I.               What is the Treatment for Post-Traumatic Stress Disorder?

 Today we are continuing our discussion of post-traumatic stress disorder by identifying treatments options.

Post-traumatic stress disorder consists of a spectrum of pathologic symptoms and behaviors involving the environment, the brain, and psychosocial influences. The environment is both cause and effect as the trauma from the environment initiates the disorder and leaves its imprint as an aftermath. The brain interacts with the trauma to produce symptoms of intense fear, dissociative flashback episodes, and physiological reactivity upon exposure to cues that resemble the traumatic event. Because of the constellation of symptoms typical of PTSD, the conceptualization of symptoms and pathologic behaviors related to the environment, the brain and psychosocial factors allows the clinician to select biologic, cognitive-behavior, psychosocial and environmental modalities to formulate a comprehensive treatment plan. (C.B. Scrignar)

The Mayo Clinic describes treatments.

Several types of medications can help symptoms of post-traumatic stress disorder improve.

  •  Antipsychotics. In some cases, you may be prescribed a short course of antipsychotics to relieve severe anxiety and related problems, such as difficulty sleeping or emotional outbursts.
  • Antidepressants. These medications can help symptoms of both depression and anxiety. They can also help improve sleep problems and improve your concentration. The selective serotonin reuptake inhibitor (SSRI) medications sertraline (Zoloft) and paroxetine (Paxil) are FDA-approved for the treatment of PTSD.
  • Anti-anxiety medications. These drugs also can improve feelings of anxiety and stress.
  • Prazosin. If your symptoms include insomnia or recurrent nightmares, a drug called prazosin (Minipress) may help. Prazosin, which has been used for years in the treatment of hypertension, also blocks the brain’s response to an adrenaline-like brain chemical called norepinephrine. Although this drug is not specifically approved for the treatment of PTSD, prazosin may reduce or suppress nightmares in many people with PTSD.

Several types of therapy may be used to treat both children and adults with post-traumatic stress disorder. You may try more than one, or combine types, before finding the right fit for you. You may also try individual therapy, group therapy or both. Group therapy can offer a way to connect to others going through similar experiences.

Some types of therapy used in PTSD treatment include:

  • Cognitive therapy. This type of talk therapy helps you recognize the ways of thinking (cognitive patterns) that are keeping you stuck — for example, negative or inaccurate ways of perceiving normal situations.

In PTSD treatment, cognitive therapy often is used along with a behavioral therapy called exposure therapy.

  • Exposure therapy. This behavioral therapy technique helps you safely face the very thing that you find frightening, so that you can learn to cope with it effectively. A new approach to exposure therapy uses "virtual reality" programs that allow you to re-enter the setting in which you experienced trauma — for example, a "Virtual Iraq" program.
  • Eye movement desensitization and reprocessing (EMDR). This type of therapy combines exposure therapy with a series of guided eye movements that help you process traumatic memories.

All these approaches can help you gain control of lasting fear after a traumatic event. The type of therapy that may be best depends on a number of factors that a PTSD sufferer and a health care professional can discuss.

As identified above, Medications and psychotherapy also can help you with other problems related to traumatic experience, such as depression, anxiety. Many PTSD sufferers engage in “self-medication” with alcohol or substance abuse. Therapy and treatment can help curb the burden of PTSD.

Next week we will look at special issues germane to litigation and post-traumatic stress disorder.