Conditions & Diseases: Psychological & Mental Health

Posttraumatic Stress Disorder

See Also:
Posttraumatic Stress Disorder: Introduction
Posttraumatic Stress Disorder: Symptoms
Posttraumatic Stress Disorder: Causes & Risk Factors
Posttraumatic Stress Disorder: Treatment Options

Posttraumatic Stress Disorder Treatment

Posttraumatic stress disorder is a complex disorder that if left untreated can impair life functions. However, individuals with PTSD can regain control over their life and treat their symptoms with two effective treatment options, psychotherapy and medication.

I. Psychotherapy: The psychotherapeutical intervention focuses on several key elements such as: re-exposure to trauma-related memories and stimuli, cognitive restructuring of the traumatic experience, expression and management of emotion, and stress management. Some of the psychotherapeutical approaches effective in treating PTSD symptoms include:

Cognitive-behavioral therapy (CBT). Cognitive-behavioral therapy is one of the most effective psychological treatments for PTSD. It is a structured form of psychotherapy that combines methods from behavioral and cognitive therapies. The core beliefs of CBT is that our thoughts and not the external situations, people or events, trigger the behavior and feelings. For individuals with PTSD, cognitive-behavioral therapy aims to modify those behaviors and cognitions that were developed in response to the trauma and maintain the symptoms. CBT focuses around three important elements:

1. Psychoeducation, a step when the individual learns about the cognitive-behavioral model and the cause of their disorder.
2. Exposure, a step that targets the avoidance patterns encouraging the individual to identify feared stimuli and to confront them.
3. Cognitive restructuring, a step when the individual becomes aware of the dysfunctional cognitions by observing their own thoughts, identifying and challenging their maladaptive thinking patterns, and formulating new adaptive responses.

Eye movement desensitization and reprocessing (EMDR). Eye movement desensitization and reprocessing is a fairly new treatment approach for PTSD. It is a form of cognitive therapy that allows the individual to access and process the traumatic memories and the associated disturbing feelings while focusing on an external stimulus such as eye movement, hand-tapping, or aural stimulation. EMDR is a brief therapy where individuals with PTSD achieve emotional stress desensitization, physiological arousal relief, and cognitive restructuring.

Exposure therapy. Exposure therapy is another form of cognitive behavioral therapy where individuals with PTSD are gradually exposed to the disturbing memories of the trauma into a safe setting. This form of therapy follows four steps:

1. Psychoeducation, a step where the individual learns about normal reactions to traumatic events and the cause of the PTSD symptoms.
2. Breathing retraining and relaxation, a step when the individual is taught a relaxation technique that allows a better control of the anxiety symptoms.
3. Imaginal exposure (exposure in vitro), a step when the individual confronts the traumatic memories using their imagination.
4. Real exposure (exposure in vivo), a step when the individual gradually approaches reminders or resembling stimuli of the traumatic event.

Exposure therapy seems to be effective in women that were victims or rape, assault, and child abuse, and in women and men that participated in combat and are victims of traffic and industrial accidents or violent crimes.

Cognitive Processing Therapy (CPT). Cognitive processing therapy is a treatment specially designed for individuals with PTSD due to a sexual assault. This form of therapy believes that PTSD symptoms are the result of a conflict between pre-trauma beliefs about self (such as "nothing bad can happen to me") and world and post-traumatic information (such as "the world is not a safe place"). In cognitive processing therapy, the conflict is called a "stuck point" and is approached by writing about the trauma. The individual has to write about their trauma using as many details as possible and then repeatedly read it loud during and outside the therapy sessions. The therapist helps the individual to identify the resistance points and dysfunctional cognitions.

II. Medication. In addition to the psychological treatment, certain medications can also be effective in treating posttraumatic stress disorder symptoms.

Antidepressants. Antidepressant medication can be prescribed for individuals with PTSD. Some of the most prescribed antidepressants for PTSD are Selective Serotonin Reuptake Inhibitors (SSRI's), such as Prozac, Celexa, Paxil, Luvox, Effexor, and Zoloft. This type of medication corrects the serotonin imbalance by blocking the reuptake of the serotonin from the synapse to the nerve and artificially increasing the serotonin that is available in the synapse. Serotonin is a neurotransmitter that controls the mood. The treatment with Selective Serotonin Reuptake Inhibitors seems to be effective in reducing the risk of relapse if is followed for a year.

Benzodiazepines (Tranquilizers). Benzodiazepines (such as Valium, Xanax, Ativan) are an anti-anxiety medication used because of their sedative effect. Unfortunately, benzodiazepine was not found to be significantly effective in treating PTSD symptoms, and was associated with several side effects, such as: (1) the addictive effect and withdrawal symptom, (2) the risk of overdose, and (3) can interfere with some forms of psychotherapy (it affect the mental sharpness). However, in some patients benzodiazepines seem to help with sleep problems and bring improvements to the day-to-day functioning.

See Also:
Posttraumatic Stress Disorder: Introduction
Posttraumatic Stress Disorder: Symptoms
Posttraumatic Stress Disorder: Causes & Risk Factors
Posttraumatic Stress Disorder: Treatment Options

Article by Alina Morrow
MS Psychology
Medical Writer
OmniMedicalSearch.com