Treating Post-Traumatic Stress Disorder (PTSD)

The main treatments for people with post-traumatic stress disorder (PTSD) are psychotherapy (“talk” therapy), medications, or both. Everyone is different, so a treatment that works for one person may not work for another. It is important for anyone with PTSD to be treated by a mental health care provider who is experienced with treating PTSD. Some people with PTSD need to try different treatments to find what works best for their symptoms.

If someone with PTSD is experiencing an ongoing trauma, such as being in an abusive relationship, both of the problems need to be treated. Other ongoing problems can include panic disorder, depression, substance abuse, and suicidal thoughts.

Psychotherapy:

Psychotherapy is “talk” therapy. It involves talking with a mental health professional to treat a mental illness. Psychotherapy can occur one-on-one or in a group. Talk therapy treatment for PTSD usually lasts 6 to 12 weeks, but can take more time. Research shows that support from family and friends can be an important part of therapy.

Many types of psychotherapy can help people with PTSD. Some types target the symptoms of PTSD directly. Other therapies focus on social, family, or job-related problems. The doctor or therapist may combine different therapies depending on each person’s needs.

One helpful therapy is called cognitive behavioral therapy, or CBT. It appears to be the most effective type of counseling for PTSD.  In cognitive therapy, the therapist helps patients understand and change how they think about their trauma and its aftermath. The goal is to understand how certain thoughts about the trauma cause the patient stress and make their symptoms worse. There are several parts to CBT, including:

• Exposure therapy. This therapy helps people face and control their fear. It exposes them to the trauma they experienced in a safe way. It uses mental imagery, writing, or visits to the place where the event happened. The therapist uses these tools to help people with PTSD cope with their feelings.
• Cognitive restructuring. This therapy helps people make sense of the bad memories. Sometimes people remember the event differently than how it happened. They may feel guilt or shame about what is not their fault. The therapist helps people with PTSD look at what happened in a realistic way.
• Stress inoculation training. This therapy tries to reduce PTSD symptoms by teaching a person how to reduce anxiety. Like cognitive restructuring, this treatment helps people look at their memories in a healthy way.

There is also a similar kind of therapy called eye movement desensitization and reprocessing (EMDR) that is used to treat PTSD.

Medications:

The FDA has approved two medications for treating adults with PTSD:

• sertraline (Zoloft)
• paroxetine (Paxil)

Both of these medications are antidepressants, which are also used to treat depression. They may help control PTSD symptoms such as sadness, worry, anger, and feeling numb inside. Taking these medications may make it easier to go through psychotherapy. Other antidepressants are sometimes prescribed off-label for PTSD.