Treatment, Services and Support for PTSD
Treating Posttraumatic Stress Disorder
In the aftermath of a traumatic event, individual choices can make a difference. Several common coping strategies, such as substance use, appear to yield short-term relief but create problems over time and should be discourage. Receiving proper treatment as soon as possible is key to producing positive outcomes.
Treatment strategies should be customized to the individual’s needs and reflect the treatment plan of their choosing. Treatment and support options should also reflect an individual’s stage of recovery—interventions that make sense immediately after a trauma may not be appropriate years later.
Psychological First Aid
Support and compassion are critical in the immediate aftermath of a traumatic event. Some people will want to talk about the event frequently, while others will find it troubling to discuss the trauma. It is important to provide support to the individual, help the individual maintain connections with others and encourage him or her to seek assistance in dealing with trauma. Since many people living with PTSD go to a primary care doctor first, it’s important that symptoms be identified at this stage.
There are many different kinds of psychotherapy in the field of mental health. People living with PTSD respond better to select, structured interventions than to unstructured, supportive psychotherapy. In addition to EMDR (see below), research is being conducted on dream revision therapy, also known as Imagery Rehearsal Therapy (IRT).
Cognitive Behavior Therapy (CBT)
Cognitive Behavior Therapy (CBT) employs tailored exposure to the traumatic event through a memory or another form of exposure. By tolerating the exposure to the trauma, the individual’s anxiety and symptoms can gradually reduce. CBT has two different parts: a behavioral component (usually referred to as “exposure therapy”) and a cognitive component that aims to correct distorted thoughts that can result in shame and self-blame. There are many forms of exposure therapy that are all designed to expose the person to triggers in a safe way so that he or she can learn to tolerate them. Newer forms of CBT may involve computer simulations or other technology to create a safe form of exposure to circumstances similar to the trauma.
Eye Movement Desensitization Reprocess (EMDR)
Developed in 1989, EMDR is an eclectic psychotherapy intervention designed for trauma that employs several strategies, including exposure to traumatic memories with alternating stimuli (eye movements are one of several options) in structured sessions with an individual certified to perform EMDR. EMDR has been shown to be effective for PTSD as it is an information-processing therapy. It is not now clear if the alternating movements of the eyes are related to the intervention’s usefulness.
Joining a group of people who have been through similar experiences can uplift and support an individual who is feeling alone and isolated with upsetting and traumatic memories and symptoms. Groups can lessen shame and provide community 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. The ancient expression "pain shared is pain halved" speaks to the relief people often feel when they share their stories with others. Psychotherapy research is an active area in the PTSD field. Interest is growing in treatments that focus attention on how symptoms are experienced in the body.
The use of service dogs as forms of therapy for individuals living with PTSD, especially for veterans, is becoming increasingly common. A service dog is by a veteran’s side 24 hours a day to help navigate daily stressors. Some animals come to the veteran pre-trained with a set of commands, while others are trained by the owners themselves. Over time, an owner can rely upon the dog’s instincts for a reality check, giving their brain a break from hypervigilance. The animals can also serve as a social buffer, an incentive to exercise and a de-escalation tool during times of stress. See the resources section for more information on service dogs.
There is no one medication that will treat all cases of PTSD. Given the effectiveness of psychotherapy and medication, they should be used together to treat PTSD and reduce symptoms. Given the common co-occurrence of depression, related anxiety disorders, aggression and impulsivity, selecting medications that address these related problems might also reduce symptoms.
- Antidepressant therapy 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.
- Beta-blockers, a class of medications used for high blood pressure, may be helpful for some people with PTSD.
- Mood stabilizers and antipsychotic medications may have a role for individuals with aggression, mood instability or dissociation.
- Sleep restoration is important. Physicians may use off-label medications to normalize sleep patterns, a key component to supporting recovery.
Complex responses to trauma have been an element of the human condition since recorded time. In the modern era, researchers are uncovering the complicated relationship between mind, brain and body for people living with PTSD. The more that science learns about the deep level at which our experiences affect us, the more compassion, acceptance and possibilities are opening up for individuals and families living with the effects of trauma. When it comes to treating PTSD, there is much to be hopeful about once the first step of breaking through the isolation has been taken. People living with PTSD and their families should ask their health care providers about the latest developments and treatment options that flow from recent research.
Alternative Methods Gaining Ground
With the influx of soldiers returning from war, there has been a renewed interest in helping individuals living with posttraumatic stress disorder (PTSD). In recent years there has been an increased in interest in administering complementary and alternative methods of aid to treatment regimens. There has been much public interest in some of these categories, including yoga, aqua therapy (such as surfing) and meditation. Although many of the recent stories have solely examined soldiers, the techniques can assuredly be used by anyone diagnosed with PTSD.