Post-traumatic stress disorder (PTSD) can be a difficult and challenging condition to deal with. It can last for a few months, multiple years, or for life. PTSD is associated with nightmares, heightened reactions, loss of self-control, and anxiety. If you or a loved one has PTSD, read on to learn what the condition is, what the treatment options are, and how to live with the disorder.
PTSD is a psychiatric disorder that develops in some people who have experienced a highly traumatic experience or shocking and scary event, such as a natural disaster, sexual assault, terrorist attack, war, or other violent situation. Common symptoms include irritability or agitation, severe anxiety, insomnia, vivid flashbacks, nightmares, and emotional detachment. There are a variety of effective treatments that can help with PTSD, including cognitive behavioral therapy (CBT), group therapy, and medications like selective serotonin reuptake inhibitors (SSRIs).
This mental health condition is fairly common in the U.S., with more than three million cases occurring every year. There are many treatments that exist to combat the disorder. And, there are still new treatments that are in the experimental phase that may alleviate symptoms, such as stellate ganglion block (SGB) and MDMA-assisted psychotherapy.
PTSD is caused by a traumatic event or series of traumatic events. Those at risk for PTSD include people who have experienced war, natural disasters, assault, or other triggering events. The most common symptoms that generally lead to a diagnosis include increased irritability, nightmares or insomnia, emotional detachment, and severe anxiety. However, a medical diagnosis is generally required to rule out other diseases and conditions.
You may have PTSD if the symptoms you experience from a tragic event or exposure continue for more than a month and cause problems in your ability to function in day-to-day life. If you’re not sure whether you have PTSD, schedule an appointment with your primary healthcare provider or a mental health professional right away, as he or she can help diagnose the issue and provide further medical advice.
Here’s what you can expect at your appointment:
During your appointment, your healthcare provider may ask the following questions to better inform the diagnosis of PTSD:
If you do have PTSD, it’s important to understand its causes and course of action over the short- and long-term. Here are some of the more important questions to ask your healthcare provider during your appointment:
If you’re experiencing PTSD symptoms, your healthcare provider might refer you to a clinical psychologist, psychiatrist, psychotherapist, or other mental health professional to determine what treatment or treatment programs are best.
After receiving your PTSD diagnosis, you’ll want to know all of your options when it comes to treating the disorder. The most popular treatment options include talk therapy, cognitive processing therapy, prolonged exposure therapy, eye movement desensitization and reprocessing (EMDR), stress inoculation training, and medications.
Talk therapy, also known as psychotherapy, is centered around the idea that talking about issues that are bothering you can help put them in perspective. Cognitive processing therapy and prolonged exposure therapy are two of the more common techniques used to help people recover from post-traumatic stress disorder. EMDR was originally designed to alleviate the distress associated with traumatic memories and stress inoculation training (SIT) is another form of cognitive therapy that is used to treat PTSD.
There’s no cure for PTSD—it’s treated symptomatically. However, you can treat your symptoms and prevent them from getting out of hand with a combination of the treatments listed above and approved medications prescribed by your healthcare provider.
Your healthcare provider may prescribe one or more medications in the following drug classes to help manage PTSD symptoms. Talk to your healthcare provider about which prescription medications are safe for you and remember to always use over-the-counter medicines as directed.
Antidepressants are medications used to treat depression, anxiety, chronic pain, addiction, and other anxiety disorders. Doctors don’t know exactly how they work but they seem to reduce the intensity of one’s feeling so they are not as overwhelming. Some popular brands are Prozac, Lexapro, Zoloft, and Wellbutrin. Antidepressants can improve your mood, enhance sleep, and increase your appetite and concentration. Common side effects include weight gain, dizziness, headaches, and sexual dysfunction.
Antipsychotic medication works by altering certain chemicals in the brain, like dopamine and serotonin. Popular antipsychotics are Abilify, Zyprexa, and Risperdal. These medications are effective in reducing delusions, hallucinations, anxiety, and agitation. Some side effects include stiffness, weight gain, constipation, and drowsiness.
Beta blockers, also known as beta-adrenergic blocking agents, work by blocking the effects of epinephrine (adrenaline) in your body and reducing your blood pressure. They cause your heart to beat more slowly and with less force, lowering your overall blood pressure. Inderal LA, Zebeta, and Tenormin are common brand names. Beta blockers can improve blood flow and reduce your risk of a heart attack, but they’re known to cause dizziness, fatigue, headache, constipation, reduced libido, and erectile dysfunction.
These medications work by increasing the effects of a brain chemical called gamma-aminobutyric acid (GABA) and act as a sedative, slowing down the body’s functions. Xanax, Klonopin, Valium, and Ativan are some of the more popular benzodiazepines. This type of medicine can help people sleep, reduce anxiety, and relax muscles but are highly addictive and should be used sparingly with the utmost caution. These are not intended for long-term use.
Short-term use of benzodiazepines is generally safe and effective. However, long-term use can lead to dependence on the drug and substance abuse. Side effects may include drowsiness, confusion, trembling, vision problems, and feelings of depression and rebound anxiety.
Similar to antidepressants, MAOIs work by affecting changes in the brain chemistry that are thought to play a role in depression. Specifically, MAOIs inhibit the activity of one or both monoamine oxidase enzymes: monoamine oxidase A and monoamine oxidase B. Popular brand names include Marplan, Nardil, and Emsam.
When taking MAOIs, people may experience improved mood and less frequent panic attacks. Some of the most common side effects include dry mouth, nausea, drowsiness, insomnia, and headaches. Use of this medication comes with a host of dietary and medication restrictions that when combined can be fatal. Patients are advised to wear a medic alert tag if they are on this medication.
SSRIs work by increasing serotonin levels in the brain and blocking the reabsorption of serotonin into neurons. Some popular brand names are Zoloft, Paxil, Prozac, Lexapro, and Celexa. Paxil and Zoloft are approved by the Food and Drug Administration (FDA) for PTSD treatment. SSRIs are known to help those with anxiety, obsessive-compulsive disorder (OCD), and PTSD. Some side effects include nausea, insomnia, dizziness, sexual dysfunction including decreased libido, erectile dysfunction, and delayed or inability to orgasm for both men and women.
SNRIs are a class of antidepressants that can treat anxiety disorders, such as PTSD, OCD, and attention deficit hyperactivity disorder. They work by blocking the reabsorption of serotonin and norepinephrine back into the nerve cells that released them—this increases the levels of active neurotransmitters in the brain.
Common brand names include Cymbalta, Fetzima, Ultram, and Strattera. If you take SNRIs to treat PTSD, you may experience improved mood, fewer panic attacks, and fewer feelings of anxiety. Some side effects include excessive sweating, headaches, dry mouth, and hypertension.
The best medication for PTSD depends on patients’ symptoms, medical conditions, medical history, and medications they may already be taking that could interact with PTSD medication as well as response to treatment. Talk to your healthcare provider about which medication is safe for you.
Brand name | Drug class | Administration route | Standard dosage | How it works | Most common side effects |
Zoloft (sertraline hcl) | SSRI/antidepressant | Oral | 50 mg tablet | It increases the levels of serotonin in the brain, helping to regulate and improve one’s mood. | Indigestion, shaking, insomnia, decreased sex drive |
Prozac (fluoxetine HCl) | SSRI/antidepressant | Oral | 20 mg capsule | This medication works by affecting specific chemicals in the brain that may be unbalanced in patients who have OCD, depression, or panic attacks. | Insomnia, headache, upset stomach, dry mouth, decreased sex drive |
Zyprexa (olanzapine) | Antipsychotic | Oral | 5 mg tablet | This drug blocks the receptors in the brain that are affected by dopamine, controlling symptoms of mania. | Weight gain, headache, elevated blood glucose and cholesterol |
Tenormin (atenolol) | Beta blocker | Oral | 50 mg tablet | It works by blocking natural chemicals in your body on the heart and blood vessels. | Dizziness, nausea, slow heart rate |
Xanax (alprazolam) | Benzodiazepine | Oral | 1 mg tablet | Xanax increases the amount of neurotransmitter GABA in the brain to increase calmness. | Trouble concentrating, slurred speech, dizziness |
Marplan (benlysta) | MAOI | Oral | 10 mg tablet | It increases levels of certain chemicals in the brain, treating depression and anxiety. | Chest pain, headache, rapid weight gain |
Cymbalta (duloxetine HCl) | SNRI | Oral | 60 mg capsule (delayed-release) | It works by increasing the levels of serotonin and norepinephrine, which help regulate mood and block pain signals. | Nausea, constipation, fatigue |
Dosage is determined by your healthcare provider based on your medical condition, response to treatment, age, and weight. Other possible side effects exist. This is not a complete list.
Some common side effects of PTSD medication include:
Note: This is not a full list of side effects. Talk to a healthcare professional for a complete list of possible adverse events and drug interactions.
If you have PTSD, there are a few lifestyle changes you can make to help you cope with the disorder and prevent future episodes from recurring. Here are a few changes you can make to help alleviate symptoms:
The course of the illness varies from person to person. Some people may recover from symptoms within six months while others may experience symptoms for years. In order for someone to be diagnosed with PTSD, they must have symptoms for at least a month following the triggering event and last more than six months to meet full PTSD diagnostic criteria.
You can recover from post-traumatic stress disorder, but it won’t happen overnight. Recovery is a gradual, ongoing process that may involve multiple treatments and medications to help manage symptoms. Though there is no cure for PTSD, there are many steps you can take to cope with the residual symptoms you experience.
The most common drugs prescribed for PTSD are SSRIs like sertraline and fluoxetine. In fact, these drugs are the only FDA-approved drugs for PTSD treatment.
Though medications can help manage PTSD symptoms, there are other treatments that can make a difference. Some popular treatment options include talk therapy, cognitive processing therapy, prolonged exposure therapy, virtual reality therapy, eye movement desensitization and reprocessing, and stress inoculation training.
If PTSD goes untreated, those who are affected by the disorder could struggle with alcohol and drug use to find relief. Additionally, sufferers of PTSD can experience severe anger management issues, loneliness, and depression.
Raymond Zakhari, DNP, EdM, NP-BC, is a triple board certified nurse practitioner with a diverse clinical background ranging from Intensive Care to medical house calls. He began his career at Duke University Medical center in the cardiothoracic ICU and made his way back to the northeast as a traveling ICU and ER nurse. In 2009 he founded Metro Medical Direct, the first concierge, nurse practitioner owned, medical/ psychiatric house calls and tele-health practice in New York City. Dr. Zakhari was also trained in sex therapy at the New York University School of Medicine/Langone Medical Center and is appointed to the staff of New York PresbyterianHospital, department of internal medicine in psychiatry at the Payne Whitney Clinic. He provides consultative services as a Sexual Assault Forensic Examiner. He is a former officer of the New Jersey Air National Guard and has deployed in support of Operation Iraqi Freedom. He has held adjunct faculty appointments at the Hunter Bellevue School of Nursing, New York University, and Liberty University. Dr. Zakhari hosts a podcast called The Psychology of it All. Over the years, Dr. Zakhari has published in peer-reviewed journals and has presented at both regional and national conferences. He currently is a member of the American Academy of Nurse Practitioners (AANP), the Society for Sex Therapists and Researchers (SSTAR), and the International Association of Forensic Nurses.
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