Question: 

Is symptom relief near for patients suffering from chronic post-traumatic stress disorder? 

Answer from Justin Weeks, PhD, clinical psychologist:

From a psychological perspective, traumatic events are generally defined as ones that involve the possibility of death, serious injury or sexual violence. 

Post-traumatic stress disorder, or PTSD, is a psychiatric disorder that involves experiencing a traumatic event, combined with: 

• Re-experiencing the trauma (through flashbacks, nightmares or unwanted memories).
• Attempted avoidance of reminders of the trauma.
• Negative changes in thoughts and mood.
• Increased emotional arousal and reactivity. 

Individuals who develop PTSD most frequently experience traumatic events directly. However, some individuals develop PTSD symptoms due to indirect experiences of trauma, such as witnessing traumatic events occurring to others. 

PTSD is often a chronic problem and can last for years if one does not undergo treatment. Fortunately, effective treatments for PTSD are available.

Exposure therapy

The No. 1 recommended treatment for PTSD involves psychotherapy, or “talk therapy.” The heart of all evidence-based talk therapies for PTSD includes what we call exposure. Exposure therapy involves facing one’s fears in a controlled and systematic way, allowing us to gradually overcome the trauma. 

Overcoming trauma occurs on several levels: 

• We stop re-experiencing the trauma.
• We no longer feel the need to avoid reminders of the trauma.
• We are essentially biologically “reprogrammed” to feel fewer negative emotions in response to reminders of the trauma and are less reactive and “jumpy” overall.
• We have increased positive thoughts and moods. 

The most well-researched of the exposure therapies for PTSD is prolonged exposure, or PE, which has been shown to be very effective. Another well-researched and comparably effective therapy for PTSD is cognitive processing therapy, or CPT. Both therapies can involve weekly sessions over a period of up to several months. 

Research is starting to show that written exposure therapy, a shorter treatment option, may work similarly to PE and CPT. This involves patients writing detailed accounts of their traumatic experiences in a brief series of sessions, allowing them to process the memory without having to speak about it.

Another evidence-based therapy for PTSD is called eye movement and desensitization and reprocessing, or EMDR. Research has shown that the most active and helpful ingredient in EMDR is the exposure element itself.

It is recommended that patients diagnosed with PTSD, or those who believe they may have PTSD, visit a clinic that offers one of the above approaches and request one of these treatments.

Medication for PTSD

Medications can be helpful but are considered a second-line treatment for PTSD. One of the most helpful classes of medications is anti-depressants. If you are interested in this line of treatment, speak to your family doctor or a psychiatric prescriber. But again, medications are typically recommended as a second line of treatment after engaging in one of the above exposure-based therapies. 

Exploring other treatment options

Other treatments for PTSD are being researched. A trial is underway at University of Nebraska Medical Center, the educational partner of Nebraska Medicine, examining whether prescribed cannabidiol, or CBD, may be effective in treating PTSD. However, this approach remains experimental. More information on this trial can be found here.

Again, effective treatments for PTSD do exist. Hopefully, this information will guide you to the treatment that will work best for you.