Is it too late to get help years afterwards?

No. PTSD responds to treatment years or decades after the event. Many people seek help long afterwards, often when something triggers a resurgence, and the treatments work just as well.

Do I have to talk about what happened in detail?

Trauma-focused therapy does involve processing the memory, but it is done gradually, at your pace, with a trained person and with control over how far to go. It is not the same as being made to recount everything to a stranger once.

Can trauma cause physical symptoms?

Yes, commonly — headaches, stomach problems, chest tightness, chronic pain and exhaustion. These are real physical symptoms produced by a nervous system stuck in alarm, and they often improve when the trauma is treated.

Health library

Mental health

Trauma and PTSD – how it shows up, and what helps

South Africa has very high exposure to violence and accidents. Most people recover without treatment; the ones who do not have a specific, treatable condition.

Reaction versus disorder

After a traumatic event — an assault, a hijacking, a serious accident, a violent crime, a death witnessed — most people have intense symptoms for days to weeks and then gradually recover. That is a normal reaction, not an illness.

Post-traumatic stress disorder is diagnosed when the symptoms persist beyond about a month and continue to disrupt life. Rates in South Africa are high, which is a consequence of exposure rather than of any weakness in the people exposed.

Re-experiencing: intrusive memories, nightmares, and flashbacks where it feels like it is happening again.
Avoidance: staying away from places, people, conversations or reminders, including avoiding thinking about it.
Being on edge: jumpy, watchful, irritable, poor sleep, poor concentration, startling easily.
Changes in mood and thinking: numbness, detachment from others, persistent guilt or shame, believing the world is entirely unsafe.

The first weeks

Safety first — practical safety, then physical needs. Nothing psychological works while someone is still in danger.
Reconnect with people. Social support is the strongest predictor of recovery there is.
Return to routine gradually. Structure helps; being pushed back too fast does not.
Sleep, food and movement, in that order of priority.
Limit repeated exposure to news or footage of the event.
Do not force a detailed retelling. Single-session debriefing where someone is made to recount everything is no longer recommended and can make things worse.
Be very careful with alcohol, which is the most common self-treatment and the one that most reliably entrenches the problem.

Treatment that works

PTSD responds well to specific psychological therapies. These are not general counselling — the trauma-focused ones are what have the evidence.

Trauma-focused cognitive behavioural therapy.
Prolonged exposure, and cognitive processing therapy.
EMDR — eye movement desensitisation and reprocessing, which has good evidence despite sounding unlikely.
Medication, usually an antidepressant, where therapy is unavailable or insufficient.

Used where medication is indicated:

Sertraline — Zoloft, Serdep, Adco-Sertraline, Lustral
Major depressive disorder; OCD; PTSD; social anxiety disorder; panic disorder
Fluoxetine — Prozac, Lorien, Adco-Fluoxetine, Nuzak
Major depressive disorder; anxiety disorders; PTSD; OCD; bulimia nervosa
Paroxetine — Aropax, Lenio, Paxil, Deparoc
Major depressive disorder; generalised anxiety; panic disorder; OCD; PTSD; social anxiety
Venlafaxine — Efexor, Efexor XR, Venlor XR, Sandoz Venlafaxine
Major depressive disorder; generalised anxiety disorder; social anxiety disorder; neuropathic pain

Where to get help in South Africa

Public clinics can refer to mental health services, and SADAG maintains referral lists and helplines including specific ones for trauma and for gender-based violence. Employee assistance programmes cover many workplaces and are underused.

Common questions

Is it too late to get help years afterwards?: No. PTSD responds to treatment years or decades after the event. Many people seek help long afterwards, often when something triggers a resurgence, and the treatments work just as well.
Do I have to talk about what happened in detail?: Trauma-focused therapy does involve processing the memory, but it is done gradually, at your pace, with a trained person and with control over how far to go. It is not the same as being made to recount everything to a stranger once.
Can trauma cause physical symptoms?: Yes, commonly — headaches, stomach problems, chest tightness, chronic pain and exhaustion. These are real physical symptoms produced by a nervous system stuck in alarm, and they often improve when the trauma is treated.

Sources

Mental health support and crisis resourcesSouth African Depression and Anxiety Group (SADAG)
National Mental Health Policy Framework and Strategic PlanNational Department of Health, South Africa
Primary Healthcare Standard Treatment Guidelines and Essential Medicines ListNational Department of Health, South Africa

Last reviewed 4 August 2026.