12Although post-traumatic stress disorder (PTSD) is a debilitating anxiety disorder that may cause significant distress and increased use of health resources, the condition often goes undiagnosed. The emotional and physical symptoms of PTSD occur in three clusters: re-experiencing the trauma, marked avoidance of usual activities, and increased symptoms of arousal. Before a diagnosis of PTSD can be made, the patient's symptoms must significantly disrupt normal activities and last for more than one month. Approximately 80 percent of patients with PTSD have at least one co morbid psychiatric disorder. The most common co morbid disorders include depression, alcohol and drug abuse, and other anxiety disorders. Treatment relies on a multidimensional approach, including supportive patient education, cognitive behavior therapy, and psychopharmacology.

Many of the complications and disabilities associated with prolonged PTSD may be prevented by initiating assessment and treatment quickly after the traumatic event, well before a diagnosis of PTSD can be made.

Patient education and social support are important initial interventions to engage the patient and mitigate the impact of the traumatic event.

Treatment is often best accomplished with a combination of pharmacologic and non-pharmacologic therapies. Medications may be required to control the physiological symptoms, which can enable the patient to tolerate and work through the highly emotional material in psychotherapy. (For adolescents and children, treatment is primarily psychotherapeutic in nature.)

Types of treatment for post-traumatic stress disorder (PTSD)

  • Trauma-focused cognitive-behavioral therapy involves carefully and gradually “exposing” yourself to thoughts, feelings, and situations that remind you of the trauma. Therapy also involves identifying upsetting thoughts about the traumatic event–particularly thoughts that are distorted and irrational—and replacing them with more balanced picture.
  • Family therapy can help your loved ones understand what you’re going through. It can also help everyone in the family communicate better and work through relationship problems caused by PTSD symptoms.
  • Medication is sometimes prescribed to people with PTSD to relieve secondary symptoms of depression or anxiety. While antidepressants may help you feel less sad, worried, or on edge, they do not treat the causes of PTSD.
  • EMDR (Eye Movement Desensitization and Reprocessing) incorporates elements of cognitive-behavioral therapy with eye movements or other forms of rhythmic, left-right stimulation, such as hand taps or sounds. These work by “unfreezing” the brain’s information processing system, which is interrupted in times of extreme stress.

Here are some self help techniques that you can apply to help yourself:
Get Moving: We’ve long known that exercise can make you feel better, both mentally and physically. However, new research suggests that by really focusing on your body and how it feels as you exercise, you can actually help your nervous system become “unstuck” and move out of the immobilization stress response.

Any exercise that engages both your arms and legs—such as walking, running, swimming, or dancing—will work well if, instead of continuing to focus on your thoughts, you focus on how your body feels as you exercise. Try to notice the sensation of your feet hitting the ground, for example, or the rhythm of your breathing, or the feeling of the wind on your skin.

Connect With Others:
No matter how close they are to the person, or how helpful that person tries to be, they just don’t feel any better after talking with them. If that describes you, there are some things you can do to help the process along.

  • Before you’re due to sit down to chat with a friend or loved one, take some time to exercise. As well as calming you when you’re feeling anxious or on edge, physical activity can also open your nervous system’s pathway to social engagement.
  • If exercising isn’t practical, find a quiet place and take a few minutes before you meet your friend to move around, jump up and down, swing your arms and legs—in other words, flail around like you did as a three year old.
  • It may sound weird, but vocal toning is also a great way to open up your nervous system to social engagement—even if you can’t sing or consider yourself tone-deaf. Again, find a quiet place before hooking up with a friend and, with a straight back, your lips together and teeth slightly apart, simply make “mmmm” sounds. Change the pitch and volume until you experience a pleasant vibration in your face.

Challenge your sense of Helplessness:
Trauma can leave you feeling powerless and vulnerable. It’s important to remind yourself that you have strengths and coping skills that can get you through tough times.
One of the best ways to reclaim your sense of power is by helping others: volunteer your time, give blood, reach out to a friend in need, or donate to your favorite charity. Taking positive action directly challenges the sense of helplessness.

Take care of yourself:
The symptoms of PTSD can be hard on your body so it’s important to take care of yourself and develop some healthy lifestyle habits.

  • Take time to relax. Relaxation techniques such as meditation, deep breathing, massage, or yoga can activate the body’s relaxation response and ease symptoms of PTSD.
  • Avoid alcohol and drugs. When you’re struggling with difficult emotions and traumatic memories, you may be tempted to self-medicate with alcohol or drugs. But substance use worsens many symptoms of PTSD, including emotional numbing, social isolation, anger, and depression. It also interferes with treatment and can add to problems at home and in your relationships.
  • Eat a healthy diet. Start your day right with breakfast, and keep your energy up and your mind clear with balanced, nutritious meals throughout the day. Limit processed food, fried food, refined starches, and sugars, which can exacerbate mood swings and energy fluctuations.
  • Get enough sleep. Sleep deprivation exacerbates anger, irritability, and moodiness. Aim for somewhere between 7 to 9 hours of sleep each night. Develop a relaxing bedtime ritual (listen to calming music, watch a funny show, or read something light) and make your bedroom as quiet, dark, and soothing as possible.

Inpatient care is necessary only if the patient becomes suicidal or homicidal or if complicating co morbid conditions requiring inpatient treatment (e.g., depression, substance abuse) are present.

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