What is the most common treatment for ptsd

Post-traumatic Stress Disorder (PTSD)

Understanding PTSD
Symptoms
Treatment & Facts
Resources

• More than 8 million Americans between the age of 18 and older have PTSD.
• 3.6% of the US Adult population experienced post-traumatic stress disorder (PTSD) in the past year.* (National Institute of Mental Health)
• 67 percent of people exposed to mass violence have been shown to develop PTSD, a higher rate than those exposed to natural disasters or other types of traumatic events.
• People who have experienced previous traumatic events run a higher risk of developing PTSD.
• PTSD can also affect children and members of the military: Watch a video about Staff Sgt. Stacy Pearsall, a combat photographer who experienced PTSD. See how she got help.

PTSD brochure.

Screen yourself or a loved one for PTSD.

PTSD Treatment Information

The main treatments for people with PTSD are specific short-term psychotherapies. These treatments are described below. Everyone is different, so a treatment that works for one person may not work for another. Some people may need to try different treatments to find what works best for their symptoms. Regardless of which option you chose, it is important to seek treatment from a mental health professional who is experienced with PTSD.

Psychotherapy

Cognitive Behavior Therapy (CBT):

CBT is a type of psychotherapy that has consistently been found to be the most effective treatment of PTSD both in the short term and the long term. CBT for PTSD is trauma-focused, meaning the trauma event(s) are the center of the treatment. It focuses on identifying, understanding, and changing thinking and behavior patterns. CBT is an active treatment involved the patient to engage in and outside of weekly appointments and learn skills to be applied to their symptoms. The skills learned during therapy sessions are practiced repeatedly and help support symptom improvement. CBT treatments traditionally occur over 12 to 16 weeks.

Main Components of CBT:

While different CBTs have different amounts of both exposure and cognitive interventions, they are the main components of the larger category of CBTs that have been repeatedly found to result in symptom reduction.

• Exposure therapy. This type of intervention helps people face and control their fears by exposing them to the trauma memory they experience in the context of a safe environment. Exposure can use mental imagery, writing, or visits to places or people that remind them of their trauma. Virtual reality (creating a virtual environment to resemble the traumatic event) can also be used to expose the person to the environment that contains the feared situation. Virtual reality, like other exposure techniques can assist in exposures for treatment for PTSD when the technology is available. Regardless of the method of exposure, a person is often gradually exposed to the trauma to help them become less sensitive over time.

• Cognitive Restructuring. This type of intervention helps people make sense of bad memories. Oftentimes people remember their trauma differently than how it happened (e.g., not remembering certain parts of the trauma, remembering it is a disjointed way). It is common for people to feel guilt of shame about aspects of their trauma that were not actually their fault. Cognitive restructuring helps people look at what happened with fact to get a realistic perspective on the trauma.

What is CBT? Listen to this podcast.

It is important for anyone with PTSD to be treated by a mental health care professional who is experienced with PTSD. Some people will need to try different treatments to find what works for their symptoms.

Description of Specific CBTs for PTSD:

• Cognitive Processing Therapy (CPT) is an adaptation of cognitive therapy that aims toward the recognition and reevaluation of trauma-related thinking. The treatment focuses on the way people view themselves, others, and the world after experiencing a traumatic event. Often times inaccurate thinking after a traumatic event “keep you stuck” and thus prevent recovery from trauma. In CPT you look at why the trauma occurred and the impact it has had on your thinking. It can be especially helpful for people who, to some extent, blame themselves for a traumatic event. CPT focuses on learning skills to evaluate whether you thoughts are supported by facts and whether there are more helpful ways to think about your trauma. There is strong research support showing the effectiveness for people recovering from many types of traumas.
• Prolonged Exposure (PE) is another form of CBT that relies more heavily on behavioral therapy techniques to help individuals gradually approach trauma related memories, situations, and emotions. PE focuses on exposures to help people with PTSD stop avoiding trauma reminders. Avoiding these reminders may help in the short term, but in the long term it prevents recovery from PTSD. PE uses imaginal exposures, which involve recounting the details of the trauma experience, as well as in vivo exposures, which involve repeatedly confronting trauma-related situations or people in their life that they have been avoiding. There is strong research support showing PEs effectiveness across a wide range of traumas.
• Stress Inoculation Training (SIT) is another type of CBT that aims to reduce anxiety by teaching coping skills to deal with stress that may accompany PTSD. SIT can be used as a standalone treatment or may be used with another types of CBTs. The main goal is to teach people to react differently to react differently to their symptoms. This is done through teaching different types of coping skills including, but is not limited to, breathing retraining, muscle relaxation, cognitive restructuring, and assertiveness skills.

Other PTSD Treatments:

There are other types of PTSD interventions that are not considered CBTs.

• Eye Movement Desensitization and Reprocessing (EMDR) is a form of psychotherapy that involves processing upsetting trauma-related memories, thoughts and feelings. EMDR asks people to pay attention to either a sound or a back-and-forth movement while thinking about the trauma memory. This treatment has been found to be effective for treating PTSD, but some research has shown that the back-and -forth movement is not the active treatment component but rather the exposure alone is.
• Present Centered Therapy (PCT) is a type of non-trauma focused treatment that centers around current issues rather than directly processing the trauma. PCT provides psychoeducation about the impact of trauma on one’s life as well as teaching problem solving strategies to deal with current life stressors.

Medications:

Medications are sometimes used as an adjunct to one of the therapies described above. One of the more common types of medications used are selective serotonin reuptake inhibitors (SSRIs). SSRIs are antidepressants, and depressed mood can be part of PTSD. Also sometimes used as a short term and adjunctive treatment are benzodiazepines. Benzodiazepines are quick-acting medications that are effective but can be habit forming.

If PTSD is a problem for you or for someone you care about, seek out a consultation with an experienced mental health professional. PTSD is a treatable condition — find out what help there might be for you or your loved one.

ADAA Resources

Meet the ADAA PTSD Special Interest Group and learn about their research and treatment work.

This page was updated June 2021

Diagnosis

To diagnose post-traumatic stress disorder, your doctor will likely:

• Perform a physical exam to check for medical problems that may be causing your symptoms
• Do a psychological evaluation that includes a discussion of your signs and symptoms and the event or events that led up to them
• Use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association

Diagnosis of PTSD requires exposure to an event that involved the actual or possible threat of death, violence or serious injury. Your exposure can happen in one or more of these ways:

• You directly experienced the traumatic event
• You witnessed, in person, the traumatic event occurring to others
• You learned someone close to you experienced or was threatened by the traumatic event
• You are repeatedly exposed to graphic details of traumatic events (for example, if you are a first responder to the scene of traumatic events)

You may have PTSD if the problems you experience after this exposure continue for more than a month and cause significant problems in your ability to function in social and work settings and negatively impact relationships.

Treatment

Post-traumatic stress disorder treatment can help you regain a sense of control over your life. The primary treatment is psychotherapy, but can also include medication. Combining these treatments can help improve your symptoms by:

• Teaching you skills to address your symptoms
• Helping you think better about yourself, others and the world
• Learning ways to cope if any symptoms arise again
• Treating other problems often related to traumatic experiences, such as depression, anxiety, or misuse of alcohol or drugs

You don’t have to try to handle the burden of PTSD on your own.

Psychotherapy

Several types of psychotherapy, also called talk therapy, may be used to treat children and adults with PTSD. Some types of psychotherapy used in PTSD treatment include:

• Cognitive therapy. This type of talk therapy helps you recognize the ways of thinking (cognitive patterns) that are keeping you stuck — for example, negative beliefs about yourself and the risk of traumatic things happening again. For PTSD, cognitive therapy often is used along with exposure therapy.
• Exposure therapy. This behavioral therapy helps you safely face both situations and memories that you find frightening so that you can learn to cope with them effectively. Exposure therapy can be particularly helpful for flashbacks and nightmares. One approach uses virtual reality programs that allow you to re-enter the setting in which you experienced trauma.
• Eye movement desensitization and reprocessing (EMDR). EMDR combines exposure therapy with a series of guided eye movements that help you process traumatic memories and change how you react to them.

Your therapist can help you develop stress management skills to help you better handle stressful situations and cope with stress in your life.

All these approaches can help you gain control of lasting fear after a traumatic event. You and your mental health professional can discuss what type of therapy or combination of therapies may best meet your needs.

You may try individual therapy, group therapy or both. Group therapy can offer a way to connect with others going through similar experiences.

Medications

Several types of medications can help improve symptoms of PTSD:

• Antidepressants. These medications can help symptoms of depression and anxiety. They can also help improve sleep problems and concentration. The selective serotonin reuptake inhibitor (SSRI) medications sertraline (Zoloft) and paroxetine (Paxil) are approved by the Food and Drug Administration (FDA) for PTSD treatment.
• Anti-anxiety medications. These drugs can relieve severe anxiety and related problems. Some anti-anxiety medications have the potential for abuse, so they are generally used only for a short time.
• Prazosin. While several studies indicated that prazosin (Minipress) may reduce or suppress nightmares in some people with PTSD, a more recent study showed no benefit over placebo. But participants in the recent study differed from others in ways that potentially could impact the results. Individuals who are considering prazosin should speak with a doctor to determine whether or not their particular situation might merit a trial of this drug.

You and your doctor can work together to figure out the best medication, with the fewest side effects, for your symptoms and situation. You may see an improvement in your mood and other symptoms within a few weeks.

Tell your doctor about any side effects or problems with medications. You may need to try more than one or a combination of medications, or your doctor may need to adjust your dosage or medication schedule before finding the right fit for you.

Coping and support

If stress and other problems caused by a traumatic event affect your life, see your doctor or mental health professional. You can also take these actions as you continue with treatment for post-traumatic stress disorder:

• Follow your treatment plan. Although it may take a while to feel benefits from therapy or medications, treatment can be effective, and most people do recover. Remind yourself that it takes time. Following your treatment plan and routinely communicating with your mental health professional will help move you forward.
• Learn about PTSD. This knowledge can help you understand what you’re feeling, and then you can develop coping strategies to help you respond effectively.
• Take care of yourself. Get enough rest, eat a healthy diet, exercise and take time to relax. Try to reduce or avoid caffeine and nicotine, which can worsen anxiety.
• Don’t self-medicate. Turning to alcohol or drugs to numb your feelings isn’t healthy, even though it may be a tempting way to cope. It can lead to more problems down the road, interfere with effective treatments and prevent real healing.
• Break the cycle. When you feel anxious, take a brisk walk or jump into a hobby to re-focus.
• Stay connected. Spend time with supportive and caring people — family, friends, faith leaders or others. You don’t have to talk about what happened if you don’t want to. Just sharing time with loved ones can offer healing and comfort.
• Consider a support group. Ask your mental health professional for help finding a support group, or contact veterans’ organizations or your community’s social services system. Or look for local support groups in an online directory.

When someone you love has PTSD

The person you love may seem like a different person than you knew before the trauma — angry and irritable, for example, or withdrawn and depressed. PTSD can significantly strain the emotional and mental health of loved ones and friends.

Hearing about the trauma that led to your loved one’s PTSD may be painful for you and even cause you to relive difficult events. You may find yourself avoiding his or her attempts to talk about the trauma or feeling hopeless that your loved one will get better. At the same time, you may feel guilty that you can’t fix your loved one or hurry up the process of healing.

Remember that you can’t change someone. However, you can:

• Learn about PTSD. This can help you understand what your loved one is going through.
• Recognize that avoidance and withdrawal are part of the disorder. If your loved one resists your help, allow space and let your loved one know that you’re available when he or she is ready to accept your help.
• Offer to attend medical appointments. If your loved one is willing, attending appointments can help you understand and assist with treatment.
• Be willing to listen. Let your loved one know you’re willing to listen, but you understand if he or she doesn’t want to talk. Try not to force your loved one to talk about the trauma until he or she is ready.
• Encourage participation. Plan opportunities for activities with family and friends. Celebrate good events.
• Make your own health a priority. Take care of yourself by eating healthy, being physically active and getting enough rest. Take time alone or with friends, doing activities that help you recharge.
• Seek help if you need it. If you have difficulty coping, talk with your doctor. He or she may refer you to a therapist who can help you work through your stress.
• Stay safe. Plan a safe place for yourself and your children if your loved one becomes violent or abusive.

Preparing for your appointment

If you think you may have post-traumatic stress disorder, make an appointment with your doctor or a mental health professional. Here’s some information to help you prepare for your appointment, and what to expect.

Take a trusted family member or friend along, if possible. Sometimes it can be difficult to remember all the information provided to you.

What you can do

Before your appointment, make a list of:

• Any symptoms you’ve been experiencing, and for how long.
• Key personal information, especially events or experiences — even in your distant past — that have made you feel intense fear, helplessness or horror. It will help your doctor to know if there are memories you can’t directly access without feeling an overwhelming need to push them out of your mind.
• Things you have stopped doing or are avoiding because of your stress.
• Your medical information, including other physical or mental health conditions with which you’ve been diagnosed. Also include any medications or supplements you’re taking, and the dosages.
• Questions to ask so that you can make the most of your appointment.

Some basic questions to ask your doctor or mental health professional may include:

• What do you believe is causing my symptoms?
• Are there any other possible causes?
• How will you determine my diagnosis?
• Is my condition likely temporary or long term?
• What treatments do you recommend for this disorder?
• I have other health problems. How best can I manage these together with PTSD?
• How soon do you expect my symptoms to improve?
• Does PTSD increase my risk of other mental health problems?
• Do you recommend any changes at home, work or school to encourage recovery?
• Would it help my recovery to tell my teachers or co-workers about my diagnosis?
• Are there any printed materials on PTSD that I can have? What websites do you recommend?

Don’t hesitate to ask any other questions during your appointment.

What to expect from your doctor

Your doctor is likely to ask you a number of questions. Be ready to answer them to reserve time to go over any points you want to focus on. Your doctor may ask:

• What symptoms are concerning to you or your loved ones?
• When did you or your loved ones first notice your symptoms?
• Have you ever experienced or witnessed a traumatic event?
• Do you have disturbing thoughts, memories or nightmares of the trauma you experienced?
• Do you avoid certain people, places or situations that remind you of the traumatic experience?
• Have you been having any problems at school, work or in your personal relationships?
• Have you ever thought about harming yourself or others?
• Do you drink alcohol or use recreational drugs? How often?
• Have you been treated for other psychiatric symptoms or mental illness in the past? If yes, what type of therapy was most helpful?