PTSD is in the news almost daily, with reports of people suffering from it in the aftermath of natural disasters, accidents, trauma, major illness, terrorist acts, or war. Though many people know the acronym “PTSD” and that it stands for “post-traumatic stress syndrome,” there is still much misinformation about this mental health condition—and many people wonder if therapy and treatment work for PTSD.
What PTSD Is and Why Treatment Is Necessary
PTSD is a mental health condition that someone may develop months after experiencing a traumatic event. They commonly have flashbacks, upsetting and intrusive thoughts about what happened, recurring anxiety and distress, and go to great lengths to avoid situations similar to the traumatic event.
Those who have PTSD may suffer from insufficient sleep and other symptoms that interfere with normal functioning. They may find it difficult to sustain employment and experience other life-disrupting symptoms.
Some people with PTSD find that treatment eliminates it or relieves the symptoms. That can mean a step in the direction of getting one’s life back.
Types of PTSD Treatments
There are different approaches to treating PTSD. Much of the research comes from the urgent need to find effective evidence-based PTSD treatment for veterans. Yet the incidence of PTSD is not limited to military members and veterans and has significantly increased in recent years, paving the way to more treatment options.
Different Approaches to Treating PTSD
Many people with PTSD don’t know where to turn or how to figure out which treatment approaches will work best for them Besides PTSD, many may develop or already have another mental health issue to deal with. This includes anxiety, depression, thoughts of self-harm, anger towards others, and drug and alcohol abuse. By accepting and getting help to cope with PTSD, they can also get assistance for those issues.
Among the treatments and treatment approaches for PTSD are therapy, medication, alternative treatments, and evidence-based treatments.
The American Psychological Association (APA) recommends four therapeutic interventions to treat PTSD. These include:
- Cognitive Behavioral Therapy (CBT) — A mainstay of PTSD treatment, CBT targets the symptoms the individual experiences, with a focus on feelings, thoughts, and behaviors. CBT helps the individual change those that interfere with daily life.
- Cognitive Processing Therapy (CPT) — This type of CBT teaches people with PTSD to change and challenge unhelpful and disruptive trauma-related beliefs.
- Cognitive Therapy — A derivative of CBT, cognitive therapy helps the person with PTSD alter or modify their negative (pessimistic) memories and evaluations of their trauma. The goal is to disrupt the upsetting thought patterns and behaviors negatively affecting the person’s life.
- Prolonged Exposure (PE) — A type of CBT, prolonged exposure therapy involves teaching those with PTSD how to slowly approach memories, situations, and feelings related to their trauma. (Virtual reality, a similar PTSD therapy, also allows individuals to confront frightening or disturbing memories, thoughts, or situations, with the goal of reducing their fears and avoidance behaviors and improving their quality of life.)
- Virtual Reality Exposure — Considered a behavioral PTSD treatment, virtual reality exposure therapy targets unhealthy coping behaviors that individuals with PTSD may use when confronted with frightening or disturbing memories, thoughts, or situations. The treatment goal is fear reduction, elimination of avoidance behaviors, and better quality of life.
The National Center for PTSD at the U.S. Department of Veterans Affairs has said the best PTSD treatments for veterans include these trauma-focused therapies: CPT, PE, EMDR, and written exposure therapy. Other talk therapies include stress inoculation training (SIT) and present-centered therapy (PCT).
Certain medications may be prescribed to help individuals with PTSD better manage their symptoms. Not coincidentally, some are the same medications prescribed to treat anxiety and depression symptoms. These include:
- Antidepressants — Selective serotonin reuptake inhibitors (SSRIs), like sertraline and paroxetine, are typically the first medications used in PTSD treatment. They are the only medications approved by the FDA to treat PTSD.
- Anti-Anxiety Medications — Serotonin-norepinephrine reuptake inhibitors (SNRIs) are also used to help treat PTSD and are recommended PTSD treatments for veterans.
- Acupuncture — A holistic alternative treatment, acupuncture may be used to help with PTSD symptoms, providing relief from stress, anxiety, and chronic or acute pain.
- Trauma-Sensitive Yoga (TCTSY), is an evidence-based PTSD treatment rooted in yoga philosophy and trauma theory. It uses hatha yoga elements that have been modified to help participants feel more empowered and nurture a more positive body-self relationship.
The most commonly used and scientifically supported trauma-focused psychotherapies for PTSD include:
- Cognitive Behavioral Therapy (CBT) — CBT is the gold standard in current PTSD treatment, with several specific types derived from it. Each assists in dealing with recurring, upsetting thoughts, feelings, and behaviors and changing them, so they no longer interfere with daily functioning.
- Eye Movement Desensitization and Reprocessing (EMDR) — Most trauma-focused therapies last for several months. If symptoms are still present after that, counseling can help the individual manage them by applying the skills and strategies they learned during the treatment.
Success Rates For Therapy
A comprehensive review studied trauma-focused psychotherapies (TFTs) and SSRI medications and evaluated their effectiveness at treating PTSD. It ultimately concluded that the following interventions are more effective for PTSD:
- Cognitive Behavioral Therapy
- Prolonged Exposure
- Cognitive Processing Therapy
- Cognitive Therapy
- Trauma-Focused Cognitive Behavioral Therapy
In other words, “yes, PTSD treatment works.” Moderate recommendations were given to Dialectical Behavior Therapy, Acceptance and Commitment Therapy, Seeking Safety, and Skills Training in Affect and Interpersonal Regulation. This does not mean those treatments are ineffective, only that there is insufficient evidence for recommending them as a primary treatment.
Success Rates For Pharmacotherapy
Experts agree that trauma-focused psychotherapies are more effective in treating PTSD than medications. Still, drugs can play an important role in helping some people manage symptoms, especially depression and anxiety.
A 2022 review of pharmacotherapy for PTSD found symptom improvement in 58 percent of patients undergoing treatment with SSRIs. The study also found that 65 percent of those treated with mirtazipine, a noradrenergic and specific serotonergic antidepressant (NaSSA) had symptom improvement. Fifty percent of participants treated with amitriptyline, a tricyclic antidepressant (TCA), experienced improved symptoms.
The authors stressed the need for more effective medications to manage PTSD.
Barriers to Treatment
Many individuals who have experienced or witnessed trauma suffer from PTSD for years before it is correctly diagnosed. During that time, their symptoms may worsen, particularly depression and potentially suicidal thoughts. Why don’t they seek treatment? The reasons vary but can include pride, a sense of stigma or shame, not knowing where to go for help, or a lack of support and resources.
These factors and others can create barriers to treatment and lead to tragic outcomes. On the other hand, proper outreach, family, and community support, and a better understanding of the challenges associated with PTSD treatment can make a difference.
Seeking Help For PTSD
Treatments for PTSD can work, and research is constantly unearthing new solutions that go further in relieving symptoms and improving quality of life. For more information about treatment options, schedule an appointment with your primary care doctor. They may provide a referral. You can also contact our confidential helpline any time, day or night. Our counselors are here to answer your questions.