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What we treat

Post Traumatic Stress Disorder (PTSD)

Therapy & Medication for PTSD

What is PTSD?

PTSD is a common, sometimes debilitating psychiatric condition that is triggered in some individuals after either experiencing or witnessing a major traumatic event. Many people will have temporary difficulty adjusting, but they frequently get well with time, good support and self-care. According to the National Center for PTSD, experiencing a trauma is not unusual. Six percent of men and 10% of women develop PTSD at some time in their lives.

What causes PTSD?

There are many types of traumas. A direct threat to one’s life; sexual violence; witnessing a death; serious physical injury; and witnessing physical violence to another person are just a few examples. PTSD occurs as a consequence of personal or vicarious exposure to extreme, life threatening stress and/or serious injury or harm. Although these types of extreme stresses are difficult for everyone who experiences them, not everyone develops PTSD after these kinds of stresses.

Risk factors for developing PTSD include but are not limited to:

  • surviving a shocking, frightening or dangerous event that causes you intense or long-lasting distress
  • childhood trauma
  • seeing another person hurt or killed
  • feeling horror, helplessness or extreme fear after a traumatizing event
  • lack of support after the traumatizing event
  • added stress related to the loss of a loved one, pain, injury or job or home loss after the traumatizing event
  • having a history of mental illness or substance abuse
  • risk may be genetic

What are the symptoms of PTSD?

PTSD is characterized by intrusion and reexperiencing the trauma through flashbacks, efforts to avoid trauma – related thoughts, feelings, places or people; persistent negative cognition and mood; and hyperarousal manifested as severe anxiety, panic attacks, sleep problems and irritability. Symptoms commonly begin within 3 months of the traumatic event but can be delayed for years after the trauma.

How is PTSD diagnosed?

Your TMP provider will diagnose your PTSD based on these four characteristic symptom clusters: reexperiencing, avoidance, reactivity and arousal, and cognition and mood symptoms. These symptoms must last more than one month and be so severe as to interfere with relationships and work.

Other common symptoms include:

  • recurrent nightmares and terrorizing, disturbing memories
  • severe emotional distress
  • severe physical responses to trauma-related thoughts and feelings
  • memory problems
  • difficulty concentrating
  • difficulty with intimate and family relationships
  • feeling emotionally numb
  • easily frightened
  • crushing feelings of shame or guilt
  • suicidal ideation
  • sleep disorders affect 70-91% of individuals with PTSD
  • substance abuse

The Covid Pandemic and PTSD

Large scale traumas, such as the COVID pandemic have widespread and pervasive detrimental effects on our mental health. Ongoing exposure to danger, illness, death, disaster, stigma and discrimination can induce acute stress and post-traumatic stress. We respond to traumatic events with fear, distress, and anxiety and these emotions often lead to long term psychiatric conditions such as PTSD, depression, panic attacks, and result in functional and interpersonal difficulties.. During the COVID-19 pandemic, healthcare workers who were exposed to the virus on a regular basis; witnessed high death tolls right before their very eyes; and experienced supply shortages were and are at an increased risk for developing PTSD. Additionally, those who contracted COVID-19 and survived or experienced the death of a loved one, are also at risk for PTSD.

What are the treatments for PTSD?

The primary treatments include psychotherapy and medication. Commonly, the medication is a Selective Serotonin Reuptake Inhibitor (SSRI), similar to what is used to address depression and anxiety disorders. Other medications can treat insomnia, nightmares and anxiety attacks. If your symptoms include suicidal ideation and substance abuse you may need timely treatment directed towards these symptoms.

Existing evidence-based trauma-focused treatment modalities (such as Trauma-Focused Cognitive Behavioral Therapy, for example) can be effective in treating PTSD. It is important to note that single event PTSD is common, however, an individual can be the victim of complex traumatic events associated with war, forcible displacement, childhood sexual abuse and domestic violence which can also cause mental health problems. Studies report that psychological treatments are effective for treating PTSD, anxiety and depression and improving sleep in people with a history of complex traumas.

As mentioned above, individual psychotherapy can be very effective in treating PTSD and there is also great benefit to group therapy. Group therapy allows individuals with similar traumas to validate their experience; learn from others (e.g. what coping strategies have worked for others); help others which often reduces one’s own anxiety; and develop supportive and trusting relationships with fellow group members.

Your therapist, whether in an individual or group setting, can help you learn resilience. Another key component to recovering from a trauma is support from family and friends. Through building effective coping skills, strengthening relationships, and building psychological strength, individuals feel stronger and able to face ones challenges. One of the main outcomes of successful PTSD treatment is to learn to respond effectively to fear.

When you are struggling with overwhelming symptoms of a traumatic event that has lasted for more than one month, contact the experts at The Midtown Practice. We will work with you to design personalized treatments to address your goals and needs.


Resources

  • https://www.ptsd.va.gov/understand/common/common_adults.asp
  • https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml
  • Yuan, K., Gong, Y. M., Liu, L., Sun, Y. K., Tian, S. S., Wang, Y. J., Zhong, Y., Zhang, A. Y., Su, S. Z., Liu, X. X., Zhang, Y. X., Lin, X., Shi, L., Yan, W., Fazel, S., Vitiello, M. V., Bryant, R. A., Zhou, X. Y., Ran, M. S., Bao, Y. P., … Lu, L. (2021). Prevalence of posttraumatic stress disorder after infectious disease pandemics in the twenty-first century, including COVID-19: a meta-analysis and systematic review. Molecular psychiatry, 1–17. Advance online publication. https://doi.org/10.1038/s41380-021-01036-x
  • Belsher, B. E., Beech, E., Evatt, D., Smolenski, D. J., Shea, M. T., Otto, J. L., Rosen, C. S., & Schnurr, P. P. (2019). Present-centered therapy (PCT) for post-traumatic stress disorder (PTSD) in adults. The Cochrane database of systematic reviews, 2019(11), CD012898. https://doi.org/10.1002/14651858.CD012898.pub2
  • Coventry, P. A., Meader, N., Melton, H., Temple, M., Dale, H., Wright, K., Cloitre, M., Karatzias, T., Bisson, J., Roberts, N. P., Brown, J., Barbui, C., Churchill, R., Lovell, K., McMillan, D., & Gilbody, S. (2020). Psychological and pharmacological interventions for posttraumatic stress disorder and comorbid mental health problems following complex traumatic events: Systematic review and component network meta-analysis. PLoS medicine, 17(8), e1003262. https://doi.org/10.1371/journal.pmed.1003262

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