Treatment Options for PTSD

Post-Traumatic Stress Disorder (PTSD) is a serious and enduring psychological condition caused by exposure to a life-threatening event. A person doesn’t have to experience the trauma directly; it’s possible to develop PTSD by witnessing a shocking event alone. Examples of situations that cause PTSD include combat, assault, surviving a natural disaster or violent crime, rape, abuse or the sudden death of a loved one. Events that cause PTSD tend to be terrifying, violent or both. PTSD results in a person suffering greatly elevated anxiety, emotional numbness, inability to feel pleasure (anhedonia), disturbed sleep, re-experiencing the event through nightmares and flashbacks, and avoidance of people and situations that are reminders, even tangentially, of the trauma

In comparison to PTSD, most people experience Post-Traumatic Stress (PTS). After a frightening event, a person’s heart may race, their knees will be shaky, and intrusive images and flashes of the event may linger for a few days. PTS passes rapidly, lasting from a few hours to several days. PTS happens during the disturbing event or immediately after and lessens as time passes. PTSD may not show up for weeks or months after the traumatic event. It doesn’t get better as time goes on, either. The same event that occasions PTS in one person may in fact cause PTSD in another. 

Common Causes of PTSD

Although any of the following may cause PTSD, not everyone who experiences one of these traumas will develop PTSD. PTSD results from a complex interaction between one’s brain chemistry, temperament and approach to stress. People who already have depression or anxiety are also more prone to developing PTSD.

  • Motor Vehicle Accidents are common causes of PTSD. In fact, the American Psychological Association has declared them the most common cause of non-combat related cases of PTSD.
  • Combat or other violence experienced during military service is one of the most common causes of PTSD. PTSD has been called shell shock and combat fatigue in the past. 

  • Sexual abuse or rape. PTSD is a very common outcome of sexual violence. About half of all incidents of PTSD in the USA come from rape or sexual abuse.
  • Childbirth. Post-Partum Post-Traumatic Stress Syndrome (P-PTSD) may develop after a pregnancy marked by complications, but not always. Note that P-PTSD is not the same disorder as postpartum depression.

  • Physical Assault. Violent assault such as a mugging or home invasion can lead to PTSD. Even if there is only the threat of assault, PTSD can develop.
  • Illness. About 25 percent of people who suffer from a life-threatening illness will develop PTSD. Sudden, acute illness tends to provoke more instances of PTSD than chronic illness.

  • Domestic or childhood abuse. Suffering from domestic abuse as an adult or having lived through childhood abuse are common causes of PTSD.
  • Death of a loved one. The unexpected death of a loved one is also a cause of PTSD.

Treatments and Approaches to PTSD

Many treatment approaches to PTSD follow a Cognitive-Behavioral Therapy (CBT) framework. CBT is a short-term therapy carried out in about 12 to 16 sessions. CBT is rooted in the idea that a person’s thoughts, assumptions, and beliefs about events affect them even more powerfully than the events themselves. By identifying a client’s automatic thought processes that are sabotaging their progress, therapists help clients to change those harmful thoughts. CBT is considered goal-oriented. It is not meant to provide deep insight; rather, it seeks to alleviate the suffering caused by PTSD and eliminate symptoms.


Types of CBT Used With PTSD

  1. Exposure Therapy. People with PTSD want to avoid everything that might remind them of the event that caused their PTSD. However, it’s not possible to avoid one’s thoughts and memories. In fact, many people with PTSD die from alcohol or substance abuse that begins as a way of suppressing those horrifying feelings and memories.  Exposure therapy teaches people skills and techniques to learn to tolerate their memories and thoughts of the traumatic event. Although exposure therapy provokes anxiety at the start of therapy, it’s so effective it’s known as “the gold standard” for treatment of PTSD.
  2. Cognitive Restructuring. Cognitive restructuring helps people learn to think about traumatic events without triggering an elevated emotional response. Typically, a person’s mind touches on a traumatic event, with even a tangential thought causing an overwhelming flood of powerful negative emotions. This is problematic because the mind needs to be able to process events to put them in the past. Cognitive Restructuring allows that to happen.
  3. Cognitive Processing Therapy. Cognitive Processing Therapy (CPT) takes 12 sessions and believes that PTSD symptoms are made worse by the conflict between beliefs the person held before the trauma and the experiences of the trauma itself. In CPT, a client writes about their traumatic experience in as much detail as possible. Then, the client reads their story with their therapist. That’s just one part of CPT. Other aspects include education about PTSD, as well as education about how errors in our thinking cause much of our suffering. 
  4. Prolonged Exposure (PE). Unlike “insight-oriented” treatments, PE takes just three months. It relies on two primary techniques. Imaginal exposure and in vivo exposure. Imaginal exposure involves the client describing the distressing event, then the client and therapist discussing the emotions that arose during the recollection. In vivo exposure involves the client and therapist picking a set of situations that cause the client discomfort. The client then uses the techniques they learned in therapy to work through negative emotions while exposing themselves to the stressor. Clients start with very minor situations before working up to more serious stressors.
  5. Eye Movement Desensitization and Reprocessing (EMDR). During EMDR, a client describes or relives traumatic moments while a therapist directs the client’s eye movements. By diverting a client’s attention, therapists help reduce the strength of the client’s emotional response.
  6. Stress Inoculation Training (SIT). SIT teaches coping skills by helping clients understand their fear and anxiety triggers. SIT also teaches:

  • Deep breathing (diaphragmatic breathing)
  • Muscle relaxation training
  • Thinking about and changing negative behaviors
  • Replacing negative thinking with adaptive self-talk. Note that adaptive self-talk isn’t empty “positive thinking,” but self-talk that’s specific to the client that is designed to help the client re-shape their responses in difficult situations.

Family therapy or couples therapy is always a good idea. People who endure PTSD often do so silently, or in ways that end up alienating friends and family members. In family systems, people struggle with old secrets and toxic relationships that exacerbate PTSD. Therapy for the entire family helps to resolve this.

Self-Care for PTSD that Supports Treatment

  • Seeking support from friends, family and PTSD support groups. This is one of the most challenging ways to learn to cope, as people with PTSD often feel an intense sense of shame and guilt and opening up to others is very difficult. Still, family and friends make up one of the best support systems possible.
  • Exercise. As little as 30 minutes of moderate exercise a day liberates dopamine and serotonin in the brain, which translates to reduced anxiety, better sleep, and a lower level of reactivity. It’s good for the mood and emotions.
  • Avoid drugs and alcohol. Drugs and alcohol are major contributing factors to death from PTSD. Alcoholism and addiction are common co-ocurring conditions in all varieties of PTSD, although none more powerfully than in survivors of combat trauma and sexual abuse.
  • Eat healthy foods. PTSD creates a constant state of low-level anxiety that can peak at any time. Nutritious food keeps the body supplied with the elements necessary to fight off issues like high blood pressure that are aggravated by ongoing anxiety.
  • Treat sleep like medicine. Good sleep is at the top of the list for natural medicines for PTSD.  Getting a full night’s sleep can be impossible for people with untreated PTSD, which makes treatment 100 percent essential.
  • Address any other physical or mental illness. People mistakenly think that treating PTSD will resolve other issues, like depression or bipolar disorder. PTSD can exist at the same time as any other mental health issue. Treating both is essential for long-term recovery.
  • Practice relaxation exercises such as meditation and spending time in nature. Many people with PTSD come to value peaceful meditation.

Post-Traumatic Stress Disorder has many causes and lots of terrible symptoms, but the worst might be the loss of hope and the blanket of bleakness about the future that it brings. Sufferers of PTSD have negative, cynical outlooks on their future and on the possibility of ever getting better. It’s that grim feeling of being fated to suffer that kills many PTSD survivors. Getting professional help leads to a better, far more satisfying life.