June is PTSD Awareness Month and June 27th is PTSD Awareness Day.
Post-traumatic Stress Disorder, or PTSD, is an anxiety problem that develops in some people after extremely traumatic events, such as military combat, crime, or an accident or natural disaster. PTSD affects about 8 million people in the United States, according to the U.S. Veterans Administration (VA). Also, according to the VA, effective PTSD treatments are available.
Military veterans, civilian survivors of sexual assault, survivors of serious accidents, survivors of natural disasters, or survivors of other traumatic events make up the people who suffer from PTSD.
NAMI Toledo asked Thomas Fine, NAMI Toledo board member and Associate Professor in the Psychiatry Department at the University of Toledo, a few questions. Professor Fine has worked on a PTSD research project and teaches PTSD to 1st and 3rd year medical students at the University of Toledo.
- What was the PTSD research project you worked on, what did you research? Have there been any results from that research project to note?
I was a part of a research project that involved members of the Ohio National Guard. The project began in 2008 and ended in 2020. I was initially involved in some of the aspects of the design of the study and also conducted detailed in person interviews with selected participants each year for 4 years. After year 4 we ended the in-person interviews but continued with phone interviews for the remainder of the study. There have been numerous papers published from the study covering a variety of topics. Some of the most notable examined suicide and substance use, primarily alcohol, among Guard members who were exposed to combat. We also looked at the prevalence of PTSD and the course of the symptoms over the years. The project was funded through the Department of Defense.
- What are common PTSD symptoms or problems people experience?
The most common symptoms people with PTSD experience are repeated, unwanted thoughts about the trauma, or things related to the trauma. Sometimes these thoughts are triggered, sometimes they just happen. People can also have strong emotions or strong physical reactions (racing heart, sweating) triggered by things that represent the trauma, like a box on the road that reminds someone of a roadside bomb. Some people have very strong experiences where they feel that they are actually in the traumatic event again, this is usually called a flashback. Nightmares are also a common symptom. Along with the memory symptoms there are also avoidance symptoms. People with PTSD attempt to avoid thinking about the trauma, or being in situations that remind them of the trauma. People will also use alcohol or drugs to avoid thinking about the trauma. Another group of symptoms are very similar to depression. People with PTSD have overly negative thoughts, guilt, and strong negative emotions associated with the trauma. Finally, PTSD involves increased irritability, difficulty with sleeping, and sometimes a heightened startle reaction. The symptoms can vary in number and severity. About 50 percent of people who develop PTSD from a traumatic experience get better within 6 months, often without treatment.
- The big thing for the VA for PTSD awareness month is that there are PTSD treatment options that work available. Can you elaborate on and complement that?
There are both medication and psychotherapy options for PTSD, with the strongest evidence from treatment studies showing therapies having a more powerful effect than medication. Most psychotherapy options include a process that is called exposure, which involves repeatedly thinking about, or talking about the trauma in a therapeutic setting. Prolonged Exposure therapy, Cognitive Processing therapy, and Trauma-focused Cognitive Behavioral Therapy all use some form of exposure. The therapeutic setting, and the training of the therapist are important for the exposure to have a good therapeutic effect. EMDR (Eye Movement Desensitization and Reprocessing) involves the client attending to emotionally disturbing material in brief sequential doses while simultaneously focusing on an external stimulus. This therapy has also been found to be effective. It is important to interview a therapist about what approaches they use, and what training they may have in the therapeutic technique. The medications that are usually utilized for PTSD are Zoloft, Prozac, Lexapro, Celexa and Paxil. There are other medications, like Prazosin, that are used for nightmares.
- Anything else you want to tell NAMI Toledo about PTSD or treatment options.
While many people recover from traumatic events over time, it’s important for anyone that is continuing to have symptoms to get an evaluation from a mental health professional. Unfortunately, the avoidance symptoms that are part of PTSD, can lead us to avoid treatment, because we want to avoid talking about it, because it triggers emotional pain. This keeps the cycle of symptoms going and leads to suffering and difficulty functioning. PTSD does respond to treatment; people feel better and function better after treatment, and stop avoiding. So, pay attention to your avoidance, it’s a signal to do something different.
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PTSD Treatment
According to the VA, Trauma-focused Psychotherapies are the most highly recommended type of treatment for PTSD. “Trauma-focused” means that the treatment focuses on the memory of the traumatic event or its meaning, as Professor Fine stated in the above interview. These treatments use different techniques to help you process your traumatic experience. Some involve visualizing, talking, or thinking about the traumatic memory. Others focus on changing unhelpful beliefs about the trauma. They usually last about 8-16 sessions.
Antidepressant medications or other psychotherapies that do not focus on trauma are also recommended for PTSD.
The VA offers this website, PTSD: Treatment Decision Aid, to help people suffering from PTSD to review and make decisions about treatment types. https://www.ptsd.va.gov/apps/decisionaid/
More Valuable PTSD Links
June is Post-traumatic Stress Disorder Awareness Month on Youth.Gov – links to more PTSD and mental health resources.
Veterans Crisis Line. If you are a military veteran and are struggling or in crisis or are someone who is concerned about a veteran in crisis, you can talk to someone at the Veterans Crisis Line. https://www.veteranscrisisline.net/
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