PTSD Therapy

Post-traumatic stress disorder (PTSD) can occur when you have experienced or witnessed a traumatic event or have had prolonged exposure to trauma in any aspect of your life. In these cases, working with a therapist to develop coping strategies and a treatment plan to improve symptoms may be helpful. 

PTSD

Post-traumatic stress disorder statistics

• Societies pay approximately $42.3 billion in healthcare costs. That figure encompasses psychiatric and non-psychiatric medical treatment costs, as well as medical treatment premiums, indirect workplace costs, death-related costs, and prescription medication costs.
• About 50% of treatment costs for post traumatic stress disorder are related to repeated use of healthcare services due to undiagnosed PTSD.
• Clients with PTSD have some of the highest rates of healthcare service usage.
• The greatest cost to society pertains to medical costs, doctor visits, and hospital visits for anxiety disorders and PTSD which costs about $23 billion every year.

Furthermore, the American Psychological Association (APA) reports that about half of all individuals who are receiving treatments for addiction or substance use problems also live with post-traumatic stress disorder. This factor complicates treatment for many and increases the cost of treatment. 

Risk factors: Understanding the impacts of a traumatic event or traumatic stress

Survivors of violent acts or a traumatic event

Anyone who has been a survivor of a violent act or who has witnessed a violent act is at risk of getting PTSD. People who have been repeatedly exposed to life-threatening situations and have trauma-related memories are also at risk of acquiring post-traumatic stress disorder. Survivors may have experienced traumatic events such as physical violence, rape, sexual assault or abuse, domestic violence, mugging, school shootings, and physical or verbal abuse. However, there are many types of violent acts or traumatic events, and people react differently to trauma depending on life circumstances, temperament, personality, resources available for support, and other factors. 

Survivors of catastrophic events

Major catastrophic events can occur unexpectedly in everyday life. Car accidents and car fires, plane crashes and terrorist strikes, and industrial accidents place all survivors at risk of post-traumatic stress disorder. In addition, natural disasters such as tornadoes, earthquakes, forest fires, and flooding cause commotion and loss of life or property, which can lead to post-traumatic stress disorder. If you have experienced any of these occurrences and have been affected by them, you may benefit from PTSD trauma-focused counseling and medications. However, discuss medication with your doctor before trying this option, and do not stop taking medication for PTSD without consulting your prescribing provider. 

The BetterHelp platform is not intended to provide any information regarding which drugs, medication, or medical treatment may be appropriate for you. The content provides generalized information that is not specific to one individual. You should not take any action (including starting, stopping, or changing medications) without consulting a qualified medical professional.

Combat veterans and civilian survivors of war

The US Department of Veterans Affairs (VA) has found that between 10% and 31% of veterans return from war with PTSD, depending on which war they served in. A new study published by Clinical Psychological Science reports that soldiers who enlist in the armed forces before the age of 25 are seven times more likely to get PTSD. If you want to find out more information about this issue, refer to the VA National Center for PTSD website.

First responders

First responders, such as police officers, firefighters, paramedics, 911 dispatchers, and EMTs, are all at risk of getting job-related PTSD. For firefighters, there is a 20% higher risk of developing PTSD, according to an International Association of Firefighters (IAFF) study.

Death and illness

PTSD also affects many people who have been given a diagnosis of a life-threatening illness and those who are undergoing invasive or lengthy medical treatments or procedures. The unexpected sudden death of close friends or family is also the type of traumatic event that can cause someone to be affected by post-traumatic stress disorder.

Symptoms of PTSD

People often have a general idea of PTSD, especially related to veterans. While only an adequately licensed clinician can give someone a correct diagnosis of PTSD, the following information may help you understand how clinicians arrive at a diagnosis of post-traumatic stress disorder. Clinicians begin with three categories, or "clusters," of PTSD symptoms. The clusters include the following. 

Reliving the event

Symptoms include recurring nightmares or intrusive images that occur at any time of night or day. Extreme emotional or physical reactions can accompany these symptoms, including chills, heart palpitations, or a sense of uncontrollable panic. According to the Diagnostic and Statistical Manual of Mental Disorders, one or more of these symptoms must be present.

Avoiding reminders of the event

People with PTSD may avoid people, places, thoughts, and activities that remind them of the trauma. Avoiding thoughts and feelings can cause you to feel guilty or emotionally detached, lose interest in previously enjoyed activities, focus on unhelpful beliefs, and lose interest in daily activities. According to the Diagnostic and Statistical Manual of Mental Disorders, three or more of these symptoms must be present.

Hyperarousal or being “on guard” 

Symptoms in this cluster include becoming hyper-aroused, hypervigilant, constantly on guard with anger and irritation, difficulty getting enough rest, other sleep problems, trouble concentrating, and alertness or an easy startle reflex. Two or more of these symptoms must be present.

PTSD treatment and diagnosis

When listing the number of symptoms in each cluster, a diagnosis of PTSD is indicated when the correct number of symptoms in each category has lasted for more than a month. Also, these symptoms cause severe obstructions at home, at work, or in the throes of daily life. Other symptoms that may not be clear until a clinician has made a diagnosis of PTSD are low self-esteem, a sense of being disconnected from their lives, or having relationship problems. These issues by themselves may also be indicative of some other mental health disorder. When combined with the clustered symptoms, they become added symptoms of PTSD. 

Accessing treatment for post-traumatic stress disorder and overlap with other mental health disorders

Mental health can be a complicated field because many symptoms overlap. Other psychological symptoms that may be related to PTSD are depression, anxiety, and panic disorder. Physical disorders also commonly accompany a diagnosis of PTSD. Individuals living with PTSD may complain of chronic pain, fatigue, stomach aches, respiratory ailments, headaches, muscle pain, low backaches, or heart problems. These symptoms could call for additional medications during your treatment. 

Many people living with PTSD lack proper specialized treatments or other options to alleviate their pain and discomfort, help them manage stress, or reduce mental health issues. This barrier can cause people living with undiagnosed post-traumatic stress disorder to engage in self-destructive behavior such as alcohol or substance use or experience suicidal tendencies in attempts at self-treatments and self-soothing.

Of the nearly 70% of adults who have experienced a traumatic event during their lifetime, only 20% develop PTSD. Among those who do go on to develop post-traumatic stress disorder, the symptoms often surface within the first few weeks after the trauma. In rarer cases, individuals may experience symptoms months or years later, which can be part of delayed-onset PTSD.

Hospitals like the Cleveland Clinic and the Mayo Clinic offer evidence-based therapies and treatments that can help someone living with post-traumatic stress disorder get a proper diagnosis and relief from symptoms. Some of these treatments can be completed in short-term therapy lasting weeks or months, while other treatments may involve longer stays in mental health facilities. With early intervention and continuous treatment, many people living with post-traumatic stress disorder can experience significant improvements in their quality of life and manage their symptoms effectively.

Addiction and PTSD: Impacts on mental health

Stress increases the levels of a neurotransmitter called GABA (gamma-aminobutyric acid), which can cause a natural tranquilizing effect within the brain. Certain substances and alcohol can also stimulate GABA, which puts people in a happier state of mind. People who live with PTSD often turn to substance use as a means of dealing with symptoms associated with their traumatic event. When this happens, the body works against itself as the brain views a substance as treatment.

After prolonged substance use, the neurotransmitters are not as easily affected, and the brain asks for more, which creates the cycle of addiction. As the effects of these substances diminish, the effects of PTSD worsen, leading people to struggle with their mental health. Most clinicians favor treatments for addiction and post-traumatic stress disorder simultaneously. Individual or group therapy may be helpful. 

Common PTSD treatment options 

PTSD treatments are evidence-based for managing PTSD symptoms. Psychotherapy, such as cognitive-behavioral therapy, which focuses on reframing negative beliefs and eye-movement desensitizing response (EMDR), is the most common treatment option for PTSD, and a few others work well, too, such as medications. People with PTSD may also be able to have a PTSD service dog to cope with symptoms. If you or a loved one finds yourself in a crisis, a PTSD hotline is also an available resource. 

Can PTSD group therapy help? Group therapy with a support group can provide many benefits, such as developing social skills and finding your voice. However, one-on-one therapy with mental health professionals can also be an effective choice since not everyone is comfortable with group therapy.

Cognitive-behavioral therapy and cognitive processing therapy

Cognitive-behavioral therapy is an effective combination of talk and behavioral therapy where clinicians teach clients how to reframe negative thinking patterns into positive thoughts. Cognitive processing therapy for PTSD is a similar modality focused more on trauma processing. CPT is a trauma-focused treatment designed to aid you in changing the way you think about the trauma you have experienced.

Present-centered therapy is another type of cognitive behavioral therapy or so-called talk therapy that may be helpful in the treatment of PTSD. This type of therapy centers each unique client to tailor the approach to their needs. 

EMDR therapy 

Eye-movement desensitizing response (EMDR), also known as eye movement desensitization and reprocessing (EMDR), is a type of trauma therapy where repetitive back-and-forth movements of the eye that mirror REM sleep work in tandem with a clinician, who guides the client to transform harmful thoughts into thoughts that improve confidence and control over symptoms. This rapid eye movement therapy is also a trauma-focused or trauma-informed therapy, where the client is asked to focus on the memory instead of avoiding it. 

Prolonged exposure therapy 

Prolonged exposure therapy (PET) is a therapy that helps the brains of individuals living with PTSD to disassociate the connection between trauma triggers (sights, sounds, smells, tastes, feelings) and the traumatic event. This prolonged exposure therapy may be a way for a client to gain control over their trauma and symptoms and develop a new understanding of their experiences.

Stress inoculation training 

Stress inoculation training is a type of therapy in which the therapist uses exercises to help clients learn to recognize their triggers and then employ coping skills to manage the feelings that surface. This treatment focuses on helping individuals grow their skills to handle stress and other challenges. 

Medication 

Certain medications may also be prescribed for PTSD treatment, based on the symptoms and severity of symptoms that an individual experiences, following a clinician's guide. A physical exam or blood test may be required to ensure that there are no underlying health issues before starting medication treatment. 

Several different medications are used for PTSD and co-occurring conditions, such as monoamine oxidase inhibitors (MAOIs) and second-generation antipsychotics. Antidepressants are commonly prescribed, but each person is different. The best medication option often depends on the client, as possible side effects and effectiveness may vary. 

Some types of mental illness can evolve with time. If you respond effectively to a combination of medication and therapy, your needs may change as you progress. Continue seeking treatment and remain in communication with your mental health providers to ensure that you are getting the best care possible. There is no one-size-fits-all solution for PTSD, so it may take some trial and error to find what works best for you. In addition, do not stop, change, or start a medication without consulting your doctor. 

Alternative PTSD therapy options 

Finding a therapist for PTSD can be difficult for some. If you are under a doctor's care, you can ask for a referral to a psychologist. Veterans can find therapists and many other helpful support and services through their local Veterans Affairs association. Local mental health clinics may also be helpful. However, if you face barriers to in-person therapy, you can also try an online therapy platform like BetterHelp. 

With an online platform, you can be matched with a therapist specializing in PTSD treatment, like CBT or eye movement desensitization and reprocessing (EMDR), in as little as 48 hours. You can meet with them from the comfort of your home on a flexible schedule and message them anytime to track your symptoms in real time and get between-session advice. Online therapy is also more affordable than in-person therapy, which makes it more available to more people.

Research supports the success of online therapy for PTSD-related symptoms and improved connection to resources. If you are concerned you are managing PTSD, do not hesitate to reach out for help from a licensed therapist. 

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