The Role Of A PTSD Doctor And Therapist In PTSD Treatment
Post-traumatic stress disorder is a complex mental illness. Often, because of the severity and nature of symptoms, a combined approach to treatment, including medication and therapy, may be required to manage them. Connecting with a PTSD doctor, like a psychiatrist, or a mental health professional, like a therapist, may be a way to start receiving support and obtain an individualized treatment plan.
What is PTSD?
Post-traumatic stress disorder (PTSD) is a mental illness that can develop after a person experiences a traumatic event. Traumatic events can include (but are not limited to):
- Sexual assault or harassment
- Living in or fleeing a war zone, either as a soldier or a civilian
- Being a refugee or immigrant
- Experiencing abuse (including childhood abuse, sexual abuse, and emotional abuse)
- Surviving domestic violence
- Being bullied at school or at work
- Experiencing an accident or natural disaster
- Losing a loved one unexpectedly
- Being a survivor of a crime
- Being unable to gain control of or escape from a life-threatening experience
- Living through prolonged medical illness or treatment, such as chemotherapy for cancer
Traumatic experiences can be different for everyone, meaning two people may perceive the same event as traumatic or non-traumatic. Validation and support after surviving trauma can be integral to preventing the development of PTSD symptoms or mitigating symptoms once they appear.
PTSD symptoms
PTSD symptoms include cognitive, emotional, and behavioral impacts. Some more common symptoms include:
- Hypervigilance
- Flashbacks, in which a person believes or has an intense sense that they are re-experiencing the traumatic event, even though they are not
- Avoidance of places, people, emotions, memories, or thoughts related to the traumatic event
- Negative beliefs about oneself or the world, such as “I am fundamentally flawed” or “The world is a dangerous place”
- The urge to feel guilty about what happened, like the traumatic event was somehow one’s fault
- Anxiety and worry
- Angry outbursts
- A sense of numbness or believing one is disconnected from others
- Depressive symptoms, including sadness and hopelessness
A person must display a significant number of the above symptoms for more than a month after they experienced trauma to receive a PTSD diagnosis. If a person’s symptoms disappear after a few weeks, a different trauma and stressor-related disorder diagnosis may be more appropriate, such as acute stress disorder (ASD).
How a PTSD doctor can treat PTSD
You may be wondering if you need to see a doctor for PTSD. A medical doctor, physician, or primary care provider often does not provide ongoing mental health care for PTSD, but they may be able to diagnose the disorder. They may also refer you to a mental health professional who can treat PTSD, such as a counselor for therapeutic treatment. The exception to this factor is psychiatry, as psychiatrists are medical doctors who can prescribe medication for PTSD and may also, in some cases, offer therapy.
When seeking any type of PTSD treatment, look for a provider with experience working with PTSD patients who practices evidence-based forms of PTSD treatment, including but not limited to cognitive therapy, eye movement desensitization and reprocessing (EMDR) therapy, and exposure therapy. When working with a psychiatrist or other doctor, look for someone prescribing medications approved by the US Food and Drug Administration (FDA) to treat PTSD.
Medications for PTSD, like medications for some other mental health disorders, are intended to treat symptoms as opposed to addressing the disorder’s root causes. Currently, no medication option can process a person’s traumatic experience for them. However, the following medications may offer some relief from specific PTSD symptoms:
- Selective serotonin reuptake inhibitors (SSRIs): SSRIs may reduce sadness, worry, anger, and emotional numbness.
- Insomnia and sleep medications: These medications may address nightmares and other sleep-related mental health problems.
Medications are typically prescribed by a psychiatrist, a medical doctor specializing in mental health medication treatment. They can also be prescribed by nurse practitioners and psychiatric nurses (in some states), physicians, physician’s assistants, and mental health clinical pharmacy specialists. Some providers prescribe medication in conjunction with a therapeutic treatment plan for PTSD developed by a counselor.
Therapeutic options for treating PTSD
Different therapists can provide PTSD treatment. Licensed clinical social workers (LCSWs), licensed professional mental health counselors (LPMHCs), and Licensed marriage and family therapists (LMFTs) may be helpful options for treating PTSD as long as they are trained and experienced in PTSD treatment techniques. These techniques include but are not limited to the following.
Cognitive-behavioral talk therapy
Talk therapy often involves meeting with a mental health professional once weekly or every two weeks. These meetings can be one-on-one or in a support group setting. With one-on-one talk therapy, an individual may discuss their traumatic memories, PTSD symptoms, and the impact of the trauma and disorder on their mental and emotional health. With a PTSD support group, a therapist may facilitate conversation and connection between survivors of trauma and people living with PTSD.
One of the most effective forms of talk therapy in addressing PTSD symptoms is cognitive-behavioral therapy (CBT). Cognitive-behavioral therapy focuses on the relationship between thoughts and behaviors, positing that changing unhelpful thoughts may reduce the prevalence of unwanted behaviors. Because core negative beliefs can be such a significant component of PTSD, using CBT techniques to target thoughts associated with those beliefs may alleviate unwanted PTSD symptoms.
Eye movement desensitization and reprocessing (EMDR) therapy
Eye movement desensitization and reprocessing (EMDR) therapy is a technique for treating PTSD that developed relatively recently compared to other techniques but has demonstrated promise. It involves bilateral stimulation of the brain, typically by eliciting back-and-forth eye movements by having the client follow the therapist’s finger back and forth or holding buzzers in their hands that alternatively vibrate.
While researchers are still studying the exact science behind EMDR, bilateral stimulation may help the client enter a state of mind similar to rapid eye movement (REM) sleep. In this state, a client may be more capable of engaging with their traumatic memories and processing the traumatic event without re-traumatizing themselves, which can be a limitation of other PTSD treatment methods like cognitive-behavioral therapy or exposure therapy. Initial studies show that EMDR may be more effective than CBT, with one review finding it more effective in seven out of 10 cases.
Alternative options
The symptoms of post-traumatic stress disorder can sometimes be overwhelming. Hypervigilance, fear of flashbacks, and stress and anxiety may make someone with the condition hesitant to leave the house, even in pursuit of accessing services that may improve mood, like an in-person therapy appointment.
If PTSD symptoms sometimes make attending in-person therapy difficult, online therapy may be more accessible. With an accredited online therapy service like BetterHelp, clients can be matched with a therapist from a database of hundreds of providers. In addition, they can attend sessions from the safe space and comfort of their homes, choosing to connect with their therapist via video chat, phone, or in-app messaging.
Some forms of PTSD treatment, including EMDR therapy, may be more difficult to achieve online. However, other types of PTSD treatment may be as impactful when accessed online as in a traditional in-person therapy appointment. One study found that completing online PTSD therapy significantly reduced anxiety and depression-related symptoms in a group of PTSD patients. If PTSD symptoms are holding you back, online therapy could be a helpful way to process your trauma and move forward with your life.
Takeaway
While there may not be a specific PTSD ‘specialty’ doctor to address symptoms of post-traumatic stress disorder, there are many medical and therapeutic professionals who do have expertise in working with those who experience PTSD symptoms. Talking to a medical professional could be a beneficial first step in accessing PTSD treatment. Therapy is one of many effective treatment options that have been found to reduce or alleviate PTSD symptoms. Consider reaching out to a licensed therapist or psychiatrist to receive support.
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