Post Traumatic Stress Disorder
Post Traumatic Stress Disorder or PTSD is a trauma and stressor-related disorder that is caused by experiencing or witnessing a traumatic event. Some traumatic experiences that may lead to PTSD include military service, natural disasters, accidents, and experiencing or witnessing violence. However, many possible causes of trauma could lead to a PTSD diagnosis.
The most common PTSD symptoms are intrusion symptoms (like nightmares or flashbacks), avoidance, negative impact on thoughts and mood, and changes in arousal and reactivity (like a heightened startle reaction or difficulty concentrating). While most people who experience a trauma in their life will recover without the need for treatment, for some people these symptoms may persist for months or even years after the trauma.
PTSD Facts:
According to the US Department of Veterans Affairs:
- About 7 or 8 out of every 100 people (or 7-8% of the population) will have PTSD at some point in their lives.
- About 8 million adults have PTSD during a given year. This is only a small portion of those who have experienced trauma.
- About 10 of every 100 women (or 10%) develop PTSD sometime in their lives compared with about 4 of every 100 men (or 4%).
Something important that they also point out is that PTSD is not a sign of weakness. While there are some things (like a previous mental health diagnosis) that make you more likely to develop PTSD, most people are equally likely to develop it if they are exposed to trauma.
Diagnosing PTSD:
To be diagnosed with PTSD several criteria must be present, according to the Diagnostic and Statistical Manual:
- Criterion A: Experience a stressor or trauma
- Criterion B: Intrusive Memories or Thoughts
- Criterion C: Avoidance
- Criterion D: Changes in mood and behavior
- Criterion E: Changes in physical and emotional reactions
- Criterion F: Symptom duration of more than one month
- Criterion G: Symptoms create distress or functional impairment
- Criterion H: Symptoms are not due to medication, substance use, or other illness.
If any of these symptoms sound like something you or a loved one are dealing with it is probably time to find help to treat your PTSD.
Treating PTSD:
Because combat veterans are at a significantly higher risk for developing PTSD, the US Government has identified 5 evidence-based treatments for PTSD which include: Prolonged Exposure (PE), Eye Movement Desensitization and Reprocessing (EMDR), Cognitive Processing Therapy (CPT), Cognitive Behavioral Therapy (CBT), and Stress Inoculation Therapy (SIT).
Prolonged Exposure
What is prolonged exposure?
Prolonged exposure is a type of cognitive-behavioral therapy that teaches individuals to approach trauma-related memories, feelings, and situations in a safe environment, bypassing tendencies toward avoidance.
Most people avoid those people, places, and things that remind them of the trauma they experienced. The problem is that doing this only reinforces the fear. PE encourages the individual to face what they have been avoiding, which helps decrease symptoms of PTSD by seeing that the memories and emotions caused by the trauma are not dangerous.
Essentially this treatment takes the emotional charge out of the memories and allows you to experience life without being controlled by PTSD symptoms.
What are the main components? How does it work?
Prolonged exposure is provided over 3-4 months of individual therapy sessions. Initial sessions will help the provider understand your background and personal history, and gather some information about the trauma you experienced.
Once a rapport has been established they will explain in detail what to expect during treatment. Over the next 8-15 sessions, you will walk through the details of the trauma in the present tense and face the emotions that are associated with the trauma.
While this may be anxiety-provoking initially this very effective treatment quickly helps you realize that the emotion and fear you associate with the trauma can be controlled.
There are two main components of PE – Imaginal Exposure and In-vivo Exposure. Imaginal exposure is when the patient describes the event in detail in the present tense with support and guidance from their therapist. Throughout this portion, they will process the emotions that are experienced.
In-vivo Exposure can be thought of as a homework assignment for the patient. They will be asked, between sessions, to confront feared stimuli outside of therapy.
This might be visiting places that create stress or experiencing things that induce an emotional response. While the patient is asked to challenge their comfort zone, this is done in a very gradual and cautious manner.
Does Prolonged Exposure Work?
Many research studies nationwide have shown Prolonged Exposure Therapy to be highly effective in treating PTSD. In fact, according to the US Department of Veterans Affairs, “Based on the large number of studies showing its effectiveness, PE has the strongest recommendation as a treatment for PTSD in every clinical practice guideline.”
In a 2014 study on the use of prolonged exposure therapy to help patients with post-traumatic stress disorder, researchers found that several randomized trials indicate that PE is effective in reducing PTSD symptoms. It has also been shown to effectively treat both acute and chronic PTSD. They also note that gains made during treatment are maintained at follow-ups between 1–5 years, showing effectiveness long term.
Eye Movement Desensitization and Reprocessing
Living here in Colorado, you might have heard friends, family, or colleagues talk about EMDR. It is a very popular treatment here. EMDR is an individual therapy delivered once or twice weekly for a total of 6-12 sessions. During an EMDR session, the client and therapist work through carefully chosen memories, negative beliefs, and difficult emotions while stimulating your visual field.
EMDR is based on the hypothesis that recalling upsetting events from your past is less emotionally triggering when your attention is diverted. What this means is that you can be exposed to the memories you may have been avoiding. Throughout treatment, EMDR can help decrease the impact of the trauma.
EMDR vs. Prolonged Exposure
Which treatment is best for an individual varies depending on a variety of details. According to research, when compared to a control group, both PE and EMDR are more effective in decreasing the symptoms of PTSD. They also found that participants in the PE condition (but not those in the EMDR condition) were more likely to gain full remission than those in the WL condition. This means that when studied side by side, PE has a slight edge over EMDR treatments, however, both are effective treatment protocols.
Getting the Right Treatment for Your PTSD
If you or someone you love is living with PTSD, there is no need to continue suffering. Peak Psychological Services offers the supportive services you need to get the right treatment for your diagnosis. If you are looking for PTSD treatment in Aurora we offer both Prolonged Exposure and EMDR depending upon your diagnosis and preference.
Sources:
American Psychological Association: Prolonged Exposure
Do You Need To Talk About It? Prolonged Exposure for the Treatment of Chronic PTSD
Mayo Clinic: Post Traumatic Stress Disorder
Prolonged Exposure vs Eye Movement Desensitization and Reprocessing vs Waiting List for Posttraumatic Stress Disorder in Patients With a Psychotic Disorder
US Department of Veterans Affairs National Center for PTSD