PTSD: Treatment and How to Get Help

Reviewed Sep 20, 2017

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Summary

  • There are many ways to treat PTSD; a course of therapy might combine several of them.
  • Self-help can make it easier to cope with PTSD.
  • Drugs can relieve symptoms, though they do not get at the source of PTSD.

There is no one “magic bullet” to cure post-traumatic stress disorder (PTSD). Therapy comes in many forms, and even the best methods don’t necessarily wipe away all of trauma’s effects. Painful memories don’t vanish. But when treatment works, they no longer disrupt your thinking and your life. Recovery is not only possible, but likely, when one engages in a treatment plan that works for them.

The different PTSD treatments aim at basically the same goal. This is to put memories of trauma in their proper place. In PTSD these memories are “dissociated.” They are cut off from “associated” mental content, or long-term memory. That’s why you re-live them as if they are still in the present.

PTSD treatments focus on thoughts and feelings, but the body may still be affected. You still might keep feeling the physical “fight or flight” response, for instance. Your body may be denying your mind the calm that it needs to deal with painful memories. You may find relaxation therapy, yoga and meditation helpful. Drugs also can treat PTSD symptoms, though they do not get at its root causes.

“There is no one treatment that is superior,” says psychologist and author Glenn Schiraldi. “There is a tool kit of treatments, a combination which surely will help.”

Here are the treatments in that “tool kit” that are most widely used:

Cognitive-behavioral therapy (CBT) aims to help you change the way you think about trauma. In one type of CBT, cognitive processing therapy (CPT), you tell your story and the therapist looks for ways in which it twists reality. People with PTSD often feel guilt or believe, wrongly, that the event was their fault. A soldier might say, “I let my buddy die in combat.” A woman who was raped might tell herself, “It was the way I was dressed.” In cognitive processing, the therapist challenges thoughts like these.

The National Center for PTSD breaks down CPT into four parts:

  • Learning about PTSD symptoms and how treatment can help
  • Becoming aware of thoughts and feelings
  • Learning skills to test your thoughts and feelings
  • Understanding changes in beliefs that occur after trauma.

Prolonged exposure (PE). PE works by making you “confront what you fear,” says Schiraldi. In it, you recall a traumatic event in as much detail as you can. Then you re-tell your story, bringing up more details each time you tell it. At the same time, you learn skills to relax and manage your feelings. If you are avoiding certain safe situations because of the trauma, PE helps you re-enter them. This is called in vivo exposure.

Eye movement desensitization and reprocessing (EMDR) works on the brain to help it deal with painful memories. In this therapy, you might talk about your trauma while watching the therapist move her hand back and forth. Your eye movements stimulate brain activity that processes the memories to make them less disturbing. You can then think more clearly and calmly about the past.

Selective serotonin reuptake inhibitor (SSRIs) drugs are not a cure for PTSD, but some are useful for treating symptoms. SSRIs make you feel better by raising the level of serotonin in the brain. Two of them, Zoloft® and Paxil®, have been approved for adults by the U.S. Food and Drug Administration for use in PTSD. Prazosin (minipress) can be helpful at quieting nightmares and fostering restful sleep. The National Center for PTSD warns against benzodiazepines, such as Xanax® and Valium®. These anti-anxiety drugs don’t treat core PTSD symptoms. They also can be addictive.

The therapies above are well established. Other methods have less of a track record but may work for many people. These include family therapy and group therapy. Another is called brief psychodynamic therapy. It focuses on how to deal with emotional conflicts tied to trauma and on learning how your past changes your feelings today.

In addition to these treatments and seeing a trauma therapist, can you do anything on your own? The answer is yes. Here are some self-help steps (and apps) that experts suggest:

  • Changing your lifestyle. Start exercising. Seek out other trauma survivors. Many people benefit from peer-to-peer support. Stay away from drinking alcohol and using drugs. Work on your relationships. Search for a way to make something meaningful out of the trauma.
  • Mindfulness. Pay attention to your everyday experiences and how they make you feel. Accept your thoughts and feelings without judging them. Such practices have been shown to help calm anxiety, a key part of PTSD. A free Mindfulness Coach app is available from iTunes. For more, see “Resources” below.
  • Joining a peer support group. These groups give you a way to talk about your problems with others who have been through trauma. Talking with peers can reduce PTSD symptoms and can help make life simpler in other ways. You might want to join such a group during or after a course of PTSD treatment.
  • Owning a dog. Dogs are fun, they help reduce stress and they bring out feelings of love. They also take orders when they are well trained—this can be helpful to a service member who was used to giving orders in the military.
  • PTSD Coach. This app was developed jointly by the National Center for PTSD and the U.S. Defense Department’s National Center for Telehealth and Technology. It gives facts on PTSD and treatments that work, tools for screening and tracking symptoms, tools to handle stress symptoms and links to support. It comes in both iPhone and Android versions.

Self-help is a good idea, but it is important to get trauma therapy with or without medication as soon as possible. Studies show that early intervention has the best results.

If you are in a crisis, you should call 911 or visit a hospital emergency room. Or you may need to call the Suicide Prevention Lifeline (1-800-273-8255) or the Veterans Crisis Line (1-800-273-8255). To find a therapist, you might want to start by talking with a provider you already know such as your family doctor. Family and friends might be able to help you. If you have health insurance, call your insurer to see what providers they will pay for. Veterans can find help at any VA Medical Center.

There are a number of websites that can help you find a therapist. (See “Resources” below). Keep in mind that you’ll want a therapist who specializes in the healing of trauma. You’ll also want one who knows the full range of options for treatment and can explain them to you so that you can make a fully informed choice.

Resources

Online:

The National Center for PTSD, a research arm of the U.S. Department of Veterans Affairs, is full of information about PTSD (and is not just for veterans). The home page is at www.ptsd.va.gov. Pages of particular interest include:

“Understanding PTSD Treatment”: www.ptsd.va.gov/public/treatment/therapy-med/index.asp

PDF booklet on treatments: www.ptsd.va.gov/public/understanding_TX/booklet.pdf

“Where to Get Help”: www.ptsd.va.gov/public/where-to-get-help.asp

Information on mindfulness: www.ptsd.va.gov/public/treatment/therapy-med/mindful-ptsd.asp

For a list of websites that can help you find a therapist, go to “Finding a provider using the Internet” at www.ptsd.va.gov/public/treatment/therapy-med/finding-a-therapist.asp

The National Institutes of Health’s Post-Traumatic Stress Disorder Fact Sheet (http://report.nih.gov/NIHfactsheets/Pdfs/PostTraumaticStressDisorder(NIMH).pdf) is a good source for information on emerging therapies.

Books:

The Post-Traumatic Stress Disorder Sourcebook, 2nd ed., by Glenn R. Schiraldi, PhD. McGraw Hill, 2011.

The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma by Bessel van der Kolk. Viking, 2014.

By Tom Gray
Source: National Center for PTSD; Glenn Schiraldi, PhD; National Institutes of Health; Charles Ralson, MD. Psych Congress, Sept. 16-19, 2017, New Orleans LA
Reviewed by Cynthia Scott, MD, Physician Advisor, Beacon Health Options

Summary

  • There are many ways to treat PTSD; a course of therapy might combine several of them.
  • Self-help can make it easier to cope with PTSD.
  • Drugs can relieve symptoms, though they do not get at the source of PTSD.

There is no one “magic bullet” to cure post-traumatic stress disorder (PTSD). Therapy comes in many forms, and even the best methods don’t necessarily wipe away all of trauma’s effects. Painful memories don’t vanish. But when treatment works, they no longer disrupt your thinking and your life. Recovery is not only possible, but likely, when one engages in a treatment plan that works for them.

The different PTSD treatments aim at basically the same goal. This is to put memories of trauma in their proper place. In PTSD these memories are “dissociated.” They are cut off from “associated” mental content, or long-term memory. That’s why you re-live them as if they are still in the present.

PTSD treatments focus on thoughts and feelings, but the body may still be affected. You still might keep feeling the physical “fight or flight” response, for instance. Your body may be denying your mind the calm that it needs to deal with painful memories. You may find relaxation therapy, yoga and meditation helpful. Drugs also can treat PTSD symptoms, though they do not get at its root causes.

“There is no one treatment that is superior,” says psychologist and author Glenn Schiraldi. “There is a tool kit of treatments, a combination which surely will help.”

Here are the treatments in that “tool kit” that are most widely used:

Cognitive-behavioral therapy (CBT) aims to help you change the way you think about trauma. In one type of CBT, cognitive processing therapy (CPT), you tell your story and the therapist looks for ways in which it twists reality. People with PTSD often feel guilt or believe, wrongly, that the event was their fault. A soldier might say, “I let my buddy die in combat.” A woman who was raped might tell herself, “It was the way I was dressed.” In cognitive processing, the therapist challenges thoughts like these.

The National Center for PTSD breaks down CPT into four parts:

  • Learning about PTSD symptoms and how treatment can help
  • Becoming aware of thoughts and feelings
  • Learning skills to test your thoughts and feelings
  • Understanding changes in beliefs that occur after trauma.

Prolonged exposure (PE). PE works by making you “confront what you fear,” says Schiraldi. In it, you recall a traumatic event in as much detail as you can. Then you re-tell your story, bringing up more details each time you tell it. At the same time, you learn skills to relax and manage your feelings. If you are avoiding certain safe situations because of the trauma, PE helps you re-enter them. This is called in vivo exposure.

Eye movement desensitization and reprocessing (EMDR) works on the brain to help it deal with painful memories. In this therapy, you might talk about your trauma while watching the therapist move her hand back and forth. Your eye movements stimulate brain activity that processes the memories to make them less disturbing. You can then think more clearly and calmly about the past.

Selective serotonin reuptake inhibitor (SSRIs) drugs are not a cure for PTSD, but some are useful for treating symptoms. SSRIs make you feel better by raising the level of serotonin in the brain. Two of them, Zoloft® and Paxil®, have been approved for adults by the U.S. Food and Drug Administration for use in PTSD. Prazosin (minipress) can be helpful at quieting nightmares and fostering restful sleep. The National Center for PTSD warns against benzodiazepines, such as Xanax® and Valium®. These anti-anxiety drugs don’t treat core PTSD symptoms. They also can be addictive.

The therapies above are well established. Other methods have less of a track record but may work for many people. These include family therapy and group therapy. Another is called brief psychodynamic therapy. It focuses on how to deal with emotional conflicts tied to trauma and on learning how your past changes your feelings today.

In addition to these treatments and seeing a trauma therapist, can you do anything on your own? The answer is yes. Here are some self-help steps (and apps) that experts suggest:

  • Changing your lifestyle. Start exercising. Seek out other trauma survivors. Many people benefit from peer-to-peer support. Stay away from drinking alcohol and using drugs. Work on your relationships. Search for a way to make something meaningful out of the trauma.
  • Mindfulness. Pay attention to your everyday experiences and how they make you feel. Accept your thoughts and feelings without judging them. Such practices have been shown to help calm anxiety, a key part of PTSD. A free Mindfulness Coach app is available from iTunes. For more, see “Resources” below.
  • Joining a peer support group. These groups give you a way to talk about your problems with others who have been through trauma. Talking with peers can reduce PTSD symptoms and can help make life simpler in other ways. You might want to join such a group during or after a course of PTSD treatment.
  • Owning a dog. Dogs are fun, they help reduce stress and they bring out feelings of love. They also take orders when they are well trained—this can be helpful to a service member who was used to giving orders in the military.
  • PTSD Coach. This app was developed jointly by the National Center for PTSD and the U.S. Defense Department’s National Center for Telehealth and Technology. It gives facts on PTSD and treatments that work, tools for screening and tracking symptoms, tools to handle stress symptoms and links to support. It comes in both iPhone and Android versions.

Self-help is a good idea, but it is important to get trauma therapy with or without medication as soon as possible. Studies show that early intervention has the best results.

If you are in a crisis, you should call 911 or visit a hospital emergency room. Or you may need to call the Suicide Prevention Lifeline (1-800-273-8255) or the Veterans Crisis Line (1-800-273-8255). To find a therapist, you might want to start by talking with a provider you already know such as your family doctor. Family and friends might be able to help you. If you have health insurance, call your insurer to see what providers they will pay for. Veterans can find help at any VA Medical Center.

There are a number of websites that can help you find a therapist. (See “Resources” below). Keep in mind that you’ll want a therapist who specializes in the healing of trauma. You’ll also want one who knows the full range of options for treatment and can explain them to you so that you can make a fully informed choice.

Resources

Online:

The National Center for PTSD, a research arm of the U.S. Department of Veterans Affairs, is full of information about PTSD (and is not just for veterans). The home page is at www.ptsd.va.gov. Pages of particular interest include:

“Understanding PTSD Treatment”: www.ptsd.va.gov/public/treatment/therapy-med/index.asp

PDF booklet on treatments: www.ptsd.va.gov/public/understanding_TX/booklet.pdf

“Where to Get Help”: www.ptsd.va.gov/public/where-to-get-help.asp

Information on mindfulness: www.ptsd.va.gov/public/treatment/therapy-med/mindful-ptsd.asp

For a list of websites that can help you find a therapist, go to “Finding a provider using the Internet” at www.ptsd.va.gov/public/treatment/therapy-med/finding-a-therapist.asp

The National Institutes of Health’s Post-Traumatic Stress Disorder Fact Sheet (http://report.nih.gov/NIHfactsheets/Pdfs/PostTraumaticStressDisorder(NIMH).pdf) is a good source for information on emerging therapies.

Books:

The Post-Traumatic Stress Disorder Sourcebook, 2nd ed., by Glenn R. Schiraldi, PhD. McGraw Hill, 2011.

The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma by Bessel van der Kolk. Viking, 2014.

By Tom Gray
Source: National Center for PTSD; Glenn Schiraldi, PhD; National Institutes of Health; Charles Ralson, MD. Psych Congress, Sept. 16-19, 2017, New Orleans LA
Reviewed by Cynthia Scott, MD, Physician Advisor, Beacon Health Options

Summary

  • There are many ways to treat PTSD; a course of therapy might combine several of them.
  • Self-help can make it easier to cope with PTSD.
  • Drugs can relieve symptoms, though they do not get at the source of PTSD.

There is no one “magic bullet” to cure post-traumatic stress disorder (PTSD). Therapy comes in many forms, and even the best methods don’t necessarily wipe away all of trauma’s effects. Painful memories don’t vanish. But when treatment works, they no longer disrupt your thinking and your life. Recovery is not only possible, but likely, when one engages in a treatment plan that works for them.

The different PTSD treatments aim at basically the same goal. This is to put memories of trauma in their proper place. In PTSD these memories are “dissociated.” They are cut off from “associated” mental content, or long-term memory. That’s why you re-live them as if they are still in the present.

PTSD treatments focus on thoughts and feelings, but the body may still be affected. You still might keep feeling the physical “fight or flight” response, for instance. Your body may be denying your mind the calm that it needs to deal with painful memories. You may find relaxation therapy, yoga and meditation helpful. Drugs also can treat PTSD symptoms, though they do not get at its root causes.

“There is no one treatment that is superior,” says psychologist and author Glenn Schiraldi. “There is a tool kit of treatments, a combination which surely will help.”

Here are the treatments in that “tool kit” that are most widely used:

Cognitive-behavioral therapy (CBT) aims to help you change the way you think about trauma. In one type of CBT, cognitive processing therapy (CPT), you tell your story and the therapist looks for ways in which it twists reality. People with PTSD often feel guilt or believe, wrongly, that the event was their fault. A soldier might say, “I let my buddy die in combat.” A woman who was raped might tell herself, “It was the way I was dressed.” In cognitive processing, the therapist challenges thoughts like these.

The National Center for PTSD breaks down CPT into four parts:

  • Learning about PTSD symptoms and how treatment can help
  • Becoming aware of thoughts and feelings
  • Learning skills to test your thoughts and feelings
  • Understanding changes in beliefs that occur after trauma.

Prolonged exposure (PE). PE works by making you “confront what you fear,” says Schiraldi. In it, you recall a traumatic event in as much detail as you can. Then you re-tell your story, bringing up more details each time you tell it. At the same time, you learn skills to relax and manage your feelings. If you are avoiding certain safe situations because of the trauma, PE helps you re-enter them. This is called in vivo exposure.

Eye movement desensitization and reprocessing (EMDR) works on the brain to help it deal with painful memories. In this therapy, you might talk about your trauma while watching the therapist move her hand back and forth. Your eye movements stimulate brain activity that processes the memories to make them less disturbing. You can then think more clearly and calmly about the past.

Selective serotonin reuptake inhibitor (SSRIs) drugs are not a cure for PTSD, but some are useful for treating symptoms. SSRIs make you feel better by raising the level of serotonin in the brain. Two of them, Zoloft® and Paxil®, have been approved for adults by the U.S. Food and Drug Administration for use in PTSD. Prazosin (minipress) can be helpful at quieting nightmares and fostering restful sleep. The National Center for PTSD warns against benzodiazepines, such as Xanax® and Valium®. These anti-anxiety drugs don’t treat core PTSD symptoms. They also can be addictive.

The therapies above are well established. Other methods have less of a track record but may work for many people. These include family therapy and group therapy. Another is called brief psychodynamic therapy. It focuses on how to deal with emotional conflicts tied to trauma and on learning how your past changes your feelings today.

In addition to these treatments and seeing a trauma therapist, can you do anything on your own? The answer is yes. Here are some self-help steps (and apps) that experts suggest:

  • Changing your lifestyle. Start exercising. Seek out other trauma survivors. Many people benefit from peer-to-peer support. Stay away from drinking alcohol and using drugs. Work on your relationships. Search for a way to make something meaningful out of the trauma.
  • Mindfulness. Pay attention to your everyday experiences and how they make you feel. Accept your thoughts and feelings without judging them. Such practices have been shown to help calm anxiety, a key part of PTSD. A free Mindfulness Coach app is available from iTunes. For more, see “Resources” below.
  • Joining a peer support group. These groups give you a way to talk about your problems with others who have been through trauma. Talking with peers can reduce PTSD symptoms and can help make life simpler in other ways. You might want to join such a group during or after a course of PTSD treatment.
  • Owning a dog. Dogs are fun, they help reduce stress and they bring out feelings of love. They also take orders when they are well trained—this can be helpful to a service member who was used to giving orders in the military.
  • PTSD Coach. This app was developed jointly by the National Center for PTSD and the U.S. Defense Department’s National Center for Telehealth and Technology. It gives facts on PTSD and treatments that work, tools for screening and tracking symptoms, tools to handle stress symptoms and links to support. It comes in both iPhone and Android versions.

Self-help is a good idea, but it is important to get trauma therapy with or without medication as soon as possible. Studies show that early intervention has the best results.

If you are in a crisis, you should call 911 or visit a hospital emergency room. Or you may need to call the Suicide Prevention Lifeline (1-800-273-8255) or the Veterans Crisis Line (1-800-273-8255). To find a therapist, you might want to start by talking with a provider you already know such as your family doctor. Family and friends might be able to help you. If you have health insurance, call your insurer to see what providers they will pay for. Veterans can find help at any VA Medical Center.

There are a number of websites that can help you find a therapist. (See “Resources” below). Keep in mind that you’ll want a therapist who specializes in the healing of trauma. You’ll also want one who knows the full range of options for treatment and can explain them to you so that you can make a fully informed choice.

Resources

Online:

The National Center for PTSD, a research arm of the U.S. Department of Veterans Affairs, is full of information about PTSD (and is not just for veterans). The home page is at www.ptsd.va.gov. Pages of particular interest include:

“Understanding PTSD Treatment”: www.ptsd.va.gov/public/treatment/therapy-med/index.asp

PDF booklet on treatments: www.ptsd.va.gov/public/understanding_TX/booklet.pdf

“Where to Get Help”: www.ptsd.va.gov/public/where-to-get-help.asp

Information on mindfulness: www.ptsd.va.gov/public/treatment/therapy-med/mindful-ptsd.asp

For a list of websites that can help you find a therapist, go to “Finding a provider using the Internet” at www.ptsd.va.gov/public/treatment/therapy-med/finding-a-therapist.asp

The National Institutes of Health’s Post-Traumatic Stress Disorder Fact Sheet (http://report.nih.gov/NIHfactsheets/Pdfs/PostTraumaticStressDisorder(NIMH).pdf) is a good source for information on emerging therapies.

Books:

The Post-Traumatic Stress Disorder Sourcebook, 2nd ed., by Glenn R. Schiraldi, PhD. McGraw Hill, 2011.

The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma by Bessel van der Kolk. Viking, 2014.

By Tom Gray
Source: National Center for PTSD; Glenn Schiraldi, PhD; National Institutes of Health; Charles Ralson, MD. Psych Congress, Sept. 16-19, 2017, New Orleans LA
Reviewed by Cynthia Scott, MD, Physician Advisor, Beacon Health Options

The information provided on the Achieve Solutions site, including, but not limited to, articles, quizzes, and other general information, is for informational purposes only and should not be treated as medical, health care, psychiatric, psychological or behavioral health care advice. Nothing contained on the Achieve Solutions site is intended to be used for medical diagnosis or treatment or as a substitute for consultation with a qualified health care professional. Please direct questions regarding the operation of the Achieve Solutions site to Web Feedback. If you have concerns about your health, please contact your health care provider.  ©2017 Beacon Health Options, Inc.

 

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