PTSD Treatment Options
Post Traumatic Stress Disorder (PTSD) is a disease that develops in individuals who have lived through a terrifying, scary, and dangerous event. A range of reactions will result after exposure to trauma and if the symptoms persist, the person will be diagnosed with Post Traumatic Stress Disorder. Individuals diagnosed with the disorder feel stressed and frightened even when they are not in real danger.
Post Traumatic Stress Disorder can cost an individual in four main significant ways:
- Comorbidity chances are high, and reports indicate that only 17 percent of veterans with PTSD were diagnosed solely with PTSD.
- PTSD is often accompanied by a chronic course, 40 percent of individuals diagnosed with PTSD show symptoms ten years after the onset.
- PTSD has also proven to be a cause of suicide among many affected individuals.
- People with PTSD are vulnerable to other health conditions.
Many treatments have been proven to alleviate symptoms associated with posttraumatic stress disorder, yet veterans continue to suffer from the disease’s symptoms. Reports show that about 200,000 Vietnam War veterans still have PTSD and the number is rising.
The Department of Veterans Affairs has medical centers with PTSD specialists who provide treatment to affected veterans. Around 200 specialized PTSD treatment programs are available in the United States. The services provided by the PTSD treatment programs include:
- Mental health assessment and testing.
- Medications for the management of the condition.
- Coordinated psychotherapy and family therapy.
- Group therapy, various topics such as anger management, stress management, and combat support are covered. It may also involve groups of veterans for a particular trauma or a specific conflict.
The treatment used by the Veteran Affairs has been proven by research to be effective in the management of the condition. Each of the centers has personnel who have been trained in the management of the condition. They are known as PTSD Specialists.
Methods used in the prevention of Posttraumatic Stress Disorder
Prevention of the condition is the best way of lessening the damages that it can cause. The approaches used in the prevention of the disease include both pharmacological and psychological.
- Pharmacological prevention: the use of ketamine and cortisol are some of the proven strategies in the management of PTSD. Propranolol, a beta-adrenergic antagonist, has proven effective in the management of headaches, hypertension, and performance anxiety. Studies have reported a major improvement in the disorder’s symptoms.
- Psychological approaches: Psychological Debriefing is a method that was introduced with the aim of preventing long-term adverse occurrences in the wake of traumatic events. Interventions applied include the elicitation of reactions, normalizing responses, and preparing the individual for PTSD responses. Other debriefing methods such as support and psychoeducation are recommended.
Treatment of PTSD
Psychotropic medications are commonly used among veterans diagnosed with PTSD. The drugs can be administered by a non-mental specialist, and it does not take much time compared to psychotherapy. It is advisable to use both pharmacotherapy and psychotherapy for better results. Medications commonly used include paroxetine and sertraline, which are selective serotonin reuptake inhibitors and venlafaxine that works by inhibiting serotonin-norepinephrine reuptake. The drugs are ranked as the first-line treatment of the condition. Second-line treatment agents include two tricyclic antidepressants, which include amitriptyline and imipramine and one monoamine oxidase inhibitor, which is mirtazapine.
- Adjunctive treatment therapy for PTSD
Apart from using single medications for the management of PTSD, claims have been made supporting the utilization of the medications and psychotherapy in combination with other psychotropic drugs. The most common anti-psychotropic medications used include; prazosin, D-cycloserin, and the atypical antipsychotics. Prazosin is an antihypertensive agent that has been proven to help in reducing nightmares and other common sleep disorders that are commonly associated with PTSD. D-cycloserin is an antibiotic that works in enhancing the cognitive responses and also a facilitator of extinction learning in anxiety disorders. Atypical antipsychotics recommended in PTSD treatment include risperidone.
- International Psychopharmacology Algorithm
PTSD algorithm is a program that was introduced to address the issue of medications failing to give any significant results. The program provides an explicit recommendation for administering medications when the first-line treatment medicines fail to achieve the treatment goals.
Discussed below are the various approaches that are applied in the management of PTSD. Different methods implemented in the Veteran Affairs have been derived from the Cognitive Behavioral Therapy (CBT) traditions.
- Prolonged exposure: the goal of prolonged exposure is to lessen PTSD symptoms by modifying the memory structures that carry emotions such as the ubiquitous fear found in PTSD. The treatment is manual, and one session takes a period of 90 minutes. Components of prolonged exposure include imaginal exposure that involves revisiting the client’s traumatic memory, recounting the events loud, and discussing the events with the client after the recounting process. The procedure also involves in vivo exposure of the client to a safe and trauma-related conditions that client fears and avoids. Other components include training in slowed breathing techniques and psychoeducation. Post-exposure therapy has been found to be highly effective in the management of PTSD symptoms. It is one of the only two methods that was chosen by the Veteran Affairs department for widespread dissemination. Reports also indicate that prolonged exposure therapy can be transported from the academic setting into the community level. Research also highly recommends the use of prolonged exposure in the military settings and with female veterans.
- Cognitive processing therapy: the procedure is applied in a 12-session format. It comprises of many of the typical components of CBT, and an example is the challenging automatic thoughts. The method also involves an exposure component that is different from the one in prolonged exposure. The primary focus of the treatment process is self-blame management. The veterans are required to write down all their traumatic experiences in details, sensory, memory and feelings and read to themselves daily. The clients will also be asked to read their accounts loudly during sessions. Studies conducted have shown the method to be effective especially in the military samples. It has a lot of data supporting its effectiveness in PTSD management, and that was the reason it was chosen by the Veteran Affairs Department.
- Exposure therapy using virtual reality: clients are exposed to a virtual reality that involves a moving visual stimulus, smells, 3D sounds, and the general feeling one gets when involved in a traumatic situation. The procedure is effective for individuals that are having problems in imagining their traumatic experiences or those that are resistant to talk therapy.
- Hypnosis: hypnosis can be used as a stand-alone treatment, or as an adjunct therapy. It is an effective adjunct therapy for psychodynamic and CBT therapies. It is reported to be more efficient in reducing PTSD and insomnia symptoms.