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Post-Traumatic Stress Disorder (or PTSD) is a significant mental health problem. We’ve found that it develops in some people who experience or witness a major life-threatening even. Events leading to PTSD include war-time combat, a natural disaster, a major car accident, or sexual assault.
We also find that being in one of these traumatic stress situations does not automatically lead to PTSD. We see that most people will have some difficulty going about their every-day lives in the first few weeks after the event. If you’re not feeling better after a few weeks or months, you might want to consider exploring therapy for PTSD.
You should seek help if the stress after a major traumatic event.
• Triggers are experiences which bring the event back—sights, smells, and sounds.
• Flashbacks are feelings that you are reliving the event.
• Nightmares disturb your sleep
Bad accident victims might be triggered by a news story about a bad accident. Some veterans have flashbacks because of Fourth of July Fireworks, both in formal displays as well as neighborhood play. Someone who lived through Hurricane Harvey may be triggered by heavy rain.
• Avoiding crowds, because groups of people are dangerous.
• Avoiding driving, because the trauma happened in a vehicle.
• Avoiding movies and TV about similar events.
• Keeping busy, to avoid thinking about the event.
Someone sexually assaulted in a park may no longer go to parks. Someone who survived the Las Vegas attack may not go to country music concerts in the future. Survivors of a car crash may not want to get into cars anymore.
• Staying away from relationships.
• Changed feelings about friends and family.
• Forgetting parts of the traumatic event.
• Not talking about the event.
• Losing trust in everyone, because the world is dangerous.
A soldier returning home from a combat zone may turn against their significant other. A rape survivor may be unable to get into any relationship.
• Difficulty in sleeping
• Trouble in concentrating
• Startling easily with a loud noise or surprise
• You keep your back to the wall in restaurants or public spaces
First responders may refuse to eat at a restaurant where they can’t sit with their back to the wall. Fourth of July Fireworks may cause startle reactions. People may begin to consume drugs or alcohol much more severely than before.
Based on our practice, we’ve seen a pattern to therapy. While we can’t predict the course of treatment for each individual case, we think you can expect to meet with a therapist twice weekly for roughly four months. In many cases, we’ve found that most patients can then continue treatment less frequently. It’s also the point at which we would consider other treatments, including medication—especially if the PTSD has not lessened.
We use talk therapy as the basis of treatment for PTSD. During each session we will focus on certain topics and goals; the session will last between 50 and 90 minutes. We treat PTSD through four main talk therapies, in which the therapist and patient are part of a team.
Many people attend PTSD support groups. These groups can be tremendously helpful, but they don’t replace treatment. We encourage people to join support groups, while they continue therapy.
The ability to be with people who have been through similar experiences is helpful. We think it will help those having difficult trusting others.
Sometimes, we’ve found that medication may be indicated to help in the treatment of PTSD. In these cases, we’ll refer you to a psychiatrist, who can prescribe medications which will handle stress. You’ll be meeting with the psychiatrist frequently as you start on the course of medications, and you may need to try several before finding the right one.
Most of the medications which address the stress in PTSD are either SNRIs (selective norepinephrine reuptake inhibitors) or SSRIs (selective serotonin reuptake inhibitors). We have fond that medications do not address the underlying causes of PTSD—only therapy can do that.
The best thing you can do to help yourself manage PTSD. We work as a team to help you through the worst parts of it, so it becomes manageable. Through therapy, we’ll help you develop appropriate coping methods to allow you to handle those triggers which happen between sessions.
Some people find that a service dog helps with PTSD, and this might be an option for you as part of your therapy (and then life).
Finding ways to change your way of life can also help. If you start exercising, for example, you may find that physical tension decreases, and the time you spend out running, swimming, or working out may give you another safe place, at least for some time each day.
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Medication is not required, but after a period of talk therapy, medication might be indicated, and we would refer you to a psychiatrist.
It’s generally very good, provided the patient has proper and consistent treatment. PTSD does not go away—it goes into remission, so to speak, but can always be triggered.
A few people can, but they run the risk of issues arising and getting out of control. PTSD is a chronic illness.
American Psychiatric Nurses Association / providing links to other resources
American Psychological Association / general information on PTSD
National Center for PTSD / from the Department of Veteran’s Affairs
National Center for Victims of Crime / resources for crime victims and families
National Institute of Mental Health / general resource for understanding PTSD
Operation We Are Here / aimed at veterans
The Trauma Survivors Foundation / based in Wilmington, Delaware