Traumatic events—such as an accident, assault, military combat, or natural disaster—can have lasting effects on a person’s mental health. While many people will have short-term responses to life-threatening events and recover well, others will develop longer-term symptoms that can lead to a diagnosis of Posttraumatic Stress Disorder (PTSD). PTSD symptoms often coexist with other conditions such as substance abuse disorders, depression, and anxiety disorder which is why a comprehensive medical evaluation resulting in an individualized treatment plan is the most ideal resolution.
PTSD affects 3.6% of the U.S. adult population—about 9 million individuals. About 37% of those diagnosed with PTSD are classified as having severe symptoms. Women are significantly more likely to experience PTSD than men. So, how do you treat PTSD? Do you need online therapy?
Posttraumatic stress disorder (PTSD) is a psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event such as a natural disaster, a serious accident or injury, war/combat, or sexual violence.
PTSD has been known by many names in the past, such as “shell shock” during World War I, and “combat fatigue” after World War II, but PTSD does not just happen to combat veterans. PTSD can occur in all people, of any ethnicity, nationality, or culture, and at any age. People with PTSD have intense, disturbing thoughts and feelings related to their experience that last long after the traumatic event. They may relive the event through flashbacks or nightmares; they may feel sadness, fear, or anger; and they may feel detached or estranged from other people. People with PTSD may avoid situations or people that remind them of the traumatic event, and have strong negative reactions to something as ordinary as a loud noise or an accidental touch.
Though a diagnosis of PTSD requires exposure to an upsetting traumatic event, the exposure could be indirect rather than first-hand. For example, PTSD could occur secondhand, in the case of learning about the traumatic death of a loved one.
When wondering how to know if you have PTSD and how to treat PTSD, it’s important to look for symptoms. The symptoms of PTSD fall into four categories, though they can vary in severity.
A person with PTSD might experience uncontrollable intrusive thoughts such as repeated, involuntary memories, distressing dreams, or flashbacks of the traumatic event. Flashbacks may be so vivid that people feel they are re-living the traumatic experience or seeing it before their eyes in any given moment, years after the traumatic event.
Symptoms of PTSD may include avoiding reminders of the traumatic event may include avoiding people, places, activities, objects, and situations that may trigger distressing memories. People may also try to avoid remembering or thinking about the traumatic event, including talking about what happened or how they feel about it.
PTSD can affect the ability to remember important aspects of the traumatic event, encourage negative thoughts and feelings that lead to ongoing and distorted beliefs about oneself or others. It can create distorted thoughts about the cause or consequences of the event that cause a person to wrongly blame themselves or others and generate ongoing fear, horror, anger, guilt, or shame. Symptoms may include a reduced interest in activities previously enjoyed, feeling detached or estranged from others, and the inability to experience positive emotions.
Arousal and reactive symptoms may include being irritable and having angry outbursts, behaving recklessly or in a self-destructive way, being overly watchful of one's surroundings in a suspecting way, or being easily startled. PTSD can cause problems with concentrating or sleeping.
For a person to be diagnosed with PTSD, their individual bucket of symptoms must last for more than a month and must cause significant distress or problems in the individual's daily functioning. Many people develop symptoms within three months of the trauma, but symptoms may appear later and often persist for months and sometimes years. PTSD often occurs with other related conditions, such as depression, substance use, memory problems, and other physical and mental health problems.
When people are seeking out treatment for post-traumatic stress disorder (PTSD), they might mistake treatment for a cure. While there are a number of effective treatments for PTSD, such different types of therapy like trauma focused therapy, as well as evidence that medication may be useful for people struggling with symptoms of PTSD, there is no cure. These treatment methods are used to help minimize, or even eliminate, distressing symptoms that people with PTSD often experience, but they won’t make the PTSD go away completely. The best treatments for PTSD do a great job managing symptoms.
There are many treatment options for PTSD that range from medication to different approaches of psychotherapy.
Although there are no medications that have been specifically designed to treat PTSD, there are a variety of well-established medications currently used to treat other psychiatric conditions such as mood and anxiety disorders that have been found to be helpful in managing complex PTSD symptoms.
Selective serotonin reuptake inhibitors, commonly referred to as SSRIs, are a type of antidepressant medication usually prescribed to help with symptoms of depression and anxiety. Examples of common SSRIs that may be used in the treatment of PTSD include:
The two currently approved by the Federal Drug Administration (FDA) for the treatment of PTSD are Zoloft and Paxil. While SSRIs are usually the common category of medications to turn to in the treatment of PTSD, an SNRI can be used as well. SNRI stands for serotonin-norepinephrine reuptake inhibitor and they are often used for the treatment of depression. Up to 50% of those diagnosed with PTSD also meet the criteria for the diagnosis of major depressive disorder.
Not uncommonly, other categories of medications such as the atypical antipsychotics and the anti-hypertensive alpha-blocker prazosin may be used to decrease PTSD symptoms.
Unfortunately, every person will respond differently in their tolerance and the perceived effectiveness of the medications used. It can take time to find the best fit for PTSD sufferers, and will need to be closely monitored by a medical professional.
There are a variety of psychotherapy techniques that can be used in the effective treatment of post-traumatic stress disorder. However, there are a few that are growing in researched-based evidence to show their effectiveness in the treatment of PTSD, specifically.
Cognitive processing therapy is a specific type of cognitive-behavioral therapy that focuses on how a traumatic event is perceived, and how the patient copes with the emotional and mental aspect of their experience. Together, patients and therapists collaborate in processing the traumatic event and work through "stuck points." Stuck points are certain thoughts related to the trauma that is preventing recovery. This method of counseling can be conducted in an individual or group format.
Eye movement desensitization and reprocessing is more commonly referred to as EMDR. This is a type of psychotherapy often used with survivors of trauma, particularly those experiencing symptoms of PTSD. This technique utilizes bilateral sensory input such as side-to-side eye movements to help process difficult memories, thoughts, and emotions related to the trauma. As described by the EMDR Institute, "Unlike talk therapy, the insights clients gain in EMDR therapy result not so much from clinician interpretation but from the client's own accelerated intellectual and emotional processes." In EMDR therapy, the past, present, and future are all addressed using an established eight-phase treatment approach.
Cognitive behavioral therapy (CBT) is a style of talk therapy that focuses on the relationship between thoughts, feelings, and behaviors. CBT targets current symptoms and problems, usually lasting 12-16 sessions, and can be done in an individual or group format. Together with a therapist, a patient will work to identify distortions or unhelpful patterns in thoughts and feelings related to the trauma. The goal of CBT is to help the person return to a place where they can regain hope, feel a greater sense of control in thoughts and behaviors, as well as help reduce escape or avoidance behaviors.
There are a variety of treatment options available, with new and innovative techniques emerging and being researched for their effectiveness. PTSD patients often experience feelings of shame and fear, finding it difficult to initiate seeking help. Many struggle in isolation with the hope that the symptoms they are experiencing will go away on their own.
Connecting with a primary care physician can be a good place to start as well, especially for local treatment options. Many doctors and other health providers network and become familiar with people who specialize in the treatment of certain conditions, like a PTSD diagnosis.
Advekit can help you get matched with a PTSD therapist today.