Dealing with PTSD

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What is PTSD?

PTSD, or post-traumatic stress disorder, is a type of anxiety disorder that can develop in some people after experiencing a dangerous, shocking, or scary event. While most people will experience trauma or stress after such an event, symptoms typically resolve naturally over time as the individual processes and recovers from the event. PTSD is a chronic or ongoing condition that makes the individual feel frightened or stressed even when they are not in danger. Symptoms of PTSD fall into four main categories:

  • Re-experiencing: These symptoms can disrupt an individual’s routine, and include flashbacks, bad dreams, and frightening thoughts.
  • Avoidance: The individual avoids places, things, or activities that remind them of the traumatic incident. This includes avoiding thoughts or feelings about the incident.
  • Arousal and reactivity: Arousal symptoms are constant or ongoing, and include being easily startled, feeling tense, having outbursts of anger, and having difficulty sleeping.
  • Cognition and mood: PTSD-related mood and cognition symptoms must not be due to an injury or other medical condition, and include loss of interest in activities, distorted feelings such as blame and guilt, negative thoughts about the world and oneself, and trouble remembering the traumatic event or a time period surrounding the event.

Typically, PTSD symptoms are noticed within 3 months of the traumatic event, but sometimes symptoms don’t occur until years after the incident. Not everyone develops PTSD after experiencing a traumatic event. There are a variety of risk factors and resilience factors that make an individual more or less likely to develop PTSD, such as the level of social support after the incident, childhood trauma, additional life stressors, and coping strategies.

What Treatments Are There for PTSD?

There are many available treatments for individuals with PTSD; the right treatment is different for each person, but often times, two kinds of treatment together are more effective. Treatments include different types of therapy and medication.

PTSD Therapies

The goals of therapy for PTSD are to relieve symptoms, teach the individual skills to cope with symptoms, and restore self-esteem. Most therapy options fall under the category of cognitive behavioral therapy, which focuses on the connections between thoughts, feelings, and behaviors in order to change patterns that cause difficulties in functioning. For some, group or family therapy may be more effective than individual sessions.

Cognitive Processing Therapy: This type of therapy involves discussing the traumatic event with a therapist and determining how your thoughts relating to the event impact daily life. Then, you will write about the event in detail and become comfortable talking about it. This process gives you the opportunity to think differently about your trauma and discover new ways to live with it.

Prolonged Exposure Therapy: PE therapy is especially helpful for treating avoidant symptoms. The therapist will teach you techniques to control anxiety while you discuss the traumatic event. You’ll also create a list of things you avoid because of the event, and learn how to confront them one by one, in addition to talking about the event and listening to a recording of yourself.

Eye Movement Desensitization and Reprocessing: This therapy type doesn’t necessarily involve discussing the traumatic event with a therapist. Instead, you will think about the event while watching or listening to another stimulus presented by the therapist. The goal of EMDR is to be able to have positive thoughts while you remember your trauma.

Stress Inoculation Training: With SIT, instead of going into detail about your traumatic event, you will learn how to deal with the stress you experience from the incident. This can include breathing and massage techniques and other methods of relaxation to learn to stop negative thoughts.

Medication for PTSD

While cognitive therapy is the most effective way to treat PTSD and the best path to overcoming symptoms completely, therapy can often be augmented by medication. Medications can also help relieve symptoms to get back to a normal level of functioning day-to-day. Typically, doctors will first prescribe SSRIs such as:

  • Fluoxetine
  • Paroxetine
  • Setraline
  • Venlafaxine

Each individual responds differently to medication, so it is also common to try other types of medication such as antidepressants, MAOIs, SGAs, beta-blockers, and benzodiazepines. 

Alternative Therapies

In an effort to move away from traditional medications that often have debilitating side effects, a number of alternative therapies are growing in popularity.  Clinics such as TMS&BrainHealth are reporting an uptick in the number of patients seeking help with PTSD. In particular, ketamine therapy is showing promise with PTSD treatment in particular. Ketamine, when prescribed in small monitored dosage by a licensed psychologist, can improve the symptoms of PTSD, especially where traditional SSRI’s have had disappointing results. It can take time to find the right type and dosage of medication that offers safe and effective symptom relief. In fact, the FDA has approved ketamine for depressions as an alternate medicine, or to be used in conjunction with anti-depressants. 

If you are struggling with anxiety, depression, or any of the above mentioned symptoms, do consider if you have suffered a trauma in recent or distant memory. Seek the help of a professional who can evaluate your situation and work with you long term to identify the right strategy for you. PTSD is a serious and common disorder that can be managed safely.