Treatment for PTSD

In recent years, Post-Traumatic Stress Disorder (PTSD) has become a hot topic in the media. For some, PTSD conjures up an image of a combat veteran who has returned home with troubles after being exposed to land mines and air raids. Indeed, statistics show that 11-20% of veterans coming back from wars in Iraq and Afghanistan suffer from PTSD. But PTSD is not just a military problem. People who have experienced a life-threatening experience may have PTSD and not even know it. With the advent of the recent #metoo movement, more accounts and stories of people who have experienced interpersonal trauma and abuse are coming to light, and I am hearing more of these stories in my therapy room. Keep in mind that just because a person has experienced a traumatic event does not mean that they will inevitably develop PTSD. Statistics show that about 7-8% of the population will have PTSD at some point in their lives. About 10 of every 100 women develop PTSD, compared to 4 of every 100 men.

The podcast, This American Life, recently had an episode entitled Ten Sessions, where one of their journalists undergoes an accelerated treatment of Cognitive Processing Therapy (CPT) in the course of two weeks (generally not recommended). I l listened this episode this month and appreciated hearing the patient’s process and got to witness her transformation over each session in how she processed what had happened to her as a child. I have recommended this podcast to patients who are interested in processing previous traumatic experiences.

What is PTSD?

I often tell people that PTSD develops as a ‘normal reaction to an abnormal experience.’ The DSM-5 considers a traumatic experience one in which you are exposed to an actual or threatened death, serious injury, or sexual violence via direct experience, witnessing it in person, or learning about it happening to a loved one. Someone may feel like they are “in a fog” after the experience is over. Traumatic experiences may also include car accidents, being attacked by an animal, being physically or sexually assaulted, surviving a natural disaster, witnessing terrorist attacks or gang violence, or experiencing other upsetting events out of the norm of the everyday. With all that said, just because you have experienced a traumatic event does not mean you have PTSD. People who suffer from PTSD also experience symptoms that fall into four categories: 1) re-experiencing of the trauma as intrusive memories, flashbacks or nightmares, 2) avoidance of thoughts or reminders of the trauma, 3) hypervigilance or being “on edge” much of the time, and 4) negative thoughts or moods that worsen after the event. These problems persist for over a month (but usually longer) and significantly interfere with daily life long after the experience has ended.

The importance of dealing with PTSD

The effects of trauma can have long-term implications on social and family relationships and everyday life. People with PTSD may be more prone to angry outbursts, feelings of detachment from loved ones, or thoughts of suicide, which might exacerbate other life problems or lead to serious depression and anxiety. It is not uncommon for people to use alcohol or other substances to numb the pain or distract from unwanted memories of the trauma. There is some research from Dr. Bessel van der Kolk that has shown that the effects of trauma are stored not just in the mind and memory, but also within the physical body, leading to chronic health problems if not appropriately addressed. Some people are unaware of these negative effects on the mind and body for months or years or even decades.

Getting PTSD treatment

The feeling of not having control over what has happened to you can be overwhelming and even crippling, and talking about the traumatic event(s) may bring up feelings of shame and self-blame. In fact, depending on the nature of the trauma, the stigma of talking about it often stops people from seeking help for fear of appearing “crazy” or “weak”. However, treatment can offer a way to understand and process the trauma, and ultimately to regain a sense of safety and security. Many CBT treatments have been designed to do just that, including Cognitive Processing TherapyProlonged Exposure Therapy, and Trauma-Focused CBT for children and adolescents. Most recently, there has been research on yoga and mindfulness as adjunct treatments for traumatic stress to address both mind and body. Although there is no way to prevent or predict traumatic events in our lives, there are effective interventions to treat PTSD.

Jennifer ChenComment