Posttraumatic Stress Disorder

When exposed to severe trauma, people often respond in a predictable biological and psychological manner. The resulting symptoms can be overwhelming and confusing. Additionally, seeking help can be difficult as it's common for people to feel like they should just "get over" the experience.

Strategies such as substance use or drinking alcohol feel like they bring relief, but create problems over time. Immediately after a traumatic event, support and compassion are critical. Some people will want to talk about the event, while others will find it troubling. People shouldn't be forced to discuss a traumatic event in its immediate aftermath.

Psychotherapy

People with PTSD respond better to select, structured interventions than to unstructured, supportive psychotherapy. In addition to the following therapies, research is being conducted on dream revision therapy, also known as Imagery Rehearsal Therapy (IRT).

  • Cognitive behavioral therapy (CBT) helps change the negative thinking and behavior associated with depression. The goal of this therapy is to recognize negative thoughts and replace them with positive thoughts, which leads to more effective behavior.
  • Eye movement desensitization and reprocessing (EMDR) is an eclectic psychotherapy intervention designed for trauma that employs exposure to traumatic memories with alternating stimuli (eye movements are one of several options) in structured sessions with an individual certified to perform EMDR.
  • Exposure therapy helps people safely face what they find frightening so that they can learn to cope with it effectively. For example, virtual reality programs allow a person to experience the situation in which he or she experienced trauma.

Group Therapy

Finding a support group with shared experiences can build resilience when someone feels alone and isolated. Groups lessen shame and provide support, as well as reduce feelings of helplessness. Groups for survivors of combat and sexual assault frequently involve members living with PTSD and related symptoms.

Service Dogs

Using service dogs as a form of therapy for people with PTSD—especially for veterans—is very common. A service dog is by a veteran’s side 24 hours a day to help navigate daily stressors. Most animals come to the veteran pre-trained with a set of commands. The owner can rely upon the dog’s instincts for a reality check, which can help prevent a re-experience or other symptoms. The animals can also serve as a social buffer, an incentive to exercise and a de-escalation tool during times of stress.

Medications

There is no one medication that will treat all cases of PTSD. The effective combination of psychotherapy and medication should be used together to treat PTSD and reduce its symptoms. Given the common co-occurrence of depression, related anxiety disorders, aggression and impulsivity, selecting medications that address these related problems is recommended.

  • Antidepressants can be useful to reduce the symptoms of PTSD. Several selective serotonin reuptake inhibitors (SSRIs) have been approved by the FDA for the treatment of PTSD in adults and are often the first line of treatment.
  • Alpha- and beta-blockers, a class of medications used for high blood pressure, may be helpful for some people with PTSD because they interfere with the way memories are stored in the brain and can alleviate fear associated with trauma. Although it is not FDA approved, Prazocin has been shown to reduce nightmares found in PTSD. Ask your doctor for more information about this intervention.
  • Mood stabilizers and antipsychotic medications may have a role for individuals with aggression, mood instability or dissociation.

Complementary Health Approaches

Recently, many health care professionals have begun to include complementary and alternative methods into treatment regimens. Some methods that have been used for PTSD include:

  • Yoga
  • Aqua therapy, such as floatation chambers and surfing
  • Acupuncture
  • Mindfulness and meditation