Post-traumatic Stress Disorder (PTSD) (cont.)
IN THIS ARTICLE
Is It Possible to Prevent PTSD?
Many investigators have tried to learn how PTSD can be prevented after people have experienced traumatic events. The military has tried to collect information on new recruits, including psychological screening, to better understand why some people develop PTSD and others do not. Additionally, other studies are investigating whether laboratory markers, such as low cortisol levels, may help predict who might develop PTSD. We still do not completely understand psychological or laboratory predictors, but hopefully these and other studies will lead to better diagnosis and treatment in the future.
Additionally, there have been studies trying a variety of medications given after a traumatic event to see if they can prevent PTSD. The idea has been that certain medications may be able to lower the intense physiologic arousal right after trauma and prevent the brain from forming traumatic memories. Propranolol, a beta-blocker medication that prevents some of the effects of adrenaline, showed initial promise in research studies, but later studies were not as convincing. Because cortisol levels seem to be lower in PTSD, hydrocortisone (a drug similar to cortisol) was given after a trauma and reduced the rates of PTSD development. In a single study, morphine administered after combat trauma in soldiers during the Iraq war also reduced PTSD rates. Morphine might prevent consolidation of fear memories in the amygdala, but further studies will be needed to prove both how effective it might be and how it works.
Family support, clergy support, psychotherapy, and education about the medical aspects of PTSD are all important in preventing PTSD. Efforts to reduce the frequency of traumatic events, such as child abuse and neglect or sexual trauma, are also important ways that we can reduce rates of PTSD and associated depression and suicide.
What Is the Prognosis of PTSD?
The prognosis for PTSD depends upon the severity and length of time a person has suffered from the disorder. The majority of patients with PTSD respond to psychotherapy. There are often residual symptoms, however, and we cannot yet predict who will respond best. Studies have shown in other conditions such as OCD (obsessive compulsive disorder) that psychotherapy can actually change how the brain's chemistry functions. It is reasonable to assume that these changes are possible in PTSD as well.
There are significant risks to a person with PTSD if they do not receive treatment. The symptoms of PTSD are likely to continue to interfere with their function at home, at work, and in their relationships. They may lose their job and/or family due to their irritability, anxiety, or numbness interfering with their ability to love and to work. Suicide is also a risk with untreated PTSD.
Medically Reviewed by a Doctor on 9/11/2017
Michael J. Peterson, MD, PhD
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