Treating Posttraumatic Stress Disorder (PTSD) with Therapy

Posttraumatic stress disorder (PTSD) is a type of anxiety disorder. It can happen after you go through an extreme trauma, such as a car crash or combat. You constantly relive the trauma through nightmares, intrusive memories, and flashbacks with PTSD. Talk therapy (also called counseling) is a very helpful treatment for PTSD. Therapy with a trained professional helps you face and learn to manage your problem. It may take some time before you notice how much therapy is helping. But stick with it. 

Cognitive behavioral therapy (CBT)

Cognitive behavioral therapy (CBT) teaches you to manage anxiety. It does this by helping you understand how you think and act when you're anxious. Research has shown that this treatment works very well for anxiety disorders. And this includes PTSD. CBT is run almost like a class. It involves homework and skill-building activities that teach you to cope with anxiety step by step. It can be done in a group. Or it can be one-on-one. It often takes place for a set number of sessions. CBT has 2 main parts:

• Cognitive therapy. This helps you identify the negative, irrational thoughts that occur with your anxiety. You'll learn to replace these with more positive, realistic thoughts.

• Behavioral therapy. This helps you change how you react to anxiety. You'll learn coping skills and relaxation methods. These will help you deal with anxiety in a whole new way.

Other forms of therapy

Other therapy methods may work better for you than CBT. Or you may move from CBT to another form of therapy as your treatment progresses. You may meet with a therapist by yourself or in a group. This depends on your needs. Therapy can also help you work through problems in your life that may be making your anxiety disorder worse. This includes drug or alcohol abuse.

Getting better with time

Therapy will help you feel better and teach you new skills. These will help manage anxiety long-term. But change doesn't happen right away. It takes a commitment from you. And treatment only works if you learn to face the causes of your anxiety. So, you might feel worse before you feel better. This can sometimes make it hard to stick with it. Remember: Therapy is a very effective treatment. The results will be worth it.

To learn more

Anxiety and Depression Association of America at www.adaa.org

National Alliance on Mental Illness (NAMI) at www.nami.org

National Institute of Mental Health at www.nimh.nih.gov

What is PTSD?

You may have posttraumatic stress disorder (PTSD) if you’ve been through a traumatic event and are having trouble dealing with it. Such events may include a car crash, rape, domestic violence, military combat, or violent crime. While it is normal to have some anxiety after such an event, it often goes away in time. But with PTSD, the anxiety is more intense and keeps coming back. And the trauma is relived through nightmares, intrusive memories, and flashbacks. These can be vivid memories that seem real. The symptoms of PTSD can cause problems with relationships and make it hard to cope with daily life. But it can be treated. With help, you can feel better.

What causes PTSD?

PTSD may be set off by something that:

• Happened to you
• Happened to someone close to you
• You saw

Examples include:

• Serious accidents, such as car or train wrecks
• Natural disasters, such as floods or earthquakes
• Traumas, such as bombings, a plane crash, a shooting
• Violent personal attacks, such as a mugging, rape, torture, being held captive, or kidnapping
• Military combat
• Abuse in childhood or adulthood

Who is at risk for PTSD?

Anyone can develop PTSD at any age. There are many risk factors for having PTSD. Recognizing and addressing them can help prevent PTSD, when possible. These risk factors include:

• Lack of family or social support resources
• Repeated exposure to traumatic circumstances
• Personal history of trauma or of an acute stress or anxiety disorder
• Family history of mental health disorders
• Personality traits of vulnerability and a lack of resilience
• History of childhood trauma
• Personality disorder or traits including borderline personality disorder, paranoia, dependency, or antisocial tendencies

What are the symptoms of PTSD?

Symptoms of PTSD last more than a month. In adults they may include:

• Unwanted or intense memories of a trauma
• Nightmares
• Vivid memories or flashbacks that make you feel like you’re reliving the event
• Feeling worried, fearful, anxious, or suspicious
• Strong reactions when you’re reminded of the trauma (or sometimes for no obvious reason at all)
• Intrusive thoughts about combat, death, or killing
• Feeling disconnected or isolated, as if you’re not yourself
• Loss of interest in things you once enjoyed
• Feeling agitated, tense, on edge, or easily startled
• Bursts of anger or irritation
• Problems focusing
• Trouble falling or staying asleep

The symptoms of PTSD may look like other mental health conditions. Always see your healthcare provider for a diagnosis.

How is PTSD diagnosed?

Not every person who goes through trauma gets PTSD, or has symptoms at all. PTSD is diagnosed if your symptoms last more than 1 month. Symptoms often begin within 3 months of the trauma. But they can also start months or years later.

How long this illness lasts varies. Some people recover within 6 months. Others have symptoms that last much longer.

How is PTSD treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how bad the condition is. Treatment should begin as soon after diagnosis as possible. The primary goals of treatment are to keep you and others safe, lower your anxiety, and improve your ability to function. Treatment will also help you slowly begin to deal with events that set off your PTSD, and lower your risk for PTSD symptoms happening again.

You may think that asking for help is a sign of weakness. In fact, taking action to make your life better takes a lot of courage. Talking about a trauma can be hard. But it can make a big difference. The main treatment for PTSD is counseling. You’ll work with a trained therapist to learn new ways to cope with your experiences. Medicine may also be prescribed to help with anxiety, depression, or sleep. Most people with PTSD have a combination of counseling and medicine for treatment.

Types of counseling

Counseling is done in a safe environment, either one-on-one or in a group. Group therapy is often done with other people who have been through similar events. PTSD is often treated with one or more of the following forms of counseling. Talk with your healthcare provider about your choices so you can decide on a counseling format that works for you.

• Cognitive processing therapy (CPT). This type of therapy helps you cope with negative thoughts linked to the trauma. You’ll work with a therapist to better understand how you think and feel about what happened. And you’ll learn skills to help you cope with the trauma. CPT won’t make you forget about what happened. But it can make the memories easier to live with.
• Prolonged exposure therapy. This helps you deal with thoughts and situations related to the trauma in new ways. You’ll learn breathing and relaxation methods to calm yourself when you come into contact with triggers. With your therapist’s help, you may go into situations that remind you of the trauma. You’ll learn to reduce your reactions over time. This can help with staying away from thoughts and situations that set you off. You’ll also talk about the trauma to help you gain control over how you think and feel about it.
• Other therapies. Other therapies for PTSD include coping skills training, acceptance and commitment training, eye movement desensitization and reprocessing, family counseling, and PTSD psychoeducation.

Key points about PTSD

• Posttraumatic stress disorder (PTSD) is a mental health condition in which a person has experienced a traumatic event that causes long-term stress.
• PTSD may be set off by a traumatic event that happened to the person or someone close to them. Or it may be something that the person saw.
• PTSD can occur in children and adults.
• The person may have flashbacks, stay away from stressful situations, or withdraw emotionally.
• Diagnosis is made by a healthcare provider when the symptoms last longer than 1 month.
• Treatment involves medicine and therapy to decrease the emotional effects of the disorder and increase coping skills.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your healthcare provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your healthcare provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your healthcare provider if you have questions, especially after office hours or on weekends and holidays.

Understanding Post-Traumatic Stress Disorder (PTSD) in Children

Post-traumatic stress disorder (PTSD) is a series of symptoms that happen after a distressing event. A child may have anxiety, anger, and bad dreams. But PTSD can be treated. Working with a counselor and other healthcare providers will help your child. Recovery may take time. But your child can feel better.

Who is at risk for PTSD?

PTSD may follow a severe trauma. It may be something the child experiences. Or it may be an event the child sees or hears about. Even violent movies or TV shows can cause trauma.

A child is at risk for PTSD after any of these:

• A rape or sexual assault
• A car accident or plane crash
• Physical or mental abuse
• Being a victim or witness of violence, such as riots or wars
• Natural disasters such as earthquakes or floods
• The sudden death of a parent or other loved one

Symptoms of PTSD in children

Symptoms of PTSD often appear a few weeks after the trauma. But sometimes they may occur months or years later. A child with PTSD may have:

• Bad dreams about the event
• Vivid memories of the event that seem real (flashbacks)
• A fear of people or places connected with the event
• Reactions to things that remind them of the event the event (trauma cues) such as sights, sounds, people, smells, and places

And they may:

• Seem withdrawn and unfeeling
• Be nervous
• Have angry outbursts
• Have trouble sleeping or focusing
• Have headaches or other health problems
• Reenact the event over and over in play

Treating PTSD

PTSD in a child can be treated with:

• Trauma-focused cognitive behavioral therapy
• Other types of 1-on-1 or group talk therapy
• Medicines to manage anxiety, insomnia, and depression

It’s also important for a child to be with other children. It can make them feel less alone. And will help them work through their pain.

What you can do

You can play a large part in your child’s healing process. You can:

• Accept your child's emotions. Remind them of your love and support.
• Encourage them to share their feelings with you or a trusted healthcare provider.
• Schedule ongoing mental healthcare for them.
• If PTSD causes problems with schoolwork or friendships, ask school staff for support.