What is Post-Traumatic Stress Disorder?

Post-traumatic stress disorder, or PTSD, is a condition that people often develop after experiencing a traumatic event, such as a natural disaster, the death of a loved one, a domestic violence incident, sexual or physical assault, or the unexpected death of a loved one. PTSD often causes people to have long-lasting thoughts and memories of the event, which causes them to experience emotional issues. 

PTSD is characterized by re-experiencing the trauma, emotional numbing, avoidance behaviors and persistent hyperarousal.  These can all lead to considerable social, occupational and interpersonal dysfunction.  PTSD is commonly accompanied by depression, substance use disorders and recurrent medical symptoms. 

The onset of PTSD typically occurs within a few months of the traumatic event.  Diagnosis can be challenging because it can be presented very differently depending on the patient.  These patients have experienced trauma and are unable to cope with the consequences of the trauma which greatly effects their well-being.  Common traumas include military combat, violent personal assault, natural and man-made disasters, severe motor vehicle accidents, rape, incest, sexual abuse, diagnosis of a life-threatening illness or severe personal injury.  Diagnosis is made after a comprehensive psychiatric assessment which includes very specific questions to differentiate PTSD from other psychiatric disorders.  Diagnosis is made after symptoms persist for at least 4 weeks, but most patients wait many months or years.

Treatment

Sadly, PTSD is a costly psychiatric condition affecting US veterans. In conjunction with other therapies, physicians use a variety of medications to help manage symptoms. Unfortunately there is still a gap that remains in their effectiveness.

Currently serotonin reuptake-inhibiting (SRI) antidepressants are the only FDA-approved drugs for the treatment of PTSD.  Statistically, 89% of PTSD-diagnosed veterans are treated with both therapy and SRI’s.  Other drugs used to treat PTSD are:

1. Selective serotonin reuptake inhibitors (SSRI’s) such as Zoloft and Paxil

2. Other antidepressants

3. Atypical antipsychotics such as risperidone, which are not approved by the FDA for treatment of PTSD

4. Mood stabilizers

Studies have shown that these drugs often don’t work well for people who have had multiple traumas or suffer from chronic PTSD.  PTSD is the most common and most costly disorder seen by VA psychiatry services, affecting 7-8 million Americans. 10-20% of those who experience heavy combat develop lasting symptoms of PTSD.  As current drugs fall short, physicians have turned to other medications or treatments to add to existing antidepressant therapies.  Some of these alternative therapies include:

• • • Exposure therapy
    • Cognitive therapy
    • Cognitive behavioral therapy
    • Coping skills training
    • Individual and group therapy