Yes, in some cases, therapy can make PTSD (post traumatic stress disorder) worse. If you have PTSD, and your anxiety symptoms are severe, then therapy would not be helpful as a starting point. For severe, debilitating PTSD, where you are having frequent nightmares, having flashbacks of the traumatic event throughout the day, extreme irritability, uncontrollable aggressive behaviors, sleep deprivation, and constant vigilance and being constantly on guard for the next traumatic event, then you may need prescription medication treatment to calm down your anxiety symptoms first.
The problem with medication treatment for PTSD is that they are not as effective for PTSD as they are for other anxiety disorders. However, SSRIs (selective serotonin reuptake inhibitors) have the most evidence for effectiveness in PTSD, while SNRIs (serotonin norepinephrine reuptake inhibitors) and atypical antipsychotics have preliminary evidence that they are effective. SSRIs can help to decrease your PTSD symptoms to the point where you are able to tolerate psychotherapy.
The problem with psychotherapy when you are having severe anxiety symptoms is that psychotherapy can induce some worsening of anxiety symptoms when first starting therapy. So if you start therapy and your anxiety symptoms are already so severe that you can’t function, then therapy can worsen your anxiety initially and make your already severe symptoms more intolerable and overwhelming.
To see how severe your anxiety symptoms are, please take our anxiety test.