Treatment For PTSD: Finding Your Path Toward Healing

Can PTSD be fully treated?

Post-traumatic stress disorder (PTSD) is considered a treatable condition, and most people respond effectively to at least one treatment approach. However, people respond differently to treatment. Some might experience a complete resolution of their symptoms after several weekly sessions of talk therapy. In contrast, others might require lifelong support from a licensed mental health professional and other healthcare workers to keep their symptoms at bay. 

Research studies surrounding PTSD indicate a high degree of difficulty when attempting to predict someone’s course through treatment. Individual factors and underlying risk factors make it challenging to know exactly how someone’s trauma impacts them until treatment is well underway. While the length and intensity of the journey tend to vary, most people recover from their traumatic experience and can find relief from adverse symptoms. Advances in psychotherapy have improved patient outcomes considerably with the advent of tools like trauma-focused CBT, but additional research support is required for the most challenging cases. 

What happens if PTSD is left untreated?

Adverse symptoms and feelings related to a traumatic or scary event sometimes resolve within a few weeks, and the person does not develop PTSD.  However, if symptoms last more than a month, the person likely meets the criteria for PTSD if their symptoms are severe enough to interfere with their life and well-being. At that point, the person likely needs professional help to reduce the impact of their symptoms. 

Untreated PTSD can have several adverse effects and may lead to comorbid mental health conditions like anxiety disorders and depression. PTSD can often cause ongoing confusion and mood symptoms - most commonly increased irritability - and a person experiencing the condition may find it difficult to focus on essential tasks. They might also experience strong emotions related to the trauma they experienced. They might feel guilty, feel extreme fear at the prospect of the traumatic event occurring again, or find it difficult to gain control over negative thoughts about the event or themselves. 

Untreated PTSD might also lead someone to withdraw from social support. While social withdrawal is a common PTSD symptom, behavior changes caused by untreated PTSD might cause someone to push away those close to them who may have been willing to provide support. Those with PTSD also tend to demonstrate reactivity symptoms, which can make them prone to angry outbursts and increased paranoia, further pushing away people who could help. 

What is the first phase of PTSD treatment?

The first phase of PTSD treatment is typically a comprehensive evaluation to determine the extent of possible PTSD symptoms, underlying causes, and whether alternative explanations could explain the symptoms. A thorough evaluation often consists of a physical exam to identify underlying medical problems that might be present, a thorough mental, medical, and family history, psychological testing, and in-depth interviews aligned with the diagnostic criteria for PTSD. Following the evaluation, a professional and their patient typically work together to decide a treatment course that is likely to benefit them. 

What is the gold standard treatment for PTSD?

Currently, the gold standard first-line treatments for PTSD are trauma-focused therapies like prolonged exposure therapy (PE), eye movement, desensitization, and restructuring (EMDR),  and cognitive processing therapy (CPT). It is increasingly common for professionals to rely on individual, manualized trauma-focused methods to ensure treatment fidelity and maximize desired outcomes. 

In addition to therapy, certain medications also have a strong evidence base supporting their use as a primary method to treat PTSD. Clinical trials have indicated that two classes of medications, selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), are likely to help reduce symptoms. Medications might also help with sleep problems and lower how often someone might be feeling fear related to their trauma. SSRIs and SNRIs are preferred first-line medications because most people experience relief and tolerate possible side effects well. 

Why is trauma therapy so hard?

Trauma therapy typically involves directly confronting the traumatic experience in a manageable way. Many treatments for trauma symptoms utilize methods that target the extreme emotions or unhelpful beliefs that surround trauma experiences. While most professionals move slowly and let their patients set the pace of therapy, working through trauma can still bring up unpleasant sensations and may make positive emotions harder to access. 

What medication is used for PTSD sleep?

While medications like SSRIs and SNRIs often help PTSD patients improve their sleep quality, they may not be suitable as the main treatment for sleep disturbances due to PTSD, especially if those sleep disturbances are related to increased frequency of nightmares. Another medication, prazosin, is commonly prescribed specifically to manage PTSD sleep disturbances. Prazosin is typically used to treat high blood pressure, but recent research empirical studies have found that it can cross the blood-brain barrier, enabling cognitive effects. Evidence suggests that prazosin is nearly 10 times more effective at reducing PTSD-associated nightmares and improving sleep quality than SSRIs or SNRIs. 

Why is EMDR so controversial?

Eye movement, desensitization, and restructuring (EMDR) is controversial mainly due to the limited research base supporting its utility as an effective psychotherapeutic treatment. EMDR was developed in 1987 by Francine Shapiro, who created the technique after noticing how eye movements decreased her own negative emotions. Many researchers and clinicians felt that EMDR was rushed into practice before it was fully developed and supported by evidence. 

While there are studies that demonstrate EMDR’s positive effects, especially for PTSD, the quality of many studies is low, and there is yet to be sufficient evidence to claim that EMDR can be effectively used to treat another mental health condition. The United States Department of Veterans Affairs has approved EMDR for those who have experienced military combat, and PTSD treated through EMDR will likely resolve at similar or better rates compared to other approved therapies like trauma-informed CBT. 

How do you calm down PTSD?

Reducing the symptoms of PTSD often requires professional treatment. By definition, PTSD symptoms must last longer than a month, fail to resolve on their own, and adversely impact the person experiencing them. Many mental health professionals prioritize coping skills and relaxation strategies that a person with PTSD can use to calm feelings of fear, anxiety, or dread. Some of those techniques include: 

• Deep breathing exercises like diaphragmatic breathing, also known as “belly breathing.” 
• Physical relaxation strategies like progressive muscle relaxation or yoga. 
• Mindfulness meditation or other meditative strategies, like guided imagery. 
• Moderate exercise, like going for a brisk walk or bike ride. 
• Pausing to spend time in nature and greenspaces. 

Is PTSD hard to get rid of?

The difficulty someone experiences when treating PTSD is challenging to predict. Individual factors, like resilience to stress and the presence of a support network, play a significant role in how simple it is to manage symptoms. The nature of the traumatic exposure likely also plays a role. Someone who experienced PTSD following a car accident likely has very different adverse effects to manage compared to someone who experienced PTSD following a sexual assault. 

If a strong avoidance symptom is present, it may make it harder for the person to confront their traumatic experiences in a professional setting, which might slow therapy. Typically, professionals work closely with their patients to balance therapeutic progress against the adverse effects of dealing with the traumatic event. 

Can the brain heal after PTSD?

According to the National Library of Medicine, brain damage following trauma isn’t always permanent, but it can be in some cases. Evidence suggests that permanent changes are most likely to occur when trauma begins early in life and lasts a long time. Chronic trauma induces chronic stress, which can cause physiological changes that interfere with brain function. Notably, the hippocampus and anterior cingulate cortex show reduced size and function.

The hippocampus is required for memory formation, and hippocampal dysfunction is one of the main factors leading to the memory loss commonly seen in PTSD. The anterior cingulate cortex is associated with many cognitive functions, and disruption to it might cause problems with decision-making, emotional regulation, and social cognition. In many cases, treatment leads to improved function in the hippocampus and anterior cingulate cortex, but the damage cannot always be reversed.