Posttraumatic Stress Disorder (cont.)
How is PTSD treated?
Treatments for PTSD usually include psychological and medical treatments.
Providing information about the illness, helping the individual manage the
trauma by talking about it directly, teaching the person ways to manage symptoms
of PTSD, and exploration and modification of inaccurate ways of thinking about
the trauma are the usual techniques used in psychotherapy for this illness.
Education of PTSD sufferers usually involves teaching individuals about what
PTSD is, that it is caused by extraordinary stress rather than weakness, how it
is treated, and what to expect in treatment. This education thereby increases
the likelihood that inaccurate ideas the person may have about the illness are
dispelled, and any shame they may feel about having it is minimized. This may be
particularly important in populations like military personnel that may feel
particularly stigmatized by the idea of seeing a mental-health professional and
therefore avoid doing so.
Teaching people with PTSD practical approaches to coping with what can be
very intense and disturbing symptoms has been found to be another useful way to
treat the illness. Specifically, helping sufferers learn how to manage their
anger and anxiety, improve their communication skills, and use relaxation
techniques can help individuals with PTSD gain a sense of mastery over their
emotional and physical symptoms. Cognitive therapy can help people with PTSD
recognize and adjust trauma-related thoughts and beliefs by educating sufferers
about the relationships between thoughts and feelings, exploring common negative
thoughts held by traumatized individuals, developing alternative
interpretations, and by practicing new ways of looking at things. This treatment
also involves practicing learned techniques in real-life situations.
Eye-movement desensitization and reprocessing (EMDR) is a form of cognitive
therapy in which the practitioner guides the person with PTSD in talking about
the trauma suffered and the negative feelings associated with the events, while
focusing on the professional's rapidly moving finger. While
some research indicates this treatment may be effective, it is unclear if this
is any more effective than cognitive therapy that is done without the use of
rapid eye movement.
Families of PTSD individuals, as well as the sufferer, may benefit from
family counseling, couples' counseling, parenting classes, and conflict
resolution education. Family members may also be able to provide relevant
history about their loved one (for example, about emotions and behaviors, drug abuse,
sleeping habits, and socialization) that people with the illness are unable or
unwilling to share.
Directly addressing the sleep problems that can be part of PTSD has been
found to not only help alleviate those problems but to thereby help decrease
the symptoms of PTSD in general. Specifically, rehearsing adaptive ways of
coping with nightmares (imagery rehearsal therapy), training in relaxation
techniques, positive self-talk, and screening for other sleep problems have been
found to be particularly helpful in decreasing the sleep problems associated
with PTSD.
Medications that are usually used to help PTSD sufferers include serotonergic
antidepressants (SSRIs) like fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and medicines that help decrease the physical symptoms
associated with illness, like clonidine (Catapres), guaneficine (Tenex), and
propranolol. Individuals with PTSD are much less
likely to experience a relapse of their illness if antidepressant treatment is
continued for at least a year. SSRIs are the first group of
medications that have achieved approval by the U.S. Food and Drug Administration
(FDA) for the treatment of PTSD. These medicines have been found to help PTSD
sufferers modify information that is taken in from the environment (stimuli) and
to decrease fear. Research also shows that this group of medicines tends to
decrease anxiety, depression, and panic. SSRIs may also help reduce aggression,
impulsivity, and suicidal thoughts that can be associated with this disorder.
Other less directly effective but nevertheless potentially helpful
medications for managing PTSD include mood stabilizers like lamotrigine
(Lamictal), tiagabine (Gabitril), divalproex sodium (Depakote), as well as mood stabilizers
that are also antipsychotics, like risperidone (Risperdal), olanzapine
(Zyprexa), and quetiapine (Seroquel). Antipsychotic medicines seem to be most
useful in the treatment of PTSD in those who suffer from agitation,
dissociation, hypervigilance, intense suspiciousness (paranoia), or brief breaks
in being in touch with reality (brief psychotic reactions).
Benzodiazepines (tranquilizers) have unfortunately been associated with a
number of problems, including withdrawal symptoms and the risk of overdose and
have not been found to be significantly effective for helping individuals with PTSD.
Next: How can people cope with PTSD? »
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From the Doctors at MedicineNet.com  |
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