Understanding PTSD Therapy: Options and Strategies

PTSD, or post-traumatic stress disorder, is a condition that arises following exposure to a traumatic event or series of events. These experiences are typically perceived as life-threatening or deeply distressing, leaving lasting emotional and psychological scars.

The impact of PTSD extends across multiple aspects of an individual’s life, affecting their mental, physical, social, and sometimes spiritual well-being. Traumatic events that can trigger PTSD encompass a wide range, from natural disasters and accidents to acts of terrorism, combat situations, sexual assault, historical trauma, domestic violence, and bullying.

Symptoms of PTSD can manifest in various forms, including flashbacks, nightmares, intense anxiety, and avoidance of anything reminiscent of the traumatic experience. Understanding the complexity of this disorder is crucial, as it requires support and compassion to facilitate healing and effective coping mechanisms.

In this article, we take a closer look at PTSD, examining its symptoms and available treatment options such as psychotherapy and medication.

Understanding Post-Traumatic Stress Disorder (PTSD)

PTSD can develop following exposure to traumatic events beyond typical stressors, such as violent assaults, disasters, accidents, combat, or other forms of violence [12]. While about half of all U.S. adults encounter at least one traumatic event, most do not develop PTSD. However, for those who do, symptoms can be severe, including persistent thoughts and memories of the trauma, sleep disturbances, emotional numbness, and difficulty functioning in daily life.

According to the National Institute of Mental Health (NIMH), approximately 3.6% of U.S. adults experienced PTSD in the past year, with a higher prevalence among females and adolescents [12]. PTSD can result from a single traumatic event or prolonged exposure to trauma, such as childhood sexual abuse, leading to significant mental and emotional distress [2, 6].

Related: The Difference Between Complex PTSD (CPTSD) and PTSD

Symptoms of PTSD vary but commonly include:

  • Flashbacks and intrusive memories
  • Feelings of detachment or isolation
  • Loss of interest in activities
  • Explosive anger or extreme reactions
  • Persistent feelings of worry, guilt, or sadness
  • Difficulty concentrating and memory problems
  • Physical symptoms like headaches or nausea
  • Negative beliefs and irritability
  • Hypervigilance and avoidance behaviors
  • Persistent anxiety and depression [6, 16].

Anxiety, depression, and substance abuse often co-occur with PTSD, complicating treatment. Diagnosing PTSD usually requires symptoms that last for more than a month and have a significant impact on daily life. It’s important to understand that PTSD can affect anyone, including children [16].

Causes of PTSD

PTSD can stem from a variety of traumatic experiences, spanning traditional events like war, natural disasters, sexual assault, and accidents, to lesser-known factors like workplace bullying and stress [16, 8,-9]. These events induce intense fear and stress, often triggering PTSD symptoms even after the immediate danger has passed [16].

Some of the most widely recognized causes of PTSD include experiencing or witnessing events such as war, natural disasters, sexual assault, physical abuse, or accidents [16]. These incidents provoke significant fear and stress, contributing to the onset of PTSD symptoms [16].

However, not all traumatic experiences involve violence or overt threats. Research indicates that other factors can also contribute to PTSD, such as:

  • Severity of Trauma: The severity of the traumatic event significantly influences the development of PTSD [16]. Whether the trauma occurred as a one-time event or was repeated and the proximity of the individual to the traumatic event all impact the severity of symptoms [16].
  • Relationship to Trauma: The relationship between the individual and the victim or perpetrator of the trauma can affect the likelihood and severity of PTSD [16]. Close proximity or personal involvement intensifies the psychological impact [16].
  • Workplace Bullying and Stress: Workplace bullying often results in lasting psychological harm, including PTSD [8]. Victims endure harassment, which undermines their sense of safety and self-worth, leading to symptoms such as intrusive memories and hypervigilance [8]. Trauma from authority figures can cause emotional devastation and insecurity.

The Effects of PTSD

Workplace trauma resulting from bullying, racism, or blurred boundaries may lead to long-term emotional damage [9], illustrating the impact of toxic environments [9]. Although this trauma may not manifest immediately, it persists and affects careers and interpersonal interactions [9]. Power dynamics and factors like gender and race amplify the trauma, making it difficult for victims to seek help or report issues [9].

Understanding both traditional and lesser-known causes like workplace bullying is vital, as they perpetuate trauma. Victims often experience gaslighting and psychological abuse, exacerbating dissociative symptoms of PTSD. Disbelief can trigger flashbacks and worsen symptoms.

Left untreated, PTSD tends to worsen over time. Proper validation and trauma-informed support are crucial for addressing this complex condition. All individuals with PTSD deserve understanding, compassion, and access to effective treatment tailored to their needs, fostering healing and empowerment on their journey toward recovery.

PTSD Treatments

At Neuro Wellness Spa, our expert psychiatrists and therapists are dedicated to crafting personalized treatment plans that cater to each patient’s unique needs. Reaching out to a mental health professional for support can be the first step toward healing. We offer comprehensive mental health services and PTSD treatments both in-person and online.

Medications

Medications are usually one part of treatment for PTSD. Two main types of psychiatric medications commonly used to treat PTSD are Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs).

  • SSRIs: SSRIs help reduce symptoms by increasing serotonin levels in the brain, which can improve mood and reduce anxiety [7].
  • SNRIs: SNRIs work by increasing levels of both serotonin and norepinephrine [7]. This dual action can help alleviate symptoms such as depression, anxiety, and hyperarousal [7].

The three most commonly used and found to be the most effective in treating PTSD include [17]:

  • Sertraline (Zoloft) – SSRI
  • Paroxetine (Paxil) – SSRI
  • Venlafaxine (Effexor)  – SNRI

Our approach ensures patients receive the most suitable medication based on their specific symptoms and medical history, promoting better outcomes and enhancing overall well-being.

Psychotherapy (Talk Therapy)

There are many different forms of psychotherapy, but there are a few types that are the most effective in treating PTSD, including Cognitive Behavioral Therapy (CBT), Cognitive Processing Therapy (CPT), Exposure Therapy, and Eye Movement Desensitization and Reprocessing (EMDR). Beginning a journey in therapy is like investing in yourself. Through dedication and building a relationship with a therapist, individuals can experience the benefits of therapy and relief from PTSD symptoms. Let’s take a look at they types of therapy used to treat post-traumatic stress disorder.

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is a type of psychotherapy that helps treat PTSD by changing negative thought patterns and behaviors related to the traumatic event.Trauma-focused cognitive behavioral therapy (TF-CBT) is a specialized form of cognitive behavioral therapy (CBT) designed to address post-traumatic stress disorder (PTSD) [4].

Confronting PTSD with Exposure Therapy  

Exposure therapy (ET) or prolonged exposure therapy, is a method used in treating PTSD that involves facing traumatic memories in a safe and controlled environment [15].

Here’s how it works [15]:

  • Confronting Traumatic Memories: In therapy sessions, individuals discuss and confront memories of their traumatic experiences. This can be challenging, but it’s done in a supportive setting with a trained therapist.
  • Repeated Exposure: The therapy involves repeatedly exposing individuals to their traumatic memories. This repetition helps reduce the emotional impact of these memories over time.
  • Gradual Decrease in Emotional Responses: As individuals continue to confront their traumatic memories, they gradually experience a decrease in the emotional distress associated with those memories. This process, called habituation, helps individuals regain control over their emotions.

By facing their fears and processing their traumatic memories, individuals undergoing exposure therapy can experience a reduction in PTSD symptoms and an improvement in their overall well-being [15].

Components of Exposure Therapy

Exposure therapy (ET) operates on a straightforward principle: facing your fears can help you overcome them. Here’s a breakdown [15].:

  • Emotional Processing Theory: This theory suggests that repeated exposure to traumatic memories helps reduce the emotional impact over time. It’s like getting used to something scary by facing it repeatedly.
  • Facing Traumatic Memories: In therapy, individuals discuss and confront memories of the traumatic event. Though it may be difficult initially, each session helps lessen the emotional burden associated with those memories.
  • Gradual Decrease in Emotional Reactions: Emotional reactions to traumatic memories gradually decrease with continued exposure. What once caused intense distress becomes more manageable as individuals become desensitized to the memories.
  • Building Emotional Resilience: Individuals learn to cope with their emotions more effectively by confronting and processing traumatic memories. This builds emotional resilience and helps them regain control over their lives.

So, exposure therapy works by guiding individuals through a process of gradually confronting and processing their traumatic memories, leading to a reduction in emotional distress and an increase in emotional resilience [15].

Cognitive Processing Therapy (CPT)

Cognitive Processing Therapy (CPT) is a type of cognitive behavioral therapy specifically designed to help people with PTSD. It focuses on assisting individuals to understand and challenge maladaptive beliefs about themselves and the world that have developed as a result of trauma [1]. CPT often involves writing about the traumatic event, challenging beliefs associated with the trauma, and learning new ways of thinking [1].

CPT typically consists of 12 weekly sessions and has been found effective in treating PTSD across various populations, including survivors of sexual assault and military veterans [18].

The therapy begins by educating the patient about PTSD and the effects of trauma. The therapist and patient then work together to identify and address “stuck points”—problematic beliefs and thoughts related to the trauma [10]. These might include feelings of blame or changes in how the patient views themselves and the world [10].

Through structured conversations and written exercises, these stuck points are challenged and re-evaluated [10]. Over time, the therapy addresses broader themes such as safety, trust, power, control, self-esteem, and relationships [10]. The final session reviews the progress made, compares initial and current thoughts, and discusses future goals [10].

Research shows that CPT is effective when delivered via telehealth (video calls or phone) [10]. Studies have found that telehealth CPT significantly reduces PTSD symptoms and is comparable to in-person therapy [10]. This makes CPT accessible to more people, especially during times when in-person visits may not be possible, such as during the COVID-19 pandemic [10].

Eye Movement Desensitization and Reprocessing (EMDR)

Eye Movement Desensitization and Reprocessing (EMDR) is an alternative therapy commonly used for the treatment of PTSD [4]. EMDR combines exposure therapy with guided eye movements to help people process traumatic memories and change how they react to them [7].

EMDR utilizes a structured approach to facilitate the processing of traumatic memories and reduce their emotional impact [4].

  • Bilateral Stimulation: A fundamental principle of EMDR involves bilateral stimulation, which stimulates both brain hemispheres to aid in processing traumatic experiences [4]. This stimulation is believed to assist individuals in integrating and reprocessing traumatic memories more effectively [4].
  • Cognitive Restructuring: EMDR incorporates elements of cognitive restructuring, encouraging individuals to challenge and replace negative beliefs about themselves and the traumatic event [4]. By addressing these maladaptive cognitions, EMDR aims to help individuals develop healthier coping mechanisms [4].

Benefits of Treating PTSD with Talk Therapy and Medication

Combining talk therapy with medications offers a comprehensive approach to treating PTSD, addressing both psychological and physiological aspects of the disorder [5].Talk therapy is the primary treatment for PTSD, helping individuals process traumatic events, manage symptoms, and develop coping strategies [5].

Scientific guidelines advise against using medication alone for PTSD [5].Medications can be helpful in specific situations, providing temporary relief from severe symptoms like insomnia or panic attacks and long-term relief from PTSD symptoms [5]. Certain types of antidepressants, such as sertraline and paroxetine, have proven effective in reducing PTSD symptoms [5].These medications can support talk therapy by stabilizing mood and reducing anxiety, enhancing the effectiveness of psychological treatments [5].

Transcranial Magnetic Stimulation (TMS) for PTSD

Transcranial Magnetic Stimulation (TMS) is a noninvasive procedure that utilizes magnetic fields to stimulate specific areas of the brain associated with mood regulation and emotional processing [1]. This technique involves placing a coil against the scalp to deliver brief magnetic pulses to nerve cells in targeted regions of the brain, notably the dorsolateral prefrontal cortex (DLPFC) [3].

How Effective is TMS Therapy?

Research suggests that TMS might help alleviate symptoms associated with PTSD, such as avoidance behaviors, hyper-arousal, and re-experiencing traumatic events [3]. Specifically, studies have shown promising results in reducing anxiety levels in PTSD patients by up to 30% when TMS is applied to specific brain areas [11].

What Does the Research Say?

Moreover, TMS has been explored as a treatment option for PTSD in various studies. One study combined TMS with exposure therapy, a standard treatment for PTSD, and found some improvement in symptoms related to hyperarousal [13]. However, this study also highlighted the need for further research due to its limitations, such as a small sample size and the potential effects of fake TMS treatments.

Further studies, such as those conducted by Boggio et al. and Cohen et al., have shown significant reductions in PTSD symptoms with high-frequency TMS applied to the right DLPFC [3]. These studies also noted improvements lasting up to three months post-treatment and therapeutic effects, including anxiety alleviation.

Side Effects and Benefits

Despite these promising findings, more research is necessary to fully understand the effectiveness and potential side effects of TMS therapy for PTSD [11]. However, TMS therapy has generally been well-tolerated by patients, with commonly reported adverse effects such as headaches and scalp pain being mild and transient [3]. Additionally, some studies have suggested potential benefits beyond symptom reduction, including improvements in cognitive performance and reaction time [3].

Neuro Wellness Spa offers TMS as part of its comprehensive range of therapies, demonstrating our commitment to providing innovative treatments for various mental disorders. We have conducted an impressive 127,108 total TMS sessions (and counting), achieving a remarkable 73% TMS response rate. This substantial experience underscores the effectiveness of TMS as a versatile and impactful treatment option across a spectrum of healthcare needs.

Combining TMS with Psychotherapy for PTSD Treatment

Combining psychotherapy with transcranial magnetic stimulation (TMS) has shown promising results for treating post-traumatic stress disorder (PTSD) [14].

A randomized controlled trial (RCT) that combined TMS with cognitive processing therapy (CPT)—a gold-standard psychotherapy for PTSD—found that the group receiving active TMS before CPT sessions experienced significantly more significant reductions in PTSD symptoms compared to the sham group. This effect was sustained even at the 6-month follow-up [14].

Similarly, in a pilot trial involving eight participants, TMS was combined with prolonged exposure (PE) therapy. While the difference was not statistically significant, there was a trend toward a reduction in PTSD symptoms favoring active TMS, suggesting that combining TMS with therapy holds promise for improving PTSD symptoms [14].

However, it’s essential to note that the methodologies of these studies vary, with different TMS parameters and psychotherapy protocols being used. Some studies utilized brief exposure procedures instead of standardized psychotherapy. Therefore, more research is needed to conclusively determine the effectiveness of combining TMS with therapy for PTSD treatment [14].

Overcoming PTSD

Post-Traumatic Stress Disorder (PTSD) can have a profound impact on individuals. Still, with the appropriate treatment and support, they can work towards managing their symptoms and improving their quality of life. Through a combination of medication, such as SSRIs and SNRIs, and therapy, particularly Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), individuals can develop effective coping mechanisms and reduce the impact of PTSD on their daily lives. With dedication, support, and access to the right resources, those affected by PTSD can progress toward healing and enhancing their overall well-being.

About the Neuro Wellness Spa Therapy Program

At Neuro Wellness Spa, we recognize the profound impact of Post-Traumatic Stress Disorder (PTSD) and the need for personalized treatment strategies. Our therapy program provides a holistic approach, integrating evidence-based techniques to address PTSD symptoms effectively. Led by skilled therapists, our individualized treatment plans aim to empower individuals to navigate the complexities of PTSD and reclaim their sense of well-being. If you’re seeking specialized support on your journey to healing from PTSD or other mental health conditions, reach out to us today to learn more about our talk therapy program!

Interested in other treatment options? We also offer medication management through in-person or online psychiatry and alternative treatments like TMS Therapy.

References

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  2. Bisson, J. I., Cosgrove, S., Lewis, C., & Robert, N. P. (2015). Post-traumatic stress disorder. BMJ (Clinical Research Ed.), 351, h6161. https://doi.org/10.1136/bmj.h6161
  3. Edinoff, A. N., Hegefeld, T. L., Petersen, M., Patterson, J. C., 2nd, Yossi, C., Slizewski, J., Osumi, A., Cornett, E. M., Kaye, A., Kaye, J. S., Javalkar, V., Viswanath, O., Urits, I., & Kaye, A. D. (2022). Transcranial Magnetic Stimulation for Post-traumatic Stress Disorder. Frontiers in Psychiatry, 13, 701348. https://doi.org/10.3389/fpsyt.2022.701348
  4. Hofmann, S. G., Asnaani, A., Vonk, I. J., Sawyer, A. T., & Fang, A. (2012). The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses. Cognitive Therapy and Research, 36(5), 427–440. https://doi.org/10.1007/s10608-012-9476-1
  5. InformedHealth.org. (n.d.). Post-traumatic stress disorder (PTSD): Learn More – Medication for post-traumatic stress disorder. Institute for Quality and Efficiency in Health Care (IQWiG). https://www.ncbi.nlm.nih.gov/books/NBK532841/
  6. Mann, S. K., Marwaha, R., & Torrico, T. J. (2024). Posttraumatic Stress Disorder. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559129/
  7. Martin, A., Naunton, M., Kosari, S., Peterson, G., Thomas, J., & Christenson, J. K. (2021). Treatment Guidelines for PTSD: A Systematic Review. Journal of Clinical Medicine, 10(18), 4175. https://doi.org/10.3390/jcm10184175
  8. Marter, J. (2022, November 9). How to Stop Workplace Bullying. Psychology Today. https://www.psychologytoday.com/us/blog/mental-wealth/202211/how-to-stop-workplace-bullying
  9. McMenamin, L. (2021, April 19). Why long-term workplace trauma is a real phenomenon. BBC. https://www.bbc.com/worklife/article/20210415-why-long-term-workplace-trauma-is-a-real-phenomenon
  10. Moring, J. C., Dondanville, K. A., Fina, B. A., Hassija, C., Chard, K., Monson, C., LoSavio, S. T., Wells, S. Y., Morland, L. A., Kaysen, D., Galovski, T. E., & Resick, P. A. (2020). Cognitive Processing Therapy for Posttraumatic Stress Disorder via Telehealth: Practical Considerations During the COVID-19 Pandemic. Journal of Traumatic Stress, 33(4), 371–379. https://doi.org/10.1002/jts.22544
  11. Namgung, E., Kim, M., & Yoon, S. (2019). Repetitive transcranial magnetic stimulation in trauma-related conditions. Neuropsychiatric Disease and Treatment, 15, 701–712. https://doi.org/10.2147/NDT.S189498
  12. National Institute of Mental Health. (n.d.). Post-Traumatic Stress Disorder. https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd
  13. Osuch, E. A., Benson, B. E., Luckenbaugh, D. A., Geraci, M., Post, R. M., & McCann, U. (2009). Repetitive TMS combined with exposure therapy for PTSD: a preliminary study. Journal of Anxiety Disorders, 23(1), 54–59. https://doi.org/10.1016/j.janxdis.2008.03.015
  14. Petrosino, N. J., Cosmo, C., Berlow, Y. A., Zandvakili, A., van ‘t Wout-Frank, M., & Philip, N. S. (2021). Transcranial magnetic stimulation for post-traumatic stress disorder. Therapeutic Advances in Psychopharmacology, 11, 20451253211049921. https://doi.org/10.1177/20451253211049921
  15. Rauch, S. A., Eftekhari, A., & Ruzek, J. I. (2012). Review of exposure therapy: a gold standard for PTSD treatment. Journal of Rehabilitation Research and Development, 49(5), 679–687. https://doi.org/10.1682/jrrd.2011.08.0152
  16. Substance Abuse and Mental Health Services Administration. (n.d.). Post-Traumatic Stress Disorder (PTSD). https://www.samhsa.gov/mental-health/post-traumatic-stress-disorder
  17. U.S. Department of Veterans Affairs. (n.d.). Medications for PTSD. https://www.ptsd.va.gov/understand_tx/meds_for_ptsd.asp
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