Treatment of PTSD

Treatment of PTSD (Post Traumatic Stress Disorder). Introduction

PTSD is a psychological condition that can occur after a traumatiszing event. This occurrence may cause a severe impairment to those affected, causing troubling dreams and memories, strong anxiety, depression, guilt, or shame. PTSD can happen to people of all ages and genders. Being initially used as a diagnosis describing a combat trauma, today PTSD can be diagnosed by people affected by traumatic events not linked to the war, such as natural disasters, car accidents, robery, or rape. People may also develop PTSD when their family members or close friends get traumatized.

One key component of PTSD is experiencing symptoms again, in so-called “flashbacks,” in which individuals reexperience the trauma through intrusive memories, or nightmares. PTSD can also cause emotional numbness, indifference, or detachedness from others. People could develop an avoidance behaviour avoiding situations or places reminding them of the trauma. Other symptoms of PTSD is hyperarousal showing up irritability, elevated alertness, anxiety, depression and sleep deprivation. Such symptoms can disrupt social interactions, professional performance, leading in some cases to a full invalidism.

Diagnosis of PTSD

PTSD is diagnosed only if symptoms persist more than four weeks. This is because most people experience significant discomfort in the initial weeks following a traumatic incident and it takes time to process these events. As soon as symptoms appear after a traumatic event, they are known as an “acute stress reaction.”

Conversations with a mental health professional or healthcare provider will help one identify PTSD. These discussions revolve on assessing the severity of symptoms and their impact on the present situation of the person. Family, employment, and housing conditions are taken into consideration. Sometimes one uses a self-evaluation questionnaire. To help kids talk about their feelings, drawing or playing can be helpful.

Furthermore, interactions with parents or close friends are very important in the diagnostic process. PTSD might go unnoticed, especially in cases of major accidents where the focus is on physical injuries.

Moreover, some people could not relate their psychological problems to past traumatic events. Communicating specific events and problems can be difficult and depends on mutual trust for a correct diagnosis to develop. Diagnostic conversations involve careful discussions that involve only a brief mention of the traumatic event. Giving detailed explanations is not necessary. Traumatic events can also aggravate other mental health disorders including anxiety or depression; these should be considered during diagnosis.

Symptoms of PTSD

The symptoms of post-traumatic stress disorder include:

Intrusive thoughts

Trauma is repeatedly experienced once more in intrusive thoughts. People often have sudden, intense memories that they can’t stop having. These are called flashbacks. These invading images and feelings give the impression that the incident is playing back itself. Many people have recurrent nightmares. Memories and ideas might set off feelings of anxiety, powerlessness, danger, guilt, and shame as well as cause physical reactions including pain.

Hyperarousal

People with PTSD often show increased awareness, almost as if they are always on watch. They may find it difficult to concentrate, sleep, or exhibit irritability or impulsivity. Strong reactions to triggers that remind them of the horrific event—like different smells, sounds, or images—could also be experienced by them. Physical reactions including heart palpitations, constriction of the chest, trouble breathing, and shaking can follow from this.

Avoidance behaviour

Trauma-affected people often avoid events, places, or people connected to their past experiences since they might cause memories or flashbacks. This means abstaining from events, ideas, or conversations. Some people with PTSD may withdraw from society or lose interest in significant events. They can feel disconnected from their own life. Sometimes the trauma is buried so deeply that important information of the incident cannot be recalled. Moreover, PTSD can cause emotional numbness, which would make it difficult to grasp and interpret the events.

Negative thoughts and feelings

Many people start to doubt others and themselves out of negative ideas and emotions. Their confidence often falls, which makes them weak and helpless. They frequently torture themselves using questions like “Why did this occur to me?” or “What could I have done to stop it?”. A few even wonder, “Is the blame mine?” They might also start to become irritable or regularly agitated. They might get enraged toward the person causing the trauma or toward those who neglected to provide enough help later, such as police or medical professionals.

Disorders Associated with PTSD

Also, trauma can cause additional mental health issues including anxiety disorders, depression, or substance abuse. A dissociative disorder is another possibility whereby parts of the personality seem to separate, or memories are erased. As a result, some people may develop psychosis, an eating disorder, or chronic pain.

In mild PTSD, symptoms are less severe and might only show up momentarily in specific events that bring back the trauma for the person. Under such circumstances, daily life almost seems to return to normal. Still, advanced phases of PTSD can cause severe psychological symptoms, which would make it quite challenging to manage without help. Some people suffer with a disorder known as “complex PTSD.” Many of the symptoms in this condition persist over several years and are particularly severe. Either major or repeated trauma can lead to complex PTSD.  The intensity of the event as well as a person’s stress management capacity define the degree of symptoms.

However, post-traumatic stress disorder in Children and teenagers’ often presents differently than that of adults. Multiple times, they reenact their trauma using different scenarios or characters, symbolically. Many people have behavioral problems displaying symptoms of either extreme anxiety or hostility. Children and teenagers with complicated PTSD suffer particularly in terms of emotional regulation. Their greatly distorted view of others and themselves makes it challenging for them to develop in trusting relationships.

Types of PTSD

1) Acute Stress Disorder (ASD)

The brief mental illness known as acute stress disorder (ASD) develops one month following a traumatic event. Should symptoms last more than four weeks, they may develop into Post-Traumatic Stress Disorder (PTSD).

2)  Complex PTSD (CPTSD)

It is usually resulting from prolonged, intense trauma. People who have experienced ongoing child abuse, domestic violence, or ongoing war trauma often find this situation repeated. Apart from common PTSD symptoms, persons with CPTSD often face additional challenges including difficulties controlling emotions, self-awareness and handling relationships.

Prevalence of PTSD

According to estimates, 8% of people worldwide suffer with PTSD at some point in their life. PTSD appears as a delayed emotional reaction to a very traumatic event, a very threatening situation, or a disaster. These horrific events might be anything from major accidents to criminal behavior to natural disasters to war. Their length varies as well. Under such circumstances, people often feel terrified and helpless, without control in handling them.

A traumatic event will happen to more than half of people at some point in their lives. Each type of trauma generates some influence on the probability of  development of PTSD after a traumatic event. Human acts of violence—such as sexual assault, assault, or war—have a clearly higher likelihood associated with them; almost a third of those affected develop PTSD. With a rather lower relative risk in comparison, PTSD can also be brought on by natural disasters, fires, chemical or traffic accidents, and acute physical illnesses including heart attacks or cancer. On average, about 10% of trauma sufferers go on to acquire PTSD. At some point in their lifetime, almost 8% of people globally will suffer with PTSD.

Causes of PTSD

Post-traumatic stress disorder typically occurs following a situation judged as life-threatening to oneself or others or from major physical or emotional harm. Among the causes are violent crimes, war, sexual assault, car crashes, natural disasters, and medical crises including severe bleeding or heart attacks. Learning of a death or major illness of someone we know can also be distressing. Events including divorce, unemployment, or harassment have nothing to do with PTSD. Still, they could bring on anxiety or depression and cause symptoms similar to PTSD.

Although 61% to 80% of people go through trauma, only 5% to 10% of people develop PTSD.  Studies on individuals with PTSD reveal aberrant neurotransmitter levels, hormonal imbalances, and brain changes even if the causes of different responses to trauma are yet unknown. Along with high levels of corticotropin-releasing factor (CRF), people with PTSD show normal to low levels of the “stress hormone,” cortisol, despite continuous stress.

By inducing the release of norepinephrine, CRF intensifies the sympathetic nervous system response, so affecting heart rate, blood pressure, awareness, and a more intense startle reaction. Other neurotransmitter systems also show disturbances including GABA, glutamate, and serotonin. Hyperactivity in the amygdala, which regulates emotions and fear responses, and a shrinkage of the hippocampal size, thereby influencing motivation, emotions, learning, and memory, are PTSD related brain changes.

Moreover, in those with PTSD the medial prefrontal cortex, which regulates the emotional reactivity of the amygdala—appears to be smaller and less responsive. These results imply that structural and neurochemical changes in the brain correlate with PTSD.

Risk factors of PTSD

Several elements can affect the development and intensity of post-traumatic stress disorder (PTSD). These involve the nature of the traumatic event itself—that of an instance of aggression or a major incident like a collision or catastrophe.

Furthermore, important are the length and intensity of the experience since prolonged and severe trauma raises the risk of PTSD. Moreover, constant exposure to horrifying events might increase the risk. Another crucial component is psychological sensitivity since some people might be more susceptible to acquire PTSD. At last, the existence of protective systems including coping mechanisms or support networks can help to lessen the effects of trauma.

Degree of emotions such as fear, helplessness, and lack of control during a traumatic event as well as whether it was seen as life-threatening and included violence is crucial. The likelihood of developing PTSD is mostly influenced by a person’s perspective on and evaluation of the circumstances.

Those who already suffer with mental health conditions including addictions, anxiety, or depression has more chance of developing PTSD. Still, some people usually manage horrific events more skilfully than others, which lowers their chance of PTSD development. Strong social ties and emotional support can help one ease trauma’s effects. Conversely, lack of such kind of support increases the risk of PTSD.

Also, specific jobs including police officers, firefighters, train conductors, and rescue workers are particularly vulnerable to traumatic events. People living in areas of conflict also show a greater impact.

Cours of PTSD

Post-traumatic stress disorder can develop in rather different ways. While in some cases there may be a delay before symptoms show up, others may show up either directly following the trauma or during it. Although symptoms might go away in a few weeks, they might also linger for several years and become chronic. Sometimes symptoms are less severe and other times they get worse.


Trauma-related memories can still be upsetting many years after an event, and cause PTSD to develop subsequently. Soldiers frequently show delayed symptoms. Childhood memories of war are another example; some people may find them disturbing only in old age.

Many people may confront their trauma and work with the recollections. Some of those affected show notable improvement in one year, usually without any treatment. Still, about thirty percent have symptoms for three years or more and frequently deal with other issues including drug abuse.

Severe symptoms can make it difficult for one to go about daily activities. Some people find it difficult to meet employment needs since problems with sleep and concentration cause them to lose their jobs. Other people find it difficult to continue working due to constant reminders of the traumatic event. Sexual problems could also arise, particularly after abuse.

Treatment of PTSD

First of all, it is essential to specify exactly the requirements and goals of the treatment. What are the symptoms that stand out the most? What attainable goals can be met with the therapies that are currently available? What other kind of support might be needed? Is therapy necessary? Consulting a psychotherapist will help one address these questions.

While some people may find sufficient support from their family, friends, or counseling services, others may need psychotherapy to help them reintegrate into society. Medications only work in some situations. Furthermore, in addition to traditional therapies, several clinics offer alternative treatments including body, art, or music therapy.

Trauma therapy is one of the main elements of PTSD treatment, as it addresses the traumatic event directly.

Treatment of PTSD with Psychotherapy

At the start of psychotherapy, developing a trusting relationship with the therapist takes front stage. Having trust is important for dealing with trauma in the right way.

A key component of trauma therapy is that the therapist helps the patient face trauma-related memories in a controlled environment. This regulated conflict is meant to reduce the anxiety related with those memories. The therapist provides guidance meant to help with handling the experience. After some preparation, confronting the horrific event in cases of severe trauma may be most helpful since ignoring it too soon could aggravate psychological issues.

The therapy can also assist with trauma-related issues including conflicts with others or difficulties at work that would complicate coping mechanisms. Sometimes therapy may deviate from the trauma to treat other problems like anxiety, depression, or addiction.

Choosing when to start psychotherapy cannot be done with a one-size-fits-all solution. While trauma therapy can still be successful even if treatment is begun months or years after the trauma, generally early starting of treatment is beneficial.

Psychotherapy Methods Used for Treatment of PTSD

Trauma-Oriented Cognitive Behavioral Therapy (CBT)

This therapy emphasizes the need for changing thoughts and emotions connected to the trauma. This is the most often used therapy for PTSD. In some cases, talking about traumatic events and how they affected you can be helpful, even right after the event. In cases of severe trauma, early interventions may be required due to the great demand for help and worries that symptoms will not improve without psychotherapy.This might benefit individuals who have experienced frequent trauma or exhibit early, severe symptoms—such as those going through an acute stress reaction, (sometimes known as a “nervous breakdown”). These people might be confused, depressed, very anxious, sometimes hostile, have physical symptoms, and find great trouble with bad dreams.

These people took part in several studies where they got short interventions based on cognitive behavioral therapy (CBT). Cognitive-behavioral therapy seeks to alter the interpretation and understanding of upsetting events and emotions. It seeks to teach people to reinterpret and reevaluate their experiences, behaviors, and emotions. It aims to change, for example, how people manage flashbacks—vibrant, intrusive memories that are uncontrollable. CBT is especially suited for those who often avoid particular situations and is the most effective one and as well as the most researched therapy for PTSD. Usually, these sessions comprised ten to fifteen hours of therapy.

EMDR Therapy in Treatment of PTSD

EMDR therapy—also referred to as Eye Movement Desensitization and Reprocessing is a method used in psychotherapy.  Specific triggers are utilized in this therapy to enable one to navigate through trauma.  In EMDR, the therapist helps the patient to track their finger moving back and forth as they recall the traumatic memory. Apart from, or in addition to, acoustic cues, physical contact like tapping on wrist can also be used. These behaviors help people process information, so helping them to remember traumatic memories with less anxiety.

Psychodynamic Therapy

Psychoanalytic therapy consists of several techniques and is derived from psychoanalysis. It also calls for slow facing the traumatic event. The therapy aims to underline the connection between past trauma and present events. The intention is to change the mental process, emotions, and relationship behaviors sustaining the symptoms.

Debriefing

“After-action review” equates to “debriefing.” In psychology, debriefing is discussing a traumatic event immediately following its occurrence. Most of the time, a mental health or spiritual counselor leads these discussions, which usually follow a set format. Participants are asked about their perceptions of the event, their opinions of it, and their emotions toward it. Furthermore, coping strategies for handling the trauma are addressed.

Debriefing was first developed for professions like law enforcement and emergency responders, who regularly deal with stressful events. These professionals should discuss a traumatic event in a group and seek appropriate psychological assistance following it. Psychotherapists use debriefing with people who have been through a traumatic event, like being in an accident or crime. Still, there is an increasing uncertainty about how well debriefing works.

If the person has more than one mental disorder in addition to PTSD, it depends on the circumstances as to which disorder should be treated first.  Early therapy can help people who have been deeply affected by trauma avoid developing post-traumatic stress disorder (PTSD). Though individuals, assistants, or witnesses talk about the event under supervision shortly after traumatic event occurs, debriefing does not offer defense against PTSD.

People who have experienced trauma, need quick treatment and support soon after the event that led to their emotional distress. The type of help one needs is determined by the particular needs of the individual and the situations.  A lot of people find that they can handle things better when they have family, friends, or coworkers who understand. Still, some people might need assistance from a licenced psychologist.

PTSD is diagnosed only when symptoms persist for more than four weeks. Most people are ready to start therapy after this point, but some may need some time to get ready.  In some cases, professionals offer immediate psychological help after a traumatic event. For example, employers’ groups, railroad companies, or police counselors do this. These treatments are mostly meant to prevent PTSD.

Effectiveness of Treatment Methods in Treatment of PTSD

The most investigated approaches for treating post-traumatic stress disorder (PTSD) are trauma-focused cognitive behavioral therapy (CBT) and EMDR. Studies show both choices are quite successful. While some people see a reduction in symptoms, almost 50% of those undergoing treatment no longer have PTSD after therapy.


Psychodynamic therapy is frequently used for many mental health conditions,
though not thoroughly investigated for PTSD. Evaluating its effectiveness in treating PTSD is thus difficult.


Psychotherapy, particularly trauma-oriented CBT, has been well studied as helpful for children and teenagers who have gone through trauma.


Still, psychotherapy is not successful in every context. Sometimes symptoms persist in spite of treatment, which causes some patients to stop their treatment.

Additional Therapies in Treatment of PTSD

Particularly in a hospital environment, additional therapies are sometimes offered. Among these are:

-Therapy connected to one’s line of work

-Applying artistic techniques for therapeutic goals.

-Use of music to provide therapeutic benefits.

-Relaxation methods

-Treatments emphasizing movement and the body

The goal of these holistic therapies that focus on the body and creativity is to inspire and provide enjoyable experiences. They can also help in the healing from trauma. However, psychotherapy usually addresses traumatic memories, thus these therapies are insufficient on their own for severe trauma. They can help those without more severe symptoms who fail to receive psychotherapy.

Since autogenic training can trigger painful memories during the relaxation process, not everyone is suited for it.  For PTSD, methods involving physical or mental involvement are usually advised.

Activities including yoga, tai chi, or mindfulness training helps with relaxation, body awareness, and balance of emotions and the body. The goal is to help people focus and become more concentrated. Though studies on these methods are not evident, they seem to indicate some people may find help in managing particular symptoms using these methods.

There is also little evidence on the benefits of movement therapies as well. Current research, however, indicates that regular physical activity including yoga, endurance training, and strength training can help with sleep and general quality of life in addition to reducing symptoms of PTSD and depression.

Many people search for other ways outside of therapy to cope with their experiences, find meaning, and express themselves—such as music, art, craft, or dance. Religion and spirituality comfort some people. For those who are religious, spiritual counseling can help following a traumatic event. Usually, most hospitals have chaplaincy services available.

Treatment of PTSD with Medication

While medications cannot be a substitute for psychotherapy, they can enhance it in specific cases. Yet only a small number of drugs have demonstrated their effectiveness. Due to the potential for side effects, it is important to carefully evaluate their usage.

Post-traumatic stress disorder (PTSD) is treated mostly with psychotherapy. According to scientific evidence, Medications should not be used as the only or main therapy for PTSD. The appropriateness of medication depends on the specifics of the case, like the type and severity of symptoms and whether there are other problems like depression, anxiety disorders, or substance abuse.

Objectives of Pharmacotherapy in Treatment of PTSD

•Quick relief from severe problems including sudden intense fear or inability to sleep.

• Long-term treatment to help PTSD symptoms fade

People with PTSD are often given antidepressants to help them feel better. Still, people with PTSD should refrain from using benzodiazepines and sleep aids since they might cause dependency and have limited effect in reducing symptoms.

It is essential to have a good knowledge of the possible side effects and the effectiveness of the medication before starting therapy. Clearly specify treatment expectations and schedule regular check-ins to assess the efficacy of the medications and address any issues during conversations with the doctor. Doctors also have to ensure good communication with psychotherapists responsible for providing therapy, since they cannot prescribe medications.

Treating PTSD with Antidepressants

When symptoms of depression, anxiety, and irritability are clearly present, antidepressants are especially helpful. They also help in both falling asleep and staying asleep. One can use antidepressants for either long or short periods.  Many times, antidepressants need several weeks before showing any visible effects.

Studies have shown that:

-About 35 out of 100 people showed notable improvements in their symptoms within a few months without using antidepressants.

-After a few months of antidepressants, about 58 out of 100 people reported significantly improved symptoms.

Many people suffering with PTSD do not need antidepressants. Considering the possible side effects of headaches, vertigo, or nausea, it is important to carefully assess the necessity of these drugs

Cooping with PTSD in Daily Life

One’s life can be significantly altered by a traumatic event. Still, with time, some people find that they can manage their experiences fairly successfully. Up until then, a lot of support and attention could be needed.

Following a traumatic event, symptoms can also affect interactions with others and cause distrust in other people. This results in maintaining present relationships or forming new friendships difficult. One can also observe significant impacts in the sexual life. Some people with PTSD could isolate themselves completely. It’s important for family members to keep being there for each other, even when things get tough between them.

For some people, like those who engaged in accidents or attacked in violent crimes, could find protracted legal conflicts ahead. As it can cause more stress, having appropriate legal support is absolutely essential to help to ease the circumstances. People can get help with reintegrating back into work and social life, as well as with everyday problems. For example, the “Hamburger Model” program helps people get back on the job, and there are also services for psychosocial rehabilitation.

Furthermore. PTSD can affect children’s and teenagers’ educational process. People who have experienced trauma need a safe environment and consistent relationships—like those found in preschoolers and schools—to help them heal. Teachers and professors can be quite important in this regard.

Psychological First Aid after Trauma

Psychological first aid (PFA) consists of steps meant to help people soon after a traumatic event. These rules, which mostly target professionals, can also be helpful for any individual who wants to help. Under specific circumstances, the following could prove helpful:


Evaluate the situation: Understand the events, evaluate the welfare and security of the involved individuals.


Help people evacuate the tense circumstances: To relieve anxiety, assist them in moving away from harm or spectators.



Guarantee a secure setting: Establish an environment that supports personal safety so people may begin their journey of recovery.


Identify individuals who need assistance: Find individuals needing immediate help and encouragement.


Assist individuals without being pushy: Support someone in a way that respects their needs and feelings without forcing it on them.

Remain composed and patient: Stay calm to comfort others and prevent not to aggravate more stress.

Be ready and stay close: Be ready to offer extra assistance in the next hours or days when required.

These actions help to create an environment where people might begin to safely and compassionately start addressing their trauma.

Practical Assistance and Information

Getting medical help or giving first aid is the most important part of providing practical support after a traumatic event. Once basic physical needs have been taken care of, accurate and clear communication of the circumstances can help to ease uncertainty and give comfort. Furthermore, basic needs like food and drink as well as creating a comfortable environment can also help in the person’s healing process.

After a traumatic incident, it is also important to get in touch with friends, relatives, or other known people who can offer emotional support. It is very important to set up extra help if it is needed, like finding temporary housing. Lastly, providing specifics on easily available resources like trauma centers or mental health treatments helps to ensure that people affected get the required help for long-lasting recovery. Following these rules will help you create a strong basis of support and attention for people experiencing trauma.

Ways of Interacting with Traumatized Individuals

First of all, when interacting with someone who has experienced trauma, show empathy, provide comfort, and give hope. Moreover, even if a hug could be comforting, it might not be appropriate in every situation considering the possibility of physical contact. When you are unsure, it is advised to either ask whether it is desired or avoid physical touch. Furthermore, simple and honest communication is crucial; hence, it is advisable to present information in little bits to avoid overwhelming the person.

Pausing and listening intently are equally important. When needed, give the person the chance to have periods of solitude since these will allow them the time and space to process their feelings. While it’s vital to accept one’s emotions and points of view free from judgment, one should avoid supporting negative attitudes. Inquiring about their needs is a useful approach to help them in this process.

Moreover, when appropriate, involving the person in duties like helping others or planning refreshments can empower them and help them to recover control over their surroundings. On the other hand, promises that are unrealistic or false information, should not be given since they would cause doubt or mistrust. Lastly, since every person deals with trauma at their own pace, do not compel anyone to respond or choose before they are ready.

Treatment of PTSD Treatment. Summary

In summary, post-traumatic stress disorder (PTSD) could afflict a wide spectrum of individuals. This is a very common disorder that affects more people than we might think. Every sign and symptom of PTSD could also vary personally. Someone with this condition may exhibit symptoms including dreams or even nightmares, which would be reliving a terrible event.

Although there is no age restriction for PTSD, most men seem to suffer from this condition more than women. For someone who has gone through PTSD, psychological effects are rather prevalent. Many times, they are reliving their horrific event within their memory. Medication and psychotherapy are treatments shown to be effective for PSTD. A person needs to find the right kind of treatment and medicine that will help them. What would be appropriate for one person does not apply to others. Proper treatment of PTSD is necessary to prevent any kind of harm to oneself or others