Doctor's Notes on Post-traumatic Stress Disorder (PTSD)
Post-traumatic stress disorder (PTSD) is a mental health disorder that can develop following traumatic events such as violent personal assaults, natural or human-caused disasters, such as terrorist attacks, motor vehicle accidents, rape, physical or sexual abuse, severe emotional abuse, or wartime violence, including military combat.
Four main types of symptoms related to PTSD include
- re-experiencing: intrusive memories, nightmares, or flashbacks of the trauma; avoidance:
- trying to avoid thoughts, feelings, situations, or people that are reminders of the trauma;
- negative changes in thinking and mood:
- inability to remember parts of the traumatic event, negative beliefs, and
- feelings about one's self, inability to enjoy the pleasurable activity, or excessive self-blame for the trauma or its consequences, emotional detachment, social isolation, and loneliness; and changes in arousal or reactivity: always being on alert (hypervigilance), trouble sleeping, agitation, irritability, hostility, difficulty concentrating, exaggerated startle response, or heightened reactivity to stimuli, and increased likeliness of engaging in reckless or risky behaviors.
Other symptoms often associated with PTSD include
- panic attacks,
- physical symptoms (such as chronic pain, headaches, stomach pain, diarrhea, tightness or burning in the chest, muscle cramps, or low back pain),
- the feeling of mistrust,
- problems in daily living,
- substance abuse,
- relationship problems,
- depression, and
- suicidal thoughts.
What Is the Treatment for Post-Traumatic Stress Disorder (PTSD)?
Post-traumatic stress disorder (PTSD) is treated with psychotherapy and medications. Trauma-focused psychotherapies, in which the treatment focuses on the memory of the traumatic event or its meaning, are the most highly recommended type of treatment for PTSD. They usually last about 8-16 sessions.
The main trauma-focused psychotherapies used are:
- Prolonged exposure (PE)
- Teaches you how to gain control by facing your negative feelings. It involves talking about your trauma with a provider and doing some of the things you have avoided since the trauma.
- Cognitive processing therapy (CPT)
- Teaches you to reframe negative thoughts about the trauma. It involves talking with your provider about your negative thoughts and doing short writing assignments.
- Eye movement desensitization and reprocessing (EMDR)
- Helps you process and make sense of your trauma. It involves calling the trauma to mind while paying attention to a back-and-forth movement or sound (like a finger waving side to side, a light, or a tone).
- Brief eclectic psychotherapy (BEP)
- A therapy in which you practice relaxation skills, recall details of the traumatic memory, reframe negative thoughts about the trauma, write a letter about the traumatic event, and hold a farewell ritual to leave trauma in the past.
- Specific cognitive-behavioral therapies (CBTs) for PTSD
- Includes a limited number of psychotherapies shown to work for PTSD where the provider helps you learn how to change unhelpful behaviors or thoughts.
Antidepressant medications recommended for PTSD include:
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Panic attacks are repeated attacks of fear that can last for several minutes.See Answer
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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.