Treating PTSD

In a previous post I described the basics of the diagnosis of Post Traumatic Stress Disorder (PTSD).  Now a little about treatment. 

I have found PTSD to be one of the disorders that responds best to treatment.  In the last 20 years (not a long time in the history of mental disorders) there has been a huge increase in the understanding of the problem and the ways of effectively treating it.  The International Society of Traumatic Stress Studies and The International Society for the Study of Trauma and Dissociation have supported much research and training and continue to do wonderful work.  The therapists that I work with have all participated in training from these organizations and I look forward to attending as many of their events as possible. 

We now expect the return of a large number of military veterans from the wars in Iraq and Afghanistan in addition to the people in other occupations who have experienced terrible events.  Some of these people will have problems with PTSD.   In recent news reports, I have heard that there are not yet enough therapists trained to treat these people.  Recent Congressional testimony has addressed this ongoing problem in regard to the resources of the Veterans Affairs organization. 

If you know of someone who might have PTSD (or might be one), it would be a good idea to get it checked out.  There are resources out there, the internet has lots of links and pages for interested people. While some medications can be helpful in the treatment of PTSD, psychotherapy is the primary method of treatment.  Taking a pill won’t make it go away.  When selecting a therapist, ask if they have any specialized training and are aware of the recommended treatments of PTSD (the Standard of Care).  As always, be an informed consumer. 

Bill Bonacker

What is PTSD?

PTSD is the abbreviation for Post Traumatic Stress Disorder, a condition defined officially in the diagnostic manual of the American Psychiatric Association.  PTSD is also increasingly in the news and in popular publications associated with the controversy about whether the diagnosis should be given to some members of the Military Services.  There is some uncertainty and confusion about what it really is and I hope I can add some basic clarity.

Psychologist John Read has said “bad things happen to people and it screws them up” – the basic concept behind PTSD.    The official diagnosis is, of course, more complicated (about 6 pages in my copy of the diagnostic manual) and specifies what “bad things” (trauma) and what kinds of problems qualify.  It is also important to remember that not everybody who goes through a terrible experience has serious problems. 

When people who experience traumatic events do have serious problems they come in particular types.  As I wrote in previous posts, people can experience an increase in the amount of time that their minds and bodies spend “on red alert”, prepared for more trouble.  This kind of problem can be a high level of anxiety or tension, being “jumpy” (we call this an exaggerated startle response), being unable to relax or sleep well, poor concentration and others.

An additional kind of problem that people with PTSD experience is an unwanted remembering of the trauma which can include dreaming about it, feeling like it is happening again and being upset when they run into situations where they are reminded of the trauma. 

The third type of problems involve trying to avoid reminders of the trauma.  We usually see people avoiding people, places or activities that remind them of the traumatic experience, a decrease in feelings (called numbing) drug/alcohol use and other ways of avoiding. 

Bill Bonacker