PTSD Treatment

Post-traumatic stress disorder (PTSD) doesn’t affect only those who serve in the military. It’s a condition that can affect anyone who experiences a traumatic event, such as a natural disaster, severe accident, terrorist act, rape, or other violent assaults, according to the American Psychiatric Association (APA). 

An estimated 8 million Americans over age 18 struggle with PTSD, according to the Anxiety and Depression Association of America (ADAA). 

Living with PTSD can be challenging, and many individuals will turn to drugs or alcohol to self-medicate. Fortunately, PTSD treatment is available and can help immensely in the battle to overcome this disorder. Below, we’ll take a more in-depth look at the condition and how it is treated.

A Deeper Look at PTSD

PTSD is comprised of four primary symptoms, which are:

• Experiencing emotional numbness and avoiding people, places, or activities that remind the person of the traumatic event.
• Reexperiencing the traumatic event(s) through distressing or intrusive recollections, nightmares, or flashbacks.
• A sense of being cut off from others or having other adverse effects on how you think, remember, understand, and learn. The event will also affect your mood.
• Noticeable changes in reactivity and arousal. You may find it more challenging to fall asleep or concentrate. You will also feel irritated, jumpy, or easily angered.

Symptoms most commonly occur within a few weeks after the trauma occurs, but in some cases, they may not appear for several months or years.

Traumatic Events that Cause PTSD

A person who experiences these traumatic events is prone to developing PTSD, according to the Mayo Clinic:

• An accident
• Childhood physical or sexual abuse
• Being threatened with a weapon
• Combat exposure
• Sexual violence
• Physical assault

Do I Have PTSD?

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), is considered the principal authority when determining psychiatric diagnoses. It lists specific criteria that assist doctors in making a PTSD diagnosis. The following criteria must be present when making a PTSD diagnosis. 

Criterion A (one required): The individual was threatened with death, exposed to death, threatened with serious injury, or sexual violence in the following ways:

• Witnessing the trauma
• Direct exposure
• Finding out that a close friend or relative was exposed to the trauma
• Indirect exposure to details of the trauma, typically in the course of professional duties.

Criterion B (one required): The individual persistently re-experiences the traumatic event in the following way(s):

• Flashbacks
• Nightmares
• Unwanted and upsetting memories
• Emotional distress after you’ve been exposed to traumatic reminders
• Physical reactivity after you’ve been exposed to traumatic reminders

Criterion C (one required): Avoiding trauma-related stimuli after the distressing event in the following fashion:

• Trauma-related reminders
• Trauma-related thoughts or feelings

Criterion D (two required): Adverse thoughts or feeling that started or worsened after the even in the following way:

• Negative thoughts and assumptions about yourself or the world
• Inability to recall key features of the traumatic event
• Decreasing interest in specific activities
• Feelings of isolation
• Exaggerated blame of yourself or others for causing the traumatic event
• Unable to experience positivity

Criterion E (two required): Trauma-related reactivity or arousal that began or worsened after the initial trauma in the following way(s):

• Hypervigilance
• Risky or destructive behavior
• Aggression or irritability
• Sleeping problems
• Difficulty concentrating
• Heightened startle reaction

Criterion F (required): Symptoms lasting for more than a month.

Criterion G (required): Symptoms that cause functional impairment or distress

Criterion H (required): Symptoms that aren’t caused by substance use, medication, or other illnesses

• Dissociative Specification: In addition to meeting the specific criteria to be diagnosed, the individual will experience a high level of the following when reacting to trauma-related stimuli.
• Depersonalization: Being detached from oneself or an outside observer, which may feel like you’re in a dream.
• Derealization: Experience of distance, unreality, or distortion—things that don’t feel real.
• Delayed Specification: Full diagnostic criteria that aren’t met until six months after the trauma(s) occur despite the onset of symptoms occurring immediately.

PTSD Dangers & Risk Factors

PTSD can cause significant issues in your life, including at work, relationships, health, and well-being. Unfortunately, up to 80 percent of people with PTSD will have a co-occurring disorder throughout their lives. The mental disorders most commonly associated with PTSD include borderline personality disorder (BPD), major depressive disorder (MDD), substance use disorder (SUD), and anxiety disorders. 

Unfortunately, PTSD is a risk factor for substance use disorders, and substance use disorders are a risk factor for PTSD once the trauma has occurred. The two are commonly linked, and using drugs or alcohol to cope with the pain is widespread. An estimated 46 percent of people with PTSD meet the standards for a substance use disorder. 

Unfortunately, those with PTSD are more likely to have a drinking problem, and substance use can worsen PTSD in the following way(s):

• Interfering with sleep
• Altering your mood
• Affecting your concentration
• Perpetuating the cycle of avoidance

PTSD Treatment

Fortunately, various treatments exist to help an individual cope with their PTSD symptoms. Many PTSD therapies will fall under the umbrella of cognitive behavioral therapy (CBT), a psychotherapy treatment designed to change behavior patterns that drive the disorder. 

PTSD treatment has three specific goals, including:

• Teaching how to cope with PTSD
• Improving the symptoms of PTSD
• Restoring self-esteem

PTSD Therapies

The conventional therapeutic approaches for PTSD include the following:

• Eye movement desensitization and reprocessing (EMDR): EMDR aims to assist a patient to think positively while recounting the trauma. During this type of therapy, you will be asked to concentrate on the experience while watching or listening to something the therapist is doing, such as flashing light, moving a hand, or making a sound.
• Cognitive processing therapy (CPT): CPT is a 12-week treatment consisting of weekly sessions that last roughly 60 to 90 minutes. You will discuss the traumatic event and associated thoughts and how they’ve adversely impacted your life. You might have to compose a detailed account of what occurred.
• Stress inoculation training (SIT): This form of CBT can be done alone or in a group setting. The primary goal of SIT is to transform how you approach the stress related to the traumatic event. During SIT, you’ll focus on breathing techniques, massage, or other techniques that address the thoughts.
• Prolonged exposure therapy (PE): The primary purpose of this therapy is to help you confront uncomfortable memories that remind you of the event. PE will teach you breathing techniques that alleviate anxiety, and you will be asked to compose a list of things that you’ve been avoiding and learn how to face them.

PTSD Treatment Medications

Listed below are various medications used to improve the symptoms of PTSD. These include:

• Antidepressants
• Anti-anxiety medications
• Minipress

Holistic Treatments

Massage, yoga, and medication are practical means of reducing stressing and anxiety in those struggling with PTSD. Other holistic treatments include:

• Tai chi
• Reiki
• Relaxation therapy
• Acupuncture
• Hypnosis
• Biofeedback
• Guided imagery

Sources

U.S. Department of Veteran Affairs (August 2020) PTSD: National Center for PTSD. from https://www.ptsd.va.gov/understand/related/substance_misuse.asp

Everyday Health (April 2018) Is It PTSD or Something Else? from https://www.everydayhealth.com/ptsd/comorbidities-depression-anxiety-chronic-pain-more/

Mayo Clinic (August 2020) Post-Traumatic Stress Disorder (PTSD) from https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967

ADAA (August 2020) Post-Traumatic Stress Disorder PDF (PTSD) from https://adaa.org/sites/default/files/ADAA_PTSD.pdf

ADAA (August 2020) PTSD. from https://adaa.org/understanding-anxiety/posttraumatic-stress-disorder-ptsd

APA (August 2020). What Is Post-Traumatic Stress Disorder? from https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd