Post-traumatic stress disorder (PTSD) is an anxiety disorder that is brought on by memories of an extremely stressful event or series of events that cause intense fear, particularly if feelings of helplessness accompanied the fear. That event may be war, physical or sexual assault or abuse, an accident (such as an airplane crash or a serious motor vehicle accident), or a mass disaster. You can develop PTSD if the event happened to you, or even if you witnessed it. It is normal to feel stress when you experience a traumatic event. PTSD persists long after the event and is characterized by the intensity of the feelings, how long they last, how you react to these feelings, and the presence of particular symptoms. More than 5 million adults in the United States are affected by PTSD each year.
Symptoms of PTSD usually develop within the first 3 months after the event, but they may not surface until months or even years after the original traumatic event. Symptoms may include:
Experts are not entirely sure what causes some people to develop PTSD, but many think it happens when you are confronted with a traumatic event, and your mind is not able to process all the thoughts and feelings as it usually does. Scientists studying the brain think there may be some differences in the brain structure or chemistry of those with PTSD. For example, certain areas of the brain involved with feeling fear may be hyperactive in people with PTSD. Other researchers have focused on the hippocampus, the area of the brain responsible for memory and for how we deal with stress, and are investigating whether changes in that area also appear in people with PTSD.
How severe the traumatic event was and how long it lasted affect whether you are likely to develop PTSD. These factors also increase the risk:
There are no laboratory tests to detect PTSD. In fact, PTSD is not diagnosed until at least 1 month has passed since the trauma. Your doctor will ask about your symptoms and ask you to describe the traumatic event. Your doctor will likely also use psychological assessment tools to confirm the diagnosis. Your doctor may refer you to a specialist (such as a psychologist or psychiatrist) for evaluation and treatment.
Early intervention immediately after a traumatic event, through support groups, psychotherapy, and certain medications, may help prevent PTSD. Rituals, such as prayer or healing ceremonies, may be helpful in relieving stress and other effects of the trauma.
The treatment for PTSD includes:
Conventional psychotherapy, such as CBT, is the main treatment for PTSD. However, with instruction by licensed professionals, several mind-body techniques may be used as supportive treatments:
Although no studies have examined how nutrition can be used to treat PTSD, these general nutritional guidelines may be helpful:
You may address nutritional deficiencies with the following supplements:
Herbs are generally available as standardized dried extracts (pills, capsules, or tablets), teas, or tinctures/liquid extracts (alcohol extraction, unless otherwise noted). Mix liquid extracts with favorite beverage. Dose for teas is 1 to 2 heaping tsp/cup water steeped for 10 to 15 minutes (roots need longer). Herbs should be used only under the guidance of your physician and you should keep all of your doctors and therapists informed about any herbal or CAM therapies you are using. Some herbal remedies can interfere with medications.
The following herbal remedies may provide relief from symptoms:
Few studies have examined the effectiveness of specific homeopathic remedies. Professional homeopaths, however, may recommend one or more of the following treatments for PTSD based on their knowledge and clinical experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type, includes your physical, emotional, and intellectual makeup. When being treated with homeopathic remedies, it is possible to experience a brief intensification of symptoms before your condition improves. In the case of PTSD, it is important to have a qualified support team in place to help you handle any worsening of symptoms. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual.
Acupuncture may help with symptoms of PTSD, including insomnia, anxiety, and depression. In one case involving a Vietnam War veteran, acupuncture and relaxation with guided imagery reportedly reduced insomnia, nightmares, and panic attacks over a treatment period of 12 weeks. One study for anxiety (not PTSD-related) found that benefits lasted as long as 1 year after treatment. Acupuncturists treat people based on an individualized assessment of the excesses and deficiencies of qi located in various meridians in the body.
If PTSD symptoms continue for longer than 3 months, the condition is considered to be chronic (ongoing). Chronic PTSD may become less severe even if it is not treated, or it may become severely disabling, interfering with many areas of life and causing physical complaints. Some research suggests that PTSD may be related to physical disorders, such as arthritis, but few studies have examined the relationship between PTSD and physical health.
Almli LM, Fani N, Smith AK, Ressler KJ. Genetic approaches to understanding post-traumatic stress disorder. Int J Neuropsychopharmacol. 2014;17(2):355-70.
Auerbach. Wilderness Medicine. 6th ed. St. Louis, MO: Elsevier Mosby; 2011.
Beers MH, Porter RS, et al. The Merck Manual of Diagnosis and Therapy. 18th ed. Whitehouse Station, NJ: Merck Research Laboratories; 2006:1678.
Brady K, Pearlstein T, Asnis GM, et al. Efficacy and safety of sertraline treatment of posttraumatic stress disorder: a randomized controlled trial. JAMA. 2000;283(14):1837-1844.
Bryant RA. Acute stress disorder as a predictor of posttraumatic stress disorder: a systemic review. J Clin Psychiatry. 2011;72(2):233-9.
Bryant RA, Moulds ML, Nixon RD, Mastrodomenico J, Felmingham K, Hopwood S. Hypnotherapy and cognitive behaviour therapy of acute stress disorder: a 3-year follow-up. Behav Res Ther. 2006 Sep;44(9):1331-5.
Cardena E. Hypnosis in the treatment of trauma: a promising, but not fully supported, efficacious intervention. Int J Clin Exp Hypn. 2000;48(2):225-238.
Cohen J, Bukstein O, Walter H, et al. Practice Parameter for the Assessment and Treatment of Children and Adolescents with Posttraumatic Stress Disorder. J of the Amer Acad of Child and Adoles Psychiatry. 2010;49(4).
Dunleavy K, Kubo Slowik A. Emergence of delayed posttraumatic stress disorder symptoms related to sexual trauma: patient centered and trauma-cognizant management by physical therapists. Phys Ther. 2012;92(2):339-51.
Ferri: Ferri's Clinical Advisor 2015. Philadelphia, PA: Elsevier Mosby; 2014.
Forneris CA, Gartlehner G, Brownley KA, et al. Interventions to prevent post-traumatic stress disorder: a systemic review. Am J Prev Med. 2013;44(6):635-50.
Gros DF, Simms LJ, Acierno R. Specifity of posttraumatic stress disorder symptoms: an investigation of comorbidity between posttraumatic stress disorder symptoms and depression in treatement-seeking veterans. J Nerv Ment Dis. 2010;198(12):885-90.
Lipinska M, Timol R, Kaminer D, Thomas KG. Disrupted rapid eye movement sleep predicts poor declarative memory performance in post-traumatic stress disorder. J Sleep Res. 2014;23(3):309-17.
Qureshi SU, Pyne JM, Magruder KM, Schulz PE, Kunik ME. The link between post-traumatic stress disorder and physical comorbidities: a systematic review. Psychiatr Q. 2009;80(2):87-97.
Raboni MR, Tufik S, Suchecki D. Treatment of PTSD by eye movement desensitization reprocessing (EMDR) improves sleep quality, quality of life, and perception of stress. Ann N Y Acad Sci. 2006 Jul;1071:508-13.
Raphael KG, Widom CS. Post-traumatic stress disorder moderates the relation between documented childhood victimization and pain 30 years later. Pain. 2011;152(1):163-9.
Rosenthal JF, Erickson JC. Post-traumatic stress disorder in U.S. soldiers with post-traumatic headache. Headache. 2013;53(10): 1564-72.
Seidler GH, Wagner FE. Comparing the efficacy of EMDR and trauma-focused cognitive-behavioral therapy in the treatment of PTSD: a meta-analytic study. Psychol Med. 2006 Nov;36(11):1515-22.
Stapleton JA, Taylor S, Asmundson GJ. Effects of three PTSD treatments on anger and guilt: exposure therapy, eye movement desensitization and reprocessing, and relaxation training. J Trauma Stress. 2006 Feb;19(1):19-28.
Sullivan GM, Neria Y. Pharmacotherapy in post-traumatic stress disorder: evidence from randomized controlled trials. Curr Opin Investig Drugs. 2009;10(1):35-45.
Tarrier N, Humphreys L. Subjective improvement in PTSD patients with treatment by imaginal exposure or cognitive therapy: session by session changes. Br J Clin Psychol. 2000;39(pt 1):27-34.
Utzon-Frank N, Breinegaard N, Bertelsen M, et al. Occurrence of delayed-onset post-traumatic stress disorder: a systemic review and meta-analysis of prospective studies. Scand J Wrok Environ Health. 2014;40(3):215-29.
Wessely S, Rose S, Bisson J. Brief psychological interventions ("debriefing") for trauma-related symptoms and the prevention of post traumatic stress disorder. Cochrane Database Syst Rev 2000. No. 2:CD000560.
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
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