatry. 2016;77(1):72-83. https://pubmed.ncbi.nlm.nih.gov/26114394/
19. Mansour H, et al. Prevalence of Post-Traumatic Stress Disorder (PTSD) in autistic children or young people (CYP) and adults: a systematic review and meta-analysis. Clinical Psychology Review. 2025;120:102621. https://pubmed.ncbi.nlm.nih.gov/40783299/
20. Roberts NP, Lotzin A, Schäfer I. A systematic review and meta-analysis of psychological interventions for comorbid post-traumatic stress disorder and substance use disorder. European Journal of Psychotraumatology. 2022. https://pubmed.ncbi.nlm.nih.gov/35558682/
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Educational disclaimer

This article is for general education and does not replace individual medical, psychiatric, psychological or nutritional advice. Do not stop or change prescribed medication without speaking to your GP, psychiatrist, pharmacist or other prescriber. Seek appropriate medical assessment for new, severe or persistent physical symptoms.

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