Medical Author: John P. Cunha, DO, FACOEP
Medically Reviewed on 11/8/2021
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.
Medications that are helpful in treating PTSD symptoms are some of the same medications also used for symptoms of depression and anxiety.
Antidepressant medications recommended for PTSD include:
- Sertraline (Zoloft)
- Paroxetine (Paxil)
- Fluoxetine (Prozac)
- Venlafaxine (Effexor)
- Nefazodone (Serzone)
- Imipramine (Tofranil)
- Phenelzine (Nardil)
Panic Attacks (Panic Disorder) : Test Your Mental Health IQ Quiz
QuestionPanic attacks are repeated attacks of fear that can last for several minutes.
See AnswerMust Read Articles:
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Antidepressant Medications
There are many types of depression such as clinical depression, major depression, seasonal affective depression, dysthymia, and bipolar disorder. There are a variety of depression medications, and their effectiveness may vary from patient to patient. Examples of the types of depression medications include atypical antidepressants, monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants, and selective serotonin reuptake inhibitors (SSRIs). Side effects, drug interactions, and warnings and precautions should be reviewed prior to taking any medication. -
Anxiety Disorders
Anxiety as a medical condition is characterized by worry, fear, nervousness, shortness of breath, sleep problems and other symptoms. Diarrhea, tremors, and rapid heart rate are some physical symptoms of severe anxiety, which may arise from a mental or physical condition, drug use, or some combination of these causes. Treatment can include medication and psychotherapy. -
Can You Get PTSD From Having Cancer?
It is common for patients diagnosed with cancer to feel shock, fear, helplessness, or dread, any of which could lead to cancer-related post-traumatic stress. The symptoms for cancer-related PTS and post-traumatic stress disorder (PTSD) are similar, but most cancer patients don't go on to develop full PTSD. -
Grief and Bereavement
Grief is our personal experience of loss. Mourning is a public expression of our grief. Bereavement is the period after a loss during which mourning occurs (usually a relatively brief time) and grief is experienced (often for a much longer time). -
Nightmares
Nightmares occur from time to time in many children, but they are most common in preschoolers (children aged 3 to 6 years) because this is the age at which normal fears develop. Practicing good sleep hygiene and other strategies can help eliminate nightmares. -
Panic Attack
Panic attacks are episodes of extreme anxiety that are usually accompanied by chest pain. Panic attack symptoms and signs include chest pain, nausea, sweating, palpitations and shaking. Panic disorder is typically treated with medication and psychotherapy. -
Suicidal Thoughts
Suicidal thoughts may be brought about by a sudden, negative change in life circumstances, substance abuse, or even sleep deprivation. Suicidal thoughts are troubling, particularly if they're accompanied by substance abuse or depression. If you or someone you know is considering suicide and are unsure how to deal with it, call a suicide hotline, like 1-800-SUICIDE, to get help. -
What Are the Symptoms of PTSD?
Flashbacks, nightmares, avoidance reactions and panic attacks are all hallmarks of post-traumatic stress disorder, a mental condition some people develop after experiencing painful, shocking or terrifying events.
REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.