Straight, No Chaser: Post-Traumatic Stress Disorder Diagnosis and Treatment
Memorial Day serves to honor our fallen heroes. Part of that involves caring for our soldiers still with us. Understanding and acknowledging the mental components of their suffering remains a vital and underachieved need. Our soldiers disproportionately suffer from several mental disorders, notably, post-traumatic stress disorder. Straight, No Chaser has reviewed various aspects of post-traumatic stress disorder. Today’s post is a review of diagnosis and treatment, and we will link you to other Straight, No Chaser posts on the topic. We thank all of our veterans for their service.
- For a review of PTSD signs, symptoms and those at risk, click here.
- For a review of PTSD in communities, click here.
- For a review of PTSD in children, click here.
Not every traumatized person develops post-traumatic stress disorder (PTSD). In those that do, symptoms typically begin within three months of the incident but may present years afterward. The severity of symptoms is such that they must last more than a month to be considered PTSD. There is significant variation in outcome in those with PTSD; some recover within six months, and in some the condition becomes chronic.
To be diagnosed with PTSD, a person must have the following symptom complex for at least one month:
- At least one re-experiencing symptom (including flashbacks, scary thoughts or nightmares)
- At least three avoidance symptoms (a pathologic response to stay away from or forget the episode)
- At least two hyperarousal symptoms (a constant state of being on edge, sensitive and prone to overreact)
Additionally, PTSD is often accompanied by depression, substance abuse or other anxiety disorders.
PTSD is typically treated with either psychotherapy (“talk” therapy), medications or both. Mental health professionals will review and discuss all treatment options prior to initiating therapy, because some people will need to try more than one variety to discover what works for their symptoms.
If someone with PTSD is going through ongoing trauma, such as an abusive relationship, both the PTSD and the current problems need to be treated. Other ongoing problems can include panic disorder, depression, substance abuse and suicidal feelings.
The U.S. Food and Drug Administration (FDA) has approved two medications for treating adults with PTSD, sertraline (Zoloft) and paroxetine (Paxil). Both of these medications are also used to treat depression. In PTSD, they help control symptoms such as sadness, worry, anger and the feeling of numbness inside. Taking these medications often makes it easier to go through psychotherapy.
Sometimes people taking these medications have side effects at the beginning of therapy, but they usually go away. Any side effects or unusual reactions should be reported to a doctor immediately. Sometimes the medication dose needs to be reduced or the time of day it is taken needs to be adjusted to help lessen these side effects. The most common side effects of antidepressants like sertraline and paroxetine are the following:
- Nausea (feeling sick to your stomach)
- Sleeplessness or drowsiness
- Agitation (feeling jittery)
- Sexual problems (occurs in both sexes), including reduced sex drive and problems having and enjoying sex
Doctors may also prescribe other types of medications, such as benzodiazepines (commonly used for relaxation and as a sleep aid), antipsychotics and other antidepressants. There is little information on how well these work for people with PTSD.
If you believe you suffer from PTSD, please get evaluated and get the help you need.
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