What is PTSD?
A traumatic event is a situation that is extremely frightening and that threatens harm to yourself or others around you. Examples of traumatic events include motor vehicle accidents, natural disasters, rape, and combat-related experiences that include injury or death. It is common to have reactions such as jumpiness, upsetting memories, nightmares and difficulty sleeping, or irritability following such an event; however, if these symptoms do not go away and interfere with functioning (work, school, relationships), then you may have an anxiety disorder known as Posttraumatic Stress Disorder (PTSD).
Who gets PTSD?
People at any age who have witnessed or lived through a dangerous event can develop PTSD. However, most survivors of traumatic events will not get the disorder. The U.S. National Comorbidity Survey Replication conducted between February 2001 and April 2003 found the lifetime prevalence of PTSD among adult Americans to be approximately 6.8%. Surveys examining war era veterans (Vietnam, Gulf War, and Operation Enduring Freedom/Operation Iraqi Freedom) have found lifetime prevalence rates to be between 10% and 30%. Studies have also shown consistently higher rates of PTSD among female trauma survivors as compared to men, with approximately twice as many likely to develop the disorder.
How is PTSD diagnosed?
PTSD is assessed by a doctor who has experience with mental illness, such as a psychologist or psychiatrist. The doctor discusses with the person who has experienced a traumatic event the symptoms that have resulted from the trauma, the effect these symptoms have had on their life, and how long they have been experiencing these symptoms. A diagnosis of PTSD requires a pattern of symptoms to be present for at least one month. There are three major categories of symptoms: re-experiencing (e.g., flashbacks, unwanted thoughts), avoidance/numbing (e.g., avoiding activities and people that are reminders of the event, feeling emotionally detached from others), and increased arousal (e.g., outbursts of anger, difficulty sleeping, exaggerated startle response)
How is PTSD treated?
PTSD treatment includes psychotherapy (“talk” therapy), medication, or both. Since people are different, there is no one form of treatment that works for everyone or for all types of traumatic events. However, therapy which includes “exposure” to the trauma has demonstrated significant reductions in symptoms within a range of populations, including survivors of sexual assault, traffic accidents, childhood abuse, and combat. In particular, Prolonged Exposure (PE) therapy has been studied in well-controlled treatment trials for 20 years with good results. Along with Cognitive Processing Therapy (CPT) and Eye Movement Desensitization and Reprocessing (EMDR), it is considered a first line treatment for PTSD. PE should be conducted by a mental health care provider who is experienced with PTSD. The treatment program consists of 9-15 weekly therapy sessions of 90 minutes each. It focuses on learning about PTSD and common reactions to trauma, teaches breathing skills to help with relaxation, and helps people face their memories of the trauma in a safe environment. It uses mental imagery and visits to places that trigger thoughts of the event to allow trauma survivors to gain control over their fears and cope with their feelings.
Certain medications such as antidepressants can offer effective treatment for PTSD. The most research evidence exists for SSRI medications (such as Zoloft or Paxil). Sometimes other medications can also be helpful in treating PTSD. While combinations of psychotherapy and medications are typically used for treating PTSD, other techniques such as acupuncture, meditation, and general support groups can be useful additions. In fact, research shows that people who seek out enjoyable activities and support from others after experiencing a traumatic event demonstrate greater recovery.
What’s new in PTSD treatment?
Medical and psychological treatments are constantly advancing in the effort to make PTSD therapies more effective and efficient. There are currently studies being conducted using virtual reality in PE treatment. Virtual reality is a tool that builds upon traditional exposure by helping the person to engage more senses in the retelling of the trauma memory. The virtual environment simulates the sights, sounds, and smells of the traumatic event while remaining safely in the therapy room. Researchers are finding that virtual reality can aid in allowing the person to have “one foot here, one foot there” when participating in exposure treatment, thereby enhancing overall learning and improvement.