PTSD - Post-Traumatic Stress Disorder Treatment

Post-Traumatic Stress Disorder (PTSD) is a mental health condition that develops in people who may have experienced unexpected, shocking, or dangerous events. When understanding PTSD, it is also vital to identify what trauma is and its potential impact on an individual.

Trauma is a psychological response to a distressing and difficult event. Trauma can affect our thoughts, emotional patterns, and behavior. People can experience a range of responses after witnessing a traumatic event. [1]

While some may recover from the initial symptoms, others may continue to experience them even at a later point in their lives. The latter group of people may develop PTSD. As you may imagine, the effects of PTSD can make us feel out of control, and therefore, finding the appropriate treatment for PTSD becomes essential! [2]

What is Trauma?

Anyone can be affected by trauma, regardless of their age, gender, socioeconomic status, ethnicity, or geographical orientation. Trauma often stems from unexpected experiences that impact our identity and functioning. One of the core features of trauma is that it affects our sense of safety. It often makes us feel like we are moving through a dangerous world. 

Common psychological symptoms of trauma include:

• Denial or confusion
• Sadness and grief
• Anger, frustration, and mood swings
• Withdrawal and disconnection

Common physical symptoms of trauma include:

• Digestion problems, including conditions such as Irritable Bowl Syndrome (IBS). [3]
• Difficulties with sleep (flashbacks or nightmares of the traumatic event)
• Unexplained aches and body pain
• Difficulty in attention and concentration

Is trauma always of a physical nature? Not necessarily. Situations that can leave you feeling overwhelmed and unsafe can also lead to trauma.

What was earlier recognized as traumatic experience	What we also recognize as traumatic experience
Physical abuse & sexual abuse Accidents Natural disasters School shootings Witnessing war	Emotional abuse in family Severe neglect Constant yelling and criticism Punishments  Alcohol abuse or excessive substance dependence Losing a loved one

Trauma often lies on a continuum and can differ on the basis of complexity. It can result from a single event, multiple events, or even a set of experiences. It can impact your physical, social, emotional, or even spiritual well-being. It is also important to note that trauma is subjective. It is also based on each individual’s ability to cope and their experience. For instance, if one has a strong support group, a guiding caregiver, and maintains a healthy and active lifestyle, these can be protective factors for the individual. This helps them deal with the after effects of trauma.[4]

What is PTSD?

PTSD is often referred to as the ‘hidden wound’ since the symptoms may not always be noticeable or physical. Additionally, while the symptoms of PTSD can begin within 3 months of the traumatic event, many of us experience them at a later point in time. You may notice that the symptoms don’t go away even after a month and cause significant impairment in your life. 

It is important to consult with a mental health professional to see if you meet the criteria for PTSD. The symptoms often fall into the following categories:

1. Re-experiencing symptoms: These can be flashbacks or nightmares that may come out of nowhere. They may come up when you hear, see, smell, or feel something that reminds you of the trauma. Yes, even our sense organs remember the impact of the trauma. For example, you may experience recurrent nightmares about a particular incident.
2. Symptoms of arousal: Trauma impacts your sense of safety. This means you may end up feeling that you are always in danger, even in the presence of a loved one. As a result, you may be easily startled, feel on guard or on the edge, and may also engage in risky behaviors.
3. Thought and mood symptoms: A lot of individuals have fuzzy memories of their traumatic experience. You may have difficulty remembering key details of your experiences. Additionally, you may lose interest in social activities and prefer isolation.
4. Avoidance symptoms: It is very common to avoid thoughts or feelings associated with a difficult event/s. You may try not to talk about it or avoid going to places that remind you of the trauma. 

Understanding PTSD Treatment

Not everyone who experiences a traumatic event experiences PTSD. However, if your symptoms don’t seem to fade even after months of the event, you may be susceptible to developing PTSD. Working with a professional becomes essential since you can understand PTSD in detail and know its unique impact on you. At Mave Health, we cater to various clients and guide you to find the right fit for your therapeutic journey.

When looking for professional help, you may want to opt for someone who works with a trauma-informed approach. 

This also uses a bottom-up approach vs. a top-down approach to dealing with trauma. The terms ‘top’ and ‘bottom’ are used for different sections of the brain. The top can be seen as the ‘thinking’ brain, whereas the bottom is associated with ‘feeling and responding.’ Bottom-up therapy focuses on understanding your feelings, bodily sensations, and your safety in and outside the sessions.

Trauma-informed therapy often has three major elements:

• Realization of the existence of trauma
• Recognition of the impact of trauma on you and others associated with you
• Responding by putting theory into practice

Before your practitioner starts treatment, they will conduct a detailed assessment of your symptoms. This will help them tailor the therapeutic approach to your needs. Here are some common therapies for PTSD:

1. Eye Movement Desensitization and Processing (EMDR) Therapy

An EMDR therapist does not get into the depths of your traumatic experience or upsetting issues. Rather, they incorporate guided eye movements as you recall parts of the traumatic experience. 

One of the reasons why therapists engage your eye movements is that, as you are recollecting, you feel less overwhelmed. EMDR is especially for those who don’t want to talk about the details of their experience.

2. Somatic Experiencing

Somatic Experiencing is a therapy aimed at helping you cope with feelings of shock, stress, and trauma. It uses gentle exercises and techniques that help you slowly integrate traumatic memories and sensations

3. Prolonged Exposure Therapy

Prolonged exposure addresses avoidance behaviors and helps you explore the traumatic experience. You will be taught various breathing and relaxation techniques along the way. The idea is that you learn to explore your memories gradually while feeling in control.

4. Internal Family System

Internal Family System is based on the idea that our mind can have various sub-parts or personalities. Sometimes, these parts can come in conflict with each other. IFS therapy helps you accept the different parts and heal the ones that are wounded.

How can I advocate for myself when I live with PTSD?

There are a lot of things you can do before you find a therapist who specializes in managing the symptoms of PTSD. You know yourself best and that’s why it becomes important to advocate for your mental health and practice self-care. Here are a few things that you can do when diagnosed with PTSD. 

• Avoid isolation: You can find a support group and try connecting with others who may have similar lived experiences. Try to engage with people you are comfortable with. For example, The MindClan offers support groups and sharing circles for various mental health concerns.
• Create a mental first aid box: Add coping strategies that help you through tough times. You can also keep a record or journal of your symptoms and triggers. Share it with a professional once you start working with them.
• Make lifestyle modifications: Try to maintain a sleep schedule by sleeping and waking up at the same time. Eat small, yet well-balanced meals to keep you energised.

End Note

While there isn’t a ‘best’ treatment for PTSD, there are certain core elements that you can look out for. Ideally, the treatment should make you feel that you have a choice about feeling better. The treatment also makes you feel safe in the therapy room and outside of it. Finally, it offers new perspectives for you to live a better life! Working through trauma can be difficult, but it can slowly heal your internal wounds.

References

1. U.S. Department of Health and Human Services. (n.d.). Post-traumatic stress disorder. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd 
2. Center for Substance Abuse Treatment (US). (1970). Understanding the impact of trauma. Trauma-Informed Care in Behavioral Health Services. https://www.ncbi.nlm.nih.gov/books/NBK207191/ 
3. ​​Ng QX;Soh AYS;Loke W;Venkatanarayanan N;Lim DY;Yeo WS; (n.d.). Systematic review with Meta-analysis: The association between post-traumatic stress disorder and irritable bowel syndrome. Journal of gastroenterology and hepatology. https://pubmed.ncbi.nlm.nih.gov/30144372/ 
4. Herman, J. L. (2015). Trauma and recovery: The aftermath of violence--from domestic abuse to political terror. Hachette uK