PTSD Basics
In HERE. IS. BETTER., we listen and learn that PTSD is different for every person. Some Veterans had experienced trauma before they became service members, and their time in the military added additional trauma. Other Veterans developed PTSD not due to combat but due to other trauma, such as sexual assault, that occurred while serving. PTSD can encompass a range of traumatic experiences.
It is Important to Remember:
- You are not alone.
- This is not about weakness.
- You deserve to heal and recover from the invisible, psychological wounds of war as much as you deserve the best care for the physical wounds of war.
- Help is available.
Definition of PTSD
Post-traumatic stress disorder (PTSD) is a mental health problem and can develop after experiencing a life-threatening event. It’s normal to have stress reactions to these events, but most people start feeling better after a few weeks. If these types of stress symptoms continue for a few months and thoughts and feelings from the trauma continue to be upsetting and cause problems in your daily life, you may have PTSD.
Who Develops PTSD?
Anyone can develop PTSD at any age, with certain types of trauma, like combat or sexual assault, being more common. Personal factors, such as age or gender and what happens after the trauma, can all affect PTSD.
What are the Symptoms?
PTSD symptoms usually arise soon after the traumatic event but may also appear months or years later. There are four types of PTSD symptoms:
Re-Experiencing
Flashbacks: You may find yourself reliving a traumatic event. This could include physical symptoms such as a racing heart or sweating Bad dreams: These might include dreams related to the event Frightening thoughts
Avoidance
Avoiding thoughts, feelings, places, activities, or objects that remind you of the traumatic event.
Arousal and Reactivity
Being easily startled, feeling tense, having trouble sleeping.
Cognition and Mood
experiencing negative thoughts, feelings of guilt or blame, or loss of interest in hobbies.
When these symptoms last for a month or longer, it is considered PTSD.
Do I have PTSD?
This interactive tool, while not a diagnosis, can help you explore whether you might need further assessment for PTSD. While only a mental health provider can diagnose PTSD, you can use the results to start a discussion with your healthcare provider. Need to find a provider? Check out the resources here.
Sources to explore for more information:
PTSD Basics – PTSD: National Center for PTSD
PTSD Support & Resources for Veterans | Wounded Warriors Project
MYTH BUSTING
It may seem that Veterans experience more traumas; however, over half of the general population goes through trauma, and a much smaller percentage develops PTSD. For example, an estimated 6% of the population will have PTSD at some point in their lives, and about 13 million adults have PTSD in a given year (this is only a small portion of those who have experienced trauma). You do not need to be in a war zone or in combat to be vulnerable to developing PTSD. PTSD can result from any life-threatening experience, including an automobile accident, assault, or natural disaster.
Common Myths Surrounding PTSD
PTSD does exist. It is a recognized mental health problem that has been studied for many years. Strong emotions caused by the event create changes in the brain that may result in PTSD. You may get PTSD if you have lived through a traumatic event that caused you to fear for your life, see horrible things, and feel helpless. PTSD has not always had the same name. It has also been called combat fatigue or shell shock at different times.
Studies have shown that approximately 30% of Vietnam War Veterans experience PTSD over the course of their lifetimes, and approximately one in five Service Members who return from deployment operations in Afghanistan and Iraq have symptoms of PTSD.
PTSD symptoms can develop at any time after a traumatic event. Your symptoms may start soon after the event, or you may not have them until months or years later. They may come and go over many years.
Experiencing trauma does not mean you will develop PTSD. Most people recover fully after experiencing these kinds of events. Only a small percentage are diagnosed with PTSD. While the percentages are higher for Veterans, it is important to remember that trauma can be cumulative. Veterans may have had trauma before they joined the service, while others without previous trauma manage well with symptoms of PTSD.
The strong emotions you may feel during the traumatic event can create changes in your brain that result in PTSD. You may not be able to “move on” because of this. It’s important to remember that PTSD is a medical condition. People with other health conditions, such as cancer, deal with the condition as best they can. The same is true for PTSD.
PTSD is not a terminal illness. While there is no definitive cure, many types of treatment can alleviate the symptoms, some in as little as 8 weeks.
Sources to explore for more information: Veterans Affairs Training, Lesson 4
TREATMENT OPPORTUNITIES
While no “one-size-fits-all” therapy exists to treat post-traumatic stress disorder (PTSD), there are a variety of treatment options that have proven to be effective in research studies, some in as little as 8 weeks. You can discuss the options with your mental health provider and determine which one is right for you.
Several types of psychotherapy, also called talk therapy, may be used to treat PTSD. In HERE. IS. BETTER. we see the three types of trauma-focused therapies that are supported by the most evidence:
Cognitive processing therapy
helps you recognize the ways of thinking (cognitive patterns) that keep you stuck — negative beliefs about yourself and the risk of traumatic things happening again. For PTSD, cognitive therapy often is used along with exposure therapy. In HERE. IS. BETTER., we see Teresa, Tabitha, and the other women in their cohort, participating in this treatment.
Prolonged exposure therapy
helps you safely face both situations and memories that you find frightening so that you can learn to cope with them effectively. Exposure therapy can be particularly helpful for flashbacks and nightmares. One approach uses virtual reality programs that allow you to re-enter the setting in which you experienced trauma. In HERE. IS. BETTER., we see Teresa, Tabitha, and Jason having experiences with this treatment.
EMDR
(Eye movement desensitization and reprocessing) combines exposure therapy with a series of guided eye movements that help you process traumatic memories and change how you react to them. In HERE. IS. BETTER., we see John using this treatment.
Medications may also be tried and used in conjunction with psychotherapy to help improve symptoms of PTSD. Here are the most commonly used:
Antidepressants/SSRIs/SNRIs
Can help symptoms of depression and anxiety. They can also help improve sleep problems and concentration. The selective serotonin reuptake inhibitor (SSRI) medications sertraline (Zoloft) and paroxetine (Paxil) are approved by the Food and Drug Administration (FDA) for PTSD treatment.
Anti-Anxiety Medications
Can relieve severe anxiety and related problems. Some anti-anxiety medications have the potential for abuse, so they are generally used only for a short time.
Prazosin
While several studies indicated that Prazosin (Minipress) might reduce or suppress nightmares in some people with PTSD, a more recent study showed no benefit over a placebo. But participants in the recent study differed from others in ways that potentially could impact the results. Individuals who are considering prazosin should speak with a doctor to determine whether or not their particular situation might merit a trial of this drug.
Sources to explore for more information: PTSD Treatment Basics – PTSD: National Center for PTSD
Complementary and Integrative Health (CIH) Treatments
There are many activities that can complement your treatment plan, helping relieve stress and enhancing mental health. You can discuss with your therapist which one(s) may be right for you.
Here is a sampling of CIH treatments and practices to explore and consider.
Additional Therapies
There are other therapies that are sometimes used to treat PTSD that currently have limited to no research support. If evidence-based treatments are not available, you can discuss with your therapist what other options might be a good fit for you.
Ketamine
Somatic treatment
Reconsolidation of Traumatic Memories (RTM)
Cannabis
MDMA
Stellate Ganglion Block
Psilocybin
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