Help Diagnosing and Treating PTSD

Post-traumatic stress disorder (PTSD) is a mental illness triggered by trauma. It causes symptoms, like nightmares and frightening flashbacks that make it difficult for a person to function normally. Getting a professional diagnosis and going through treatment are essential for recovery. This is not a condition that will get better on its own. The main focus of treatment for PTSD is the use of trauma-focused behavioral therapy that helps patients process traumatic memories, manage negative emotions associated with trauma, and restore normal functioning.

What is PTSD?

Post-traumatic stress disorder, or PTSD , is a trauma- or stress-related mental illness characterized by exposure to a traumatic experience that causes significant stress. It is one of few mental illnesses that has a definite cause—the trauma—although it is not well known why some people exposed to trauma will react this way while others do not.

PTSD is characterized by persistent symptoms that cause impairment and dysfunction in various areas of a person’s life. Symptoms may include flashbacks and nightmares, intrusive memories, negative thoughts and feelings, avoidant behaviors and hyperarousal. PTSD can be very disruptive and is not likely to get better without intervention. There are treatments available, including trauma-focused therapies and medications that can help individuals learn to overcome trauma and move past it.

Who Gets PTSD?

Anyone from children to older adults, from all walks of life, could develop PTSD after a traumatic experience, but there are some people who are more vulnerable:¹

• According to the Department of Veterans Affairs, 60 percent of men and 50 percent of women will experience trauma at least once in their lives.
• About seven to eight percent of the population will develop PTSD.
• Eight million adults each year are diagnosed with PTSD, but many more are exposed to trauma.
• Ten percent of women will develop PTSD, while only four percent of men will.
• Women are more likely to experience sexual assault than men, and this may explain the discrepancy.
• Fifteen percent of veterans of the Vietnam War are estimated to have or have had PTSD.
• Risk factors for PTSD include experiencing trauma directly, being injured during the traumatic experience, having another mental illness, having a substance use disorder and not having a good support system.²

Diagnosing PTSD

It is not unusual for someone who has experienced or witnessed something traumatic to have symptoms characteristic of PTSD. However, it is less common for those symptoms to persist. When someone exhibits these symptoms for more than a month, it may be diagnosed as PTSD:³

• Reliving or re-experiencing symptoms are thoughts, memories, dreams and flashbacks that take a person back to the traumatic event. These are intrusive, troubling, distressing and impossible to stop. They may even feel very real, as if the event is actually happening again.
• Avoidant symptoms are actions or inactions people with PTSD take to try to prevent any reliving of the trauma. It may include avoiding a person who was there, staying away from certain locations or not going to work. Avoidance can also include not talking about the trauma.
• Negative thoughts and feelings are distorted perceptions about oneself, others or the world at large. Someone with PTSD may believe they don’t deserve to be at peace, that other people can’t be trusted and that the world is a scary, negative place. These symptoms can lead to detachment from the world, avoidance of activities and damaged or limited relationships.
• Hyperarousal occurs when someone overreacts to triggers, is always on edge or is constantly looking out for danger. This can cause a person to have angry or aggressive outbursts, to startle very easily, to struggle to sleep and to engage in reckless and destructive behaviors.

Trauma-Focused Therapies for PTSD

One of the most effective types of therapy for people with PTSD is called cognitive behavioral therapy (CBT).³ This is a therapy focused on realizing and changing negative thoughts and behaviors. It is action- and goal-oriented, and there are several variations of CBT that are used to help people with PTSD:

• Prolonged Exposure Therapy. In this type of therapy, patients are asked to face the past trauma and triggers in a safe environment. It helps individuals learn to cope with and manage the negative feelings associated with them. Tools may be used to assist the process, including virtual reality.
• Cognitive Processing Therapy. In cognitive processing, patients are taught how to reframe negative feelings and thoughts associated with the trauma. They learn to turn negative beliefs into those that are more positive and productive.
• Stress Inoculation Therapy. This kind of therapy uses a variety of strategies for stress management. These may include biofeedback, breathing and muscle relaxation exercises, meditation, role-playing and others.
• Eye-Movement Desensitization and Reprocessing (EMDR). During this type of therapy, patients with PTSD process traumatic memories and thoughts while going through eye movements guided by the professional. EMDR uses the simultaneous recollection of memories and stimulation in the brain triggered by eye movements to reduce the intensity of traumatic memories and the emotions associated with them.⁴

People with PTSD may also benefit from some alternative and creative types of therapy, like art therapy, drama therapy, animal therapy and therapy enhanced by psychedelic drugs. The latter is in the early stages of development, but there is strong evidence that using drugs like psilocybin or MDMA in a controlled manner and in a safe, guided process with a trained therapist can help reduce traumatic associations and symptoms of PTSD.⁵

Group therapy may also be useful in helping individuals relate to others and share experiences in a supportive environment. Getting family involved in therapy sessions can help loved ones learn how to better offer support and learn about PTSD. Family support is very important to managing and recovering from PTSD.

Medications for PTSD

Therapies are most important for managing and treating PTSD, but some people benefit from supplementing therapy with certain medications. Antidepressants, for instance, can help individuals combat depression and anxiety while also improving sleep. Anti-anxiety medications can be used in the short-term to relieve anxiety, especially extreme episodes of anxiety. A medication called prazosin, which is not approved for PTSD, is sometimes prescribed to help reduce the incidence of nightmares.

PTSD is a difficult mental illness that causes a lot of significant dysfunction and impairment. Without treatment the symptoms can make going to work or school, keeping up with home responsibilities and maintaining healthy relationships very challenging. PTSD can also lead to other serious complications like substance abuse or suicide. This is not a condition that will improve without professional support. It is crucial to get an accurate diagnosis and to begin treatment in order to find relief from symptoms.

¹U.S. Department of Veterans Affairs. PTSD: National Center for PTSD. How Common is PTSD?