Treatments and Therapies

The main treatments for people with post-traumatic stress disorder (PTSD) are medications, psychotherapy (talking therapy) or both. Everyone is different, and PTSD affects people differently, so a treatment that works for one person may not work for another. It is important for anyone with PTSD to be treated by a mental health provider who is experienced with PTSD. Some people with PTSD may need to try different treatments to find what works for their symptoms.

If someone with PTSD is going through an ongoing trauma, such as being in an abusive relationship, both of the problems need to be addressed. Other ongoing problems can include panic disorder, depression, substance abuse and feeling suicidal.

Medications

The most studied type of medication for treating PTSD are antidepressants, which may help control PTSD symptoms such as sadness, worry, anger and feeling numb inside. Other medications may be helpful for treating specific PTSD symptoms, such as sleep problems and nightmares. Doctors and patients can work together to find the best medication or medication combination, as well as the right dose.

Psychotherapy

Psychotherapy (sometimes called talking therapy) involves talking with a mental health professional who has the training and license required to treat a mental illness. Psychotherapy can occur one-on-one or in a group. Talking therapy treatment for PTSD usually lasts 6 to 12 weeks, but it can last longer. Research shows that support from family and friends can be an important part of recovery.

Many types of psychotherapy can help people with PTSD. Some types target the symptoms of PTSD directly. Other therapies focus on social, family or job-related problems. The doctor or therapist may combine different therapies depending on each person’s needs.

Effective psychotherapies tend to emphasise a few key components, including education about symptoms, teaching skills to help identify the triggers of symptoms and skills to manage the symptoms. One helpful form of therapy is called cognitive behavioural therapy (CBT). CBT can include

• Exposure therapy – This helps people face and control their fear. It gradually exposes them to the trauma they experienced in a safe way. It uses imagining, writing or visiting the place where the event happened. The therapist uses these tools to help people with PTSD cope with their feelings.
• Cognitive restructuring – This helps people make sense of the bad memories. Sometimes people remember the event differently than how it happened. They may feel guilt or shame about something that is not their fault. The therapist helps people with PTSD look at what happened in a realistic way.

There are other types of treatment that can help as well. People with PTSD should talk about all treatment options with a therapist. Treatment should equip individuals with the skills to manage their symptoms and help them participate in activities that they enjoyed before developing PTSD.

How Talking Therapies Help People Overcome PTSD

Talking therapies teach people helpful ways to react to the frightening events that trigger their PTSD symptoms. Based on this general goal, different types of therapy may

• Teach about trauma and its effects
• Use relaxation and anger-control skills
• Provide tips for better sleep, diet and exercise habits
• Help people identify and deal with guilt, shame and other feelings about the event
• Focus on changing how people react to their PTSD symptoms (e.g. therapy helps people face reminders of the trauma)

Beyond treatment: How can I help myself?

It may be very hard to take that first step to help yourself. It is important to realise that although it may take some time, with treatment, you can get better. If you are unsure where to go for help, ask your family doctor. An emergency department doctor can also provide temporary help and can tell you where and how to get further help.

Here are some tips to help yourself while in treatment:

• Talk with your doctor about treatment options.
• Engage in mild physical activity or exercise to help reduce stress.
• Set realistic goals for yourself.
• Break up large tasks into small ones, set some priorities and do what you can as you can.
• Try to spend time with other people, and confide in a trusted friend or relative. Tell others about things that may trigger symptoms.
• Expect your symptoms to improve gradually, not immediately.
• Identify and seek out comforting situations, places and people.

Caring for yourself and others is especially important when large numbers of people are exposed to traumatic events (such as natural disasters, accidents and violent acts).