Trauma responses are common, and most of them settle. Where they do not, what remains is often severe, long-standing and badly served. This page is deliberately framed around what a private psychiatric appointment will and will not give you, because for PTSD that distinction is sharper than for any other condition on this site.
The honest position on treatment
The main treatment for PTSD is psychological therapy that works directly with the traumatic memory. The NHS recommends trauma-focused cognitive behavioural therapy and eye movement desensitisation and reprocessing (EMDR), and those are the treatments that NHS services are directed towards; its page on PTSD treatment describes both. Medication has a supporting role. It is not an alternative.
Happy Clinic does not provide psychological therapy. It can advise on which therapy pathway fits your situation, and that advice forms part of a treatment plan, but the therapy itself has to come from elsewhere.
In England, you can refer yourself to NHS talking therapies without going through a GP. Those services treat PTSD and offer both CBT and EMDR. Where trauma is severe, repeated or began in childhood, a specialist trauma service may be more appropriate, and a GP referral is usually the route to that. In Scotland, Wales and Northern Ireland the local arrangements differ, and your GP will know what exists near you.
If reading that means you decide not to book a psychiatric appointment, this page has done its job.
What trauma-related symptoms look like
People often do not connect what they are experiencing to something that happened years earlier. The pattern usually involves some combination of the following.
- Reliving it. Flashbacks, intrusive images, nightmares, or a sense of the event happening now rather than being remembered.
- Avoidance. Steering around places, people, conversations, news items or smells; keeping permanently busy so there is no quiet moment.
- Being permanently on guard. Scanning rooms, sitting facing the door, startling at noise, sleeping badly, irritability that surprises you.
- Feeling altered. Numbness, detachment from people you love, shame or guilt, a bleaker view of yourself and the future, memory gaps around the event.
The Royal College of Psychiatrists’ information on PTSD is a useful independent description. Symptoms can begin weeks or years after the event, which is one reason the connection gets missed.
What a psychiatrist can actually do
Within those limits, there are four things a consultant psychiatrist offers that a therapist generally does not.
A diagnostic opinion. Whether this is PTSD, a more complex trauma presentation, depression with intrusive memories, panic disorder, or something else entirely. Trauma symptoms overlap heavily with anxiety and with depression, and the overlap changes the order of treatment.
Prescribing and medication review. Starting, changing, optimising or stopping psychiatric medication, and saying honestly when a medicine is not the problem or the solution.
Treating the obstacles to therapy. Severe depression, impossible sleep, panic attacks and heavy drinking all make trauma-focused therapy unworkable. Dealing with those is often the precondition for the therapy that will actually help.
A written clinical summary. Sent to you, and to your GP with your consent, which gives your GP something concrete to act on and continue.
Where medication fits
The NHS says PTSD treatment may include medicines, usually an antidepressant, alongside therapy rather than instead of it. Decisions are individual, but the shape of the thinking is straightforward.
Medication is most often considered where depression is prominent, where symptoms are severe enough that therapy cannot yet be used, where trauma-focused therapy is not available within a reasonable time, or where someone does not want therapy at present. It is not a quick route. Antidepressants take weeks rather than days to show benefit, and side effects generally appear first, so an adequate trial has to be planned rather than abandoned at a fortnight.
Two cautions are worth knowing before you book. Sleeping tablets and benzodiazepines are a poor answer in PTSD: they blunt symptoms briefly, dependence develops, and the underlying memory is unchanged. And medication started without any plan for therapy tends to plateau. A psychiatrist who says so is doing the job properly. If you already have a long medication history that nobody has untangled, a medication review is the appointment designed for it.
Sleep and nightmares
Sleep is often the symptom people most want addressed, and it is frequently the most tractable in the short term. Broken sleep, dread of going to bed, and nightmares that return to the same content all feed everything else: exhaustion worsens irritability, concentration, mood and the capacity to do therapy.
An assessment will look at the sleep pattern in detail, including what you do in the hours before bed, alcohol and cannabis use, caffeine, whether nightmares wake you and what happens afterwards. Some of what helps is not a prescription. Where medication is used, the choice depends on the whole picture rather than on sleep alone, which is why it is a conversation rather than a request form.
Depression and alcohol alongside PTSD
These two travel with PTSD so often that an assessment which ignores them is not worth having.
Depression that follows trauma is not simply “understandable” and therefore untreatable. It responds to treatment, and treating it frequently unlocks the therapy that addresses the trauma itself.
Alcohol is the harder conversation. Drinking to get to sleep, or to take the edge off being constantly on guard, is extremely common and entirely comprehensible. It also worsens sleep architecture, deepens low mood, raises risk, and changes what can be prescribed safely. A psychiatrist needs an honest figure, not an underestimate: the plan is built on it. Where dependence is established, specialist drug and alcohol services usually need to be involved first, and that is a signposting conversation the appointment can cover.
Safety, and when this is not the right service
Happy Clinic is not an emergency or crisis service, does not provide crisis care, and sees adults aged 18 and over only. Appointments are booked in advance by video.
If a life is at risk, call 999 or go to A&E. For urgent mental health help, call NHS 111 and choose the mental health option in England. Samaritans can be reached free on 116 123, at any time of day or night.
If you have thoughts of ending your life but are safe for now, say so at the assessment. It does not stop treatment going ahead; it shapes it, and it is information the psychiatrist needs.
What the assessment involves
The initial appointment is a 60-minute video consultation with a GMC-registered consultant psychiatrist. For trauma, it is paced with some care.
You will be asked what kind of event or events occurred and roughly when, but not for a detailed account. Saying that you would rather not go into the specifics is an acceptable answer and will not obstruct the assessment. Most of the hour is spent on how symptoms affect you now: sleep, flashbacks, avoidance, mood, concentration, relationships and work. The psychiatrist will also cover alcohol and drug use, physical health, other medicines, past psychiatric treatment and what has helped before.
You will leave with a diagnostic opinion, a plan that names the therapy to pursue as well as any medication, and a written summary. The first appointment page explains the practicalities, and the online psychiatry page covers how video consultations work.
Costs and next steps
An initial psychiatric assessment is £400 for 60 minutes. Follow-up appointments are £200 for 20 minutes. A repeat prescription request for existing patients is £150, subject to clinical review. Fees are paid in advance, and prescriptions issued during an appointment are included, though pharmacy charges are not. Fees checked September 2026 — see the fees page for the current list.
Consultations, diagnosis and prescriptions are provided by Happy Clinic, which is registered with the Care Quality Commission (CQC). Appointments are often available within a few days, depending on clinician availability, and no GP referral is needed.
A reasonable order of action for many people is this: put the therapy referral in first, then book an appointment if diagnosis, medication, sleep, mood or drinking need separate attention while you wait.
Speak to a Consultant Psychiatrist
Book a secure video consultation with Happy Clinic, for adults aged 18 and over anywhere in the UK. No GP referral is needed and appointments are often available within days.
This page is general information and is not a substitute for personal medical advice. Consultations, diagnosis and prescriptions are provided by Happy Clinic, which is registered with the Care Quality Commission (CQC). If you are in crisis, call 999, go to A&E, call NHS 111 or call Samaritans free on 116 123.