The Large Number of People with PTSD is Almost Overwhelming
PTSD is common so we need good PTSD treatment. It’s so common that it’s really upsetting and heartbreaking. As many as 5% of men and 10% of women in the US will have PTSD at some point during their life. Just as upsetting, PTSD has always been common. In past decades and past centuries we were unable to record how many people had it because it didn’t have a name that everyone used. And, it’s unlikely that life has gotten better for people. We can assume that life was harder in the past than it is now, with more PTSD.
Why Didn’t People Back Then Know About PTSD Treatment and Talk About PTSD?
PTSD, if it was named, had different names at different times and in different places. It wasn’t a topic that came up in everyday life or even in medical settings. Even when a country or war or clinic gave it a medical name for a while, the name would change. Supposedly all of the PTSD back then came from military service and even then people would hide and never speak of it. Any PTSD other than military, and there had to have been a lot of it, was “unknown” to people, out of public awareness. Shell shock, combat stress reaction, war neurosis, soldier’s heart. Terminology came and went with the wars and the times. Civilian PTSD was hidden because the acts that caused it could not be mentioned, especially not in “polite company”. Rape? Never a polite topic.
PTSD that’s Not Military – Civilian PTSD – Damaged People
Many, many people with PTSD are not military. Most of the women who have been threatened or physically attacked and developed PTSD are not soldiers. They’re ordinary, everyday people. Just watch the evening news and it’s obvious that there is no shortage of tragic events in our world and no shortage of evildoers. Or, maybe, decide not to watch the evening news. Every misfortune reported likely involves trauma and a victim.
The Military Is Still a Consistent Producer of PTSD
It’s difficult to find good numbers to compare how common PTSD is in civilian life vs. the military. By and large, people still believe that PTSD is mainly a military problem. It’s clear that many individuals with PTSD are military and, in history, have been military. Just considering soldiers in the US since World War II, there’s the Vietnam war, the battles in Lebanon, the Persian Gulf War, the ongoing conflicts with extremists in Afghanistan, and the continuing struggle to prevent ISIS from overtaking Iraq. We’ve probably missed one or two additional military operations that have occurred. It’s a conflict-driven, battle-raging, war-weary world.
Current PTSD Treatments are Good and Better Treatments are Coming All The Time
There are medicines commonly used with good success and therapy treatments that work for PTSD. Go see a doctor and he/she can treat your PTSD. But having said that, it’s not as though everyone who has PTSD gets well and everything is great. We need medicines and treatment that we can count on for PTSD. The good news is that the hunt for new and better ways, both medicines and therapy, is a hot area of science in the Western world. The search for new medications for PTSD is an active area of medical discovery. The search is also on for new non-medicine therapies for PTDS. People are also avidly interested in learning the best ways to combine medicines and therapies in a “one-two punch”.
There Is Not One PTSD Treatment That Works for Everyone – You Need a Plans for YOU
Every person, civilian or military, with PTSD has his/her own story and his/her own special needs. As a result, every treatment plan must be custom designed for that one specific individual. There is no single best treatment that works for everyone. So, the best hope for success for you is a care plan made with you in mind.
Medicines for PTSD Treatment
The medicines we have now do help. Many times a person with PTSD is so upset, fearful, and angry that thinking about a plan for “therapy” or “psychotherapy” just adds to the frustration and makes things worse. Such a situation might call for trying a medicine first. Taking the medicine that seems like the best choice for a while can help lessen the PTSD symptoms just enough so that maybe therapy will seem okay or might not even be needed. But therapy is a good, effective path to take. Usually the combination of a good medicine and helpful therapy is the most powerful and fastest way to get better.
Medicine Choices for PTSD Treatment
Not every individual with PTSD is depressed. So it surprises people with PTSD when the first medicine suggested to them is a medicine for depression. While these medicines do work to correct the brain changes of depression, they also work to correct the brain changes of PTSD whether you’re depressed or not. The type of medicine often tried first is the SSRIs, selective serotonin reuptake inhibitors. In fact, the SSRIs sertraline (Zoloft) and paroxetine (Paxil) are both approved by the FDA for PTSD. There are other SSRIs to try, like, for example, fluoxetine (Prozac). If a trial of 1 or 2 SSRIs doesn’t help, there are other choices. Some are newer medicines and others are older medicines that have been used for a long time and are known to work and to be safe.
The Nightmares of PTSD
Nightmares are often a part of PTSD, and there are medicines that usually work to decrease these nightmares. Prazocin (Minipress, Vasoflex, Lentopres, Hypovase) seems to be everyone’s favorite medicine to use first for PTSD nightmares.
If the medicines mentioned above don’t seem to work for you, there are other medicines to try that might help and are certainly worth trying. There is, for example, the whole family of “mood stabilizer” medicines, such as lithium, valproate, lamotrigine, or carbamazepine. Another class of medicine, one that was originally developed for psychosis, can have a good effect on PTDS. Quetiapine and aripiprazole are two such medicines. They work best when they are not used by themselves but instead are added to another medicine like an SSRI. A general calming medicine that is sometimes used is clonidine.
New Medicine Ideas for PTSD Treatment
There are new ideas for medicines for PTSD treatment coming down the pike. After several small studies showed that psychedelic drugs might have in treating PTSD the FDA granted one a “Breakthrough Therapy” designation See our page on Psychedelics for PTSD.
There are several types of therapies that can be really helpful. For example, there are education-based therapies, experiential therapies that rely on experiences, psychotherapies or “talk therapies”, occupational therapies that focus on how to do specific tasks, and rehabilitation therapies that work on getting back to some better way to live. Some education-based therapies were designed to teach people what PTSD is all about. Others go further into the why and the how of getting PTSD symptoms to go away.
When You Pick Your Therapist You Pick Your Therapy
Most clinicians who do therapy have their favorite “brand” of therapy that they use on all their clients. Because of this, if you don’t like the approach of one therapist you probably need to find and try a different therapist to get a different therapy. Some people are of the opinion that, for PTSD, therapy is better than medicine. Their opinion is that if you’re getting psychotherapy from a good therapist you don’t need medicine. This is usually not true, and the combination of a good medicine and a helpful therapy is often the best and quickest way to get PTDS to stop.
ClinicalTrials.gov has 230 studies recruiting or to be recruiting for PTSD (as of 3/5/2020).
Post-Traumatic Stress Disorder – National Institutes of Health
PTSD Treatment Programs – U.S. Department of Veterans Affairs
Post-traumatic stress disorder (PTSD) – The Mayo Clinic
Causes of PTSD by Tyler Merchant DO at Elevate Holistics
Treatment for PTSD – Anxiety and Depression Association of America
Posttraumatic Stress Disorder – National Alliance on Mental Illness