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Post-traumatic stress disorder (PTSD) can take a real physical and emotional toll on affected individuals and their families. But if you’re facing a diagnosis of the condition, rest assured that with the right combination of medication and therapy, you can help relieve symptoms and live a healthy life.
“Children, adults, and families are resilient and can heal from the experience of trauma. There are treatments and approaches that work to support both children’s and families’ recovery,” says Kay Connors, LCSW-C, program director of the Family Informed Trauma Treatment Center and instructor in the psychiatry department at the University of Maryland School of Medicine in Baltimore.
During any given year, about eight million adults have PTSD — which represents only a small portion of those who have gone through a trauma, explains Ken Yeager, PhD, director of the Stress, Trauma and Resilience program at The Ohio State University Wexner Medical Center in Columbus.
Read on to learn more about the different treatment options for PTSD, including oral medications, talk therapies, and some general tips for coping with the condition.
“PTSD is one diagnosis for which the psychotherapy modalities, which are evidence-based, are shown to be far more effective than any medication,” says Scott R. Hunter, MD, a board-certified psychiatrist in Santa Monica, California. Those modalities include therapies like prolonged exposure therapy, cognitive processing therapy, and eye movement desensitization (all described later).
“A core component of the most effective therapies is that you talk to someone who helps you learn how to manage your symptoms yourself,” Dr. Hunter says.
Essentially, the idea behind talk therapy is that it can bring out a patient’s fight-or-flight response. It can then help them move thoughts from survival mode to the intellectual processing areas of the brain, like the frontal cortex, Dr. Yeager explains. That process, in turn, helps the patient process his or her experience on a logical level. He says it also helps to reframe the traumatic experience so they no longer blame themselves or make statements like “I should have ...” or “If I had only ....”
You may undergo just one type of talk therapy, or your doctor may use a combined treatment approach. “Depending on the traumatic experience, biopsychosocial issues, symptom presentation, and patient preferences, a carefully selected and sequenced approach to providing therapy may be necessary,” Connors explains. Because PTSD might show up in a number of different ways, providers have to make complex decisions on how to treat it, including addressing a number of different ongoing stressors to help manage patients’ condition, she says.
Hunter also cautions that talk therapy can be a misleading term because all effective therapies for PTSD have a behavioral component to them.
Below are some of the different types of talk therapy that can treat PTSD.
Mental imagery, writing, or a visit to the location where the event occurred may be used to help you face and control your fears.
“What helps is essentially, through repetition, changing the physical and emotional response you have when you are reminded of the trauma,” Hunter says.
You may even use a virtual reality device that allows you to virtually re-enter the trauma setting.
Cognitive processing therapy helps people address unhelpful thoughts regarding the trauma. It may help you gain a new understanding of the traumatic event, leading to fewer ongoing negative thoughts and symptoms.
For example, if a patient has an inaccurate belief, like “Nobody follows the rules, so the world is not safe,” this type of therapy would help them find alternative explanations for that evidence, and see their own biases of interpretation, Hunter explains.
CPP is a form of psychotherapy for children up to age 5 who have experienced traumatic events or who are experiencing trauma symptoms, difficulty bonding, or behavioral problems, Connors says. One of the main goals is to support and strengthen the relationship between the caregiver and child to protect the child’s development and recovery from trauma, she explains.
This is a trauma-focused, multifamily, skill-building intervention. SFCR offers trauma treatment and therapeutic strategies to help improve families’ abilities to cope with ongoing stress and threats of re-exposure, Connors says.
In many cases, PTSD treatment involves medication as well, usually in combination with psychotherapy.
“Trauma psychotherapies are generally first-line treatments,” Connors says. “After a complete psychiatric assessment, the treating prescriber may recommend medication for comorbid disorders, like attention deficit hyperactivity disorder (ADHD) or depressive disorders.”
Common drugs prescribed to treat PTSD include:
These drugs help control symptoms of depression and anxiety.
These drugs can help relieve feelings of anxiety and stress. They’re usually not taken long term because of their potential for dependence and abuse.
Besides the more traditional routes of treatment, some alternative therapies are also showing promise.
Psychedelics like ketamine, psilocybin, and methylenedioxymethamphetamine (MDMA, colloquially known as ecstasy) are being explored as potential treatments, along with cannabinoids and other novel treatments. Some of these are used in conjunction with psychotherapies.
“PTSD can affect a child and family’s overall functioning,” Connors explains. “After trauma, families often have difficulty stabilizing and keeping up with the demands of family life.” She notes that children and teens, for example, may have difficulty keeping up with the academic and social demands of school, and may withdraw from certain activities.
But there are ways that you can cope with PTSD on a daily basis. The following strategies may help supplement your other treatment:
The National Center for PTSD has a list of some of these groups.
People who are living with untreated PTSD may turn to drugs and alcohol as a temporary way to alleviate their social anxiety or escape from unwanted thoughts and memories, Connors explains. Attempting to medicate with drugs or alcohol can prevent progress in your recovery and lead to additional problems in the future.
It may take a while before your therapy and medication help relieve your PTSD symptoms.
“Oftentimes with the psychotherapy interventions, symptoms get worse before they get better,” Hunter says. “And that ought to be made clear to people when you develop their treatment plan.” He notes that within the first couple of weeks of treatment, some people may see a worsening of symptoms, but that they should see improvement within three to four weeks after starting.
Be sure to follow your treatment plan even if improvements don’t come as quickly as you’d like, and talk to your provider about any questions or concerns you may have.
“The most important thing to know is that PTSD is a very treatable condition, and that with appropriate intervention, people who have PTSD can expect not just to recover from their symptoms, but most likely to experience post-traumatic growth,” Hunter says. PTSD is not a lifelong sentence of difficulties: Even though symptoms may persist, by learning to manage them, people can ultimately develop skills that will lead to great benefits in their lives, he says.
PTSD is a very treatable condition, and with the right balance of treatment and support, most people can overcome it to live fulfilling lives. That said, it’s important to know that PTSD greatly depends on individual circumstances. Some people with PTSD recover within six months of starting a treatment plan, while others battle symptoms of the condition for the rest of their lives.
“Everyone reacts in their own way to the experience of trauma,” Connors explains. “There are a number of risk and resiliency factors that help determine the course of illness, including gender, previous history of trauma, etc.”
A combination of medications, such as antidepressants, and talk therapies are usually the best course of action. There are also some alternative therapies you can try in addition to more standard treatment methods. Speak with a doctor to discuss your options and together you can come up with a best way to treat and manage your condition.
Additional reporting contributed by Lynn Marks.
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