Posttraumatic stress disorder (PTSD) can occur after experiencing a traumatic event such as a natural disaster, act of mass violence, or terrorist attack and can cause an individual's capacity to react or feel safe, even when he or she is no longer in danger.
About 8% of Americans will have PTSD at some point in their lives, and about 5.2 million adults have PTSD during a given year. About half of those who responded to, survived, or lost loved ones on September 11th have the disorder as well. Because PTSD is classified as an anxiety disorder, this means it is treatable. It is often early detection and increased awareness about the disorder that can help those suffering seek successful treatment as soon as possible.
PTSD can range from being less disruptive to severe and can affect the way one goes about daily life. Individuals may develop PTSD depending on the trauma's intensity or longevity, one's proximity to the event, or how much control one had in responding to the event. If an individual was seriously hurt, in danger or believed to be in danger, or seriously injured from the trauma, he or she may be more likely to develop the disorder.
Factors in the aftermath of a trauma such as an individual's support or personal reactions may also influence whether or not he or she will develop PTSD symptoms.
If you are interested in learning more about PTSD or about available resources, please visit the U.S. Department of Veterans Affairs National Center for PTSD's website: http://www.ptsd.va.gov
Symptoms of PTSD
Symptoms of PTSD may include the following:
- Frequent or constant reliving or re-experiencing the traumatic event
- Flashbacks with vivid memories
- Reoccurring dreams and difficulty sleeping or staying asleep
- Distress around things that resemble the traumatic event
Those suffering from PTSD may also experience the following:
- Negative changes in beliefs
- Outbursts in anger
- Difficulty concentrating
- Exaggerated startled response
- Emotional detachment
If you or someone you know are concerned that you may have PTSD, you may take a screening online
to help identify symptoms. Please be sure to share with your health care professional to discuss in more detail and available treatment options if applicable.
Treating Posttraumatic Stress Disorder (PTSD)
There are good treatments available for PTSD. The main two types are psychotherapy, often referred to as counseling, and medications. There are many variations of each and a combination of the two is often used. The following are recognized treatments for PTSD:
1. Psychotherapy (Counseling)
Cognitive Behavioral Therapy (CBT) is the most effective treatment for PTSD. Cognitive behavior therapy is used to help people with their PTSD, and is based on the idea that psychological problems arise as a result of the way in which we interpret or evaluate situations, thoughts, and feelings, as well as our behaviors. The goal of CBT, then, is to help people learn healthier ways of coping with distressing thoughts, as well as reducing avoidance or other problematic behaviors (like substance use).
CBT usually involves meeting with your therapist once a week for up to four months. There are different types of cognitive behavioral therapy. The two most researched types of CBT are Cognitive Processing Therapy (CPT) and Prolonged Exposure (PE). The idea is that if someone can change how they evaluate their environment or thoughts and feelings, anxiety and avoidance may be reduced, improving a person's mood and overall quality of life.
Cognitive Processing Therapy (CPT) focuses on patterns of thinking, behaviors, and emotions associated with distress. You learn to be able to recognize and change these patterns to improve everyday functioning and life satisfaction. In CPT you will focus on examining and challenging thoughts about the trauma. By changing your thoughts, you can change the way you feel.
Prolonged Exposure Therapy (PET) involves the gradual confrontation of the traumatic memory, including thoughts, objects, environments, and situations that remind you of the trauma. Typically, exposure to the traumatic memory begins in a counseling session. The purpose of this exposure is to allow you to fully process the traumatic event, and to teach you that 1) memories/ reminders the trauma are not in themselves dangerous, and are not the same as experiencing the trauma again, 2) anxiety can be controlled without escaping or avoiding the feared stimuli, and 3) anxiety and PTSD symptoms can be experienced without the loss of control.
Prolonged exposure therapy last approximately 8-16 sessions and is often delivered twice-weekly or weekly; it is often used alongside other cognitive-behavioral techniques. With time and practice you learn to manage your rations to stressful memories.
Eye Movement Desensitization and Reprocessing (EMDR) pairs eye movements with cognitive processing of the traumatic memories. The idea is that rapid eye movements make it easier for our brains to work through traumatic memories. The initial phases of EMDR involve techniques, such as relaxation. During the processing stage of therapy, the patient describes the traumatic memory and identifies and labels the images, beliefs, and physiological symptoms elicited by it. The patient is instructed to focus on these aspects of the traumatic memory while moving his/her eyes back and forth by tracking the therapists' finger (other methods such as finger-tapping, can also be used). The theoretical basis for EMDR is that PTSD symptoms result from insufficient processing/integration of sensory, cognitive, and other elements of the traumatic memory. Over time EMDR is designed to change how you react to memories of the trauma.
Virtual Reality Exposure Therapy (VRET) has been found to be another effective and efficient treatment method for anxiety and stress disorders caused by specific events and situations. Virtual Reality Exposure Therapy provides both exposure-based therapeutic procedures and anxiety management techniques, among the most the effective types of therapy for phobias and posttraumatic stress disorder (PTSD).
Following the attacks of September 11th, individuals reported experiencing symptoms characteristic of posttraumatic stress disorder. The virtual reality treatment of these symptoms combines traditional exposure therapy with computer graphic images that aid in the reenactment of that day. Traditional exposure therapy involves having the patient retell their experiences of that day, while offering other behavioral and cognitive coping techniques. The virtual reality treatment incorporates all of these aspects into its treatment, while utilizing a virtual world that helps engage the patient through their senses of sight and hearing.
During the virtual reality treatment, the individual is shown different computer graphic scenes recreating the experience of September 11th. The scenes range from a plane flying past the first tower to a reenactment of two planes hitting both towers and their collapses, accompanied by realistic sound effects. Each scene is viewed through the 3-D headset that responds to the patient's head movements. The patient progresses through the scenes in a gradual fashion, ensuring that they will not become overwhelmed. The therapist watches the scenes from a computer screen as the patient retells their personal experience.
2. Medications: Serotonin Reuptake Inhibitors (SSRIs)
SSRIs can raise the level of serotonin in your brain and can make you feel better. The two medications that are approved by the FDA for the treatment of PTSD are sertaline (Zoloft) and paroxetine (Paxil).
There are possible side effects that may occur, including nausea, decreased interest in sex and feeling drowsy, feeling tired or sleeping too much. As these medications can interact with other medications you are taking, it is important that your doctor knows all medications that you are taking.
Other medications may be prescribed by your doctor but there is less evidence of them working on PTSD. These include Benzodiaepine which can help you relax or sleep, antipsychotics and other antidepressants (Prozac and Celexa are among the most well known).
An exercise program can provide many benefits including better sleep, digestion, energy and greater sense of well being and self control. Additionally, exercise can provide a distraction from disturbing emotions while building self-esteem.
Breath/breathing control and various meditation techniques have also been used to help with PTSD.
Department of Veterans Affairs
Mental Health America
Post-traumatic Stress Disorder Alliance
Center for Deployment Psychology
The National Child Traumatic Stress Network