How is PTSD Treated?: PTSD Treatment & Therapy Options

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What is PTSD?

Exposure to or experiencing a terrible event can cause an anxiety disorder known as posttraumatic stress disorder (PTSD). Flashbacks, nightmares, severe anxiety, low self-esteem, and irrational thoughts about the incident are just a few symptoms that may appear.¹

You may repeatedly replay the incident or even forget about it entirely. Even if you weren’t personally engaged in the experience, you might still find it challenging to lead a normal life due to the shock of what happened.²

Most of the time, symptoms appear within three months of the traumatic event. However, they might appear years afterward. To be deemed as PTSD, symptoms must last for more than a month and be severe enough to interfere with relationships or jobs.³

Types of PTSD Treatment

It may seem impossible to regain your life when you have PTSD. However, it is treatable. Both short- and long-term medication and psychotherapy can be quite effective. The two types of treatment frequently work better when combined.

Therapy & Counseling

People with PTSD can benefit from a variety of psychotherapies. Some specifically target PTSD symptoms. Other treatments concentrate on issues with the family, workplace, or society. Depending on the needs of each patient, the doctor or therapist may mix various therapies.

• Cognitive Behavioral Therapy (CBT): CBT targets current issues and symptoms, focuses on the connections between ideas, feelings, and behaviors, and aims to change thoughts, feelings, and behavior patterns that make it difficult to function.⁴
• Cognitive Processing Therapy (CPT): With this treatment, you’ll learn how to alter and refute harmful ideas about the trauma.
• Prolonged Exposure Therapy: Prolonged exposure teaches you how to gradually approach traumatic memories, feelings, and circumstances. By confronting what has been avoided, you will likely discover that the traumatic memories and cues are safe and do not need to be avoided.
• Eye Movement Desensitization and Reprocessing (EMDR): This structured therapy that can last up to 90 minutes urges you to concentrate on the traumatic memory while undergoing bilateral stimulation (usually eye movements or tapping). This is linked to a decrease in the vividness and strong emotion attached to the traumatic memories.
• Group Therapy: Your experiences in dealing with PTSD may be helpful to other group members, just as you can learn from others via their experiences. Your sense of self-worth and confidence in your capacity to manage PTSD symptoms can rise due to being able to assist others.⁵

PTSD Medications

Several different kinds of medications can help reduce PTSD symptoms:⁶

• Antidepressants: Typically, medical professionals will begin with drugs that impact the neurotransmitters serotonin or norepinephrine (SSRIs and SNRIs). These drugs can help with anxiety and depression symptoms. They can also aid in enhancing attention and sleep issues. The Food and Drug Administration (FDA) has granted SSRI approval only for the drugs paroxetine (Paxil) and sertraline (Zoloft).
• Anti-anxiety medications: These medications can treat severe anxiety and its related issues. Since some anti-anxiety drugs have the potential for abuse, they are often only taken temporarily.
• Prazosin: A more recent study found no advantage over a placebo, despite multiple studies suggesting that prazosin (Minipress) may lessen or suppress nightmares in some people with PTSD.

Together, you and your doctor may choose the best drug that will treat your symptoms and situation and have the fewest adverse effects. Inform your doctor of any prescription side effects or issues. Before finding the correct prescription, you might need to try more than one, a combination of medications, or your doctor might need to change the dosage or schedule. Within a few weeks, your mood and other symptoms may improve.

Other Types of Treatment Options

Alternative treatment options, including yoga, meditation, and acupuncture, can relieve some PTSD symptoms. However, it’s always recommended to consult your doctor before opting for alternative treatments.

In addition, the below may also be considered for the treatment of PTSD:

• Transcranial Magnetic Stimulation (TMS):⁷ TMS therapy is a non-invasive procedure that stimulates the cells in a particular brain region by delivering electromagnetic impulses using an electromagnetic coil. Additionally, this therapy regulates the activity of PTSD-related brain cells in other areas of the brain, possibly restoring them to baseline. Bringing your brain’s equilibrium and stability back to normal reduces the symptoms of PTSD.
• Stress Inoculation Training (SIT):⁸ SIT is a type of Cognitive Behavioral Therapy (CBT) that can be done individually or within a group. It equips you to quickly defend against PTSD-related fear and anxiety when exposed to reminders or cues that cause these symptoms.
• Present Centered Therapy (PCT):⁹ This non-trauma-oriented therapy focuses on current problems rather than processing the trauma directly. PCT teaches problem-solving techniques to deal with the stressors in one’s everyday life, as well as psychoeducation regarding the effects of trauma.

PTSD Treatment Costs & Insurance Coverage

According to a recent study published in the Journal of Psychiatry, the national economic impact of PTSD outweighs the expenditures of other prevalent mental health problems like anxiety and depression. The burden extends beyond direct medical costs.¹⁰ 2018 was the most recent year for which data were available at the time of the study, and researchers estimated the cost of PTSD at $232.2 billion.

In contrast to the military population, which accounted for 18% of the total PTSD expenditures, the research team discovered that civilians bore 82% of them. The fact that there are much more civilians than veterans and active-duty military personnel accounts for this imbalance, although PTSD is more common in veterans.

The annual expenses per civilian with PTSD ($18,640) were lower than those in the military population ($25,684), even though civilians accounted for more than three times the total costs of PTSD. The economic impact was driven mainly by unemployment and direct health care expenditures for the civilian population. In contrast, disability and direct health care costs were major contributors for the military community.

As the Affordable Care Act requires, most private health insurance policies must provide coverage for mental health treatment like PTSD therapy. The cost for therapy for PTSD may be partially or entirely covered, depending on your specific type of health insurance, personal policy coverage, and deductible or lifetime limits.

Furthermore, health insurance companies frequently cover the cost of inpatient PTSD therapy programs, especially when co-occurring illnesses like substance abuse are present.

PTSD Treatment Success & Outlook

• In the US, PTSD affects more than 8 million adults.
• A higher rate of PTSD development has been observed in those exposed to mass violence—67%—than in those who have experienced natural disasters or other traumatic occurrences.
• With treatment sessions typically lasting between 12 and 16 weeks, Cognitive Behavioral Therapy (CBT) has repeatedly been demonstrated as the most effective treatment for PTSD, especially in veterans.¹¹
• Once highly controversial, Eye Movement Desensitization and Reprocessing (EMDR) is now accepted and advised as a successful treatment for PTSD in civilian and combat-related situations.
• Although SSRIs have a general response rate of about 60% in PTSD patients, only 20% to 30% of patients experience a full recovery.¹²
• Clinical data suggest that some individuals’ PTSD symptoms may be lessened by cannabis (marijuana) use. According to one study, cannabis use by PTSD patients reduced their symptom levels by an average of 75%.¹³
• According to recommendations, combining therapy and medication may improve outcomes, particularly in patients with more severe PTSD or those who have not benefited from either medication or psychotherapy alone.¹⁴

The typical symptom duration in people undergoing PTSD treatment is about 36 months. The average symptom duration in people not receiving therapy is 64 months.

Over one-third of PTSD patients never fully recover. Rapid treatment initiation, early and persistent social support, prevention of re-traumatization, good premorbid function, and the lack of other mental conditions or substance abuse are all factors associated with a favorable prognosis.

To seek treatment for PTSD, it’s essential to receive an official diagnosis from an experienced therapist or psychiatrist. In addition, it’s ideal to find a therapist with extensive experience treating PTSD or patients who experienced trauma similar to yours.

If you find yourself spending less time recalling the disturbing memory or spending less energy trying to forget it, that’s a good sign that therapy is working. A successful outcome results in complete remission or the ability to function throughout the day without becoming derailed by the symptoms associated with PTSD. For example, you’re no longer frequently worried that you will experience or witness the traumatic event again.

Sources

1. “Post-traumatic Stress Disorder (PTSD) – Symptoms and Causes.” Mayo Clinic, 6 July 2018, www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967.
2. “What Are the Treatments for PTSD?” WebMD, 22 Mar. 2017, www.webmd.com/mental-health/what-are-treatments-for-posttraumatic-stress-disorder.
3. “Post-Traumatic Stress Disorder.” National Institute of Mental Health (NIMH), www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd. Accessed 18 Sept. 2022.
4. “PTSD Treatments.” American Psychological Association, July 2017, www.apa.org/ptsd-guideline/treatments.
5. Tull, Matthew PhD. “The Benefits of PTSD Group Therapy.” Verywell Mind, 23 Jan. 2021, www.verywellmind.com/the-benefits-of-group-therapy-for-ptsd-2797656.
6. “Post-traumatic Stress Disorder (PTSD).” Mayo Clinic, 6 July 2018, www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/diagnosis-treatment/drc-20355973.
7. “TMS Therapy for PTSD | Success TMS Depression Treatment.” Success TMS, 2 Mar. 2020, successtms.com/tms-for-ptsd.
8. Tull, Matthew PhD. “How to Manage PTSD Stress With Stress Inoculation Training.” Verywell Mind, 12 Aug. 2021, www.verywellmind.com/stress-inoculation-training-2797682.
9. “PTSD Facts and Treatment.” Anxiety and Depression Association of America, ADAA. adaa.org/understanding-anxiety/posttraumatic-stress-disorder-ptsd/treatment-facts. Accessed 18 Sept. 2022.
10. Richman, Mike. “Study: Economic Burden of PTSD ‘staggering’: U.S. Civilian, Military Populations Combine for More Than $230 Billion in Annual Costs.” ScienceDaily, 25 Apr. 2022, www.sciencedaily.com/releases/2022/04/220425135929.htm.
11. Reisman, Miriam. “PTSD Treatment for Veterans: What’s Working, What’s New, and What’s Next.” National Institute of Health (NIH), Oct. 2016, www.ncbi.nlm.nih.gov/pmc/articles/PMC5047000.
12. Berger, William et al. “Pharmacologic alternatives to antidepressants in posttraumatic stress disorder: a systematic review.” Progress in neuro-psychopharmacology & biological psychiatry vol. 33,2 (2009): 169-80. doi:10.1016/j.pnpbp.2008.12.004
13. Greer, George R et al. “PTSD symptom reports of patients evaluated for the New Mexico Medical Cannabis Program.” Journal of psychoactive drugs vol. 46,1 (2014): 73-7. doi:10.1080/02791072.2013.873843
14. Forbes, David et al. “A guide to guidelines for the treatment of PTSD and related conditions.” Journal of traumatic stress vol. 23,5 (2010): 537-52. doi:10.1002/jts.20565