Post-traumatic Stress Disorder (PTSD) (cont.)
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When Should Someone Seek Medical Care for PTSD?
Most people bounce back from traumatic events such as car crashes or assaults, including rape. Short term, most of us would experience some PTSD symptoms. A smaller percentage of people have symptoms that are bad enough to interfere with day-to-day function and are diagnosed with acute stress disorder. Most of these people will also recover within the first month, but a subset of those with ASD will have symptoms lasting longer than a month and are diagnosed with PTSD. We know that some people recover from PTSD at later times -- maybe six months, a year, or even longer. However, some people will have long-term or chronic PTSD symptoms.
At any time after the trauma, if any symptoms are serious enough to affect job performance or the ability to function in day-to-day life, you should consult a licensed mental health professional. Depending on how long the symptoms have cause problems, and which symptoms are worst, different treatments will be appropriate.
Although it may seem painful to remember your trauma, many studies show that avoiding it continues to cause problems. Talking about it with a professional is helpful to many people with PTSD.
What Are PTSD Treatments?
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As with most psychiatric disorders, there are both psychotherapy and medication (psychopharmacologic) ways of treating PTSD. Either type of treatment can be effective for people with PTSD, but the best type of treatment for an individual should be determined by working with a mental health professional.
Psychotherapy for PTSD
The best evidence for psychotherapy treatments of PTSD are for exposure-based therapies, including prolonged exposure therapy (PE), trauma-focused cognitive behavioral therapy (TFCBT), and eye movement desensitization and reprocessing (EMDR). Many other psychotherapy approaches are used by therapists, but there are fewer studies and less evidence about how effective they are. The studies that have been published show that other therapies (non-trauma-focused CBT, psychodynamic psychotherapy, narrative exposure therapy, and others) are more effective than not receiving therapy.
Exposure therapies are based on the principle that people can extinguish a fear response by repeated exposures without negative consequences (a process known as exposure and response prevention). Cognitive behavioral therapies (CBT) involve the identification of dysfunctional/negative thoughts and behaviors, and with structured therapy sessions and between session assignments, work to change them. TFCBT specifically addresses thoughts, fears, and behaviors related to the traumatic event. The theory is that more completely processing the trauma will allow the person to resolve issues around the trauma and reduce PTSD symptoms. EMDR is a specific type of therapy that follows similar principles to TFCBT but specifically pairs a procedure of controlled eye movements linked to processing memories of the trauma. Psychodynamic psychotherapy helps you become more aware of your current feelings and to understand how your past affects the way you feel now. This, in turn, may help in coping with intense feelings from the past trauma.
Medically Reviewed by a Doctor on 9/11/2017
Michael J. Peterson, MD, PhD
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