Medication for PTSD: What You Need to Know

Post-traumatic stress disorder (PTSD) is a condition that causes emotional and mental distress following a traumatic event or experience.

While PTSD is commonly thought to affect veterans, it can happen in any person who has experienced any level of terror, trauma, abuse, or other triggers.

In this article, I will explain more about PTSD, including symptoms, causes, diagnosis, and treatment options.

It may mention words or suggest ideas that may be triggering for people who are dealing with PTSD, so read with caution.

It is important to know that if you are dealing with symptoms of PTSD in your life, you are not alone and help is available.

While it can feel overwhelming to open up about something that caused trauma in your life, a medical provider will not necessarily make you relay specific details.

Healthcare providers will work with you to make you feel safe and cared for, while finding evidence-based and effective ways to find relief from your symptoms.

If you are experiencing severe PTSD symptoms and need immediate assistance, call the National Suicide Prevention Lifeline at 988, or dial 9-1-1.

What is PTSD?

Post-traumatic stress disorder is a condition that impacts a person’s mental health.

It is caused by an event that leaves a person traumatized.

PTSD can happen in people who experienced or witnessed violent or terrifying events.

It can also happen in people who deal with physical or emotional abuse, live through natural disasters or mass shootings, or who live through other traumatizing events such as sexual assault, vehicle accidents, and robberies.

Some people who go through terrifying events may recover without developing PTSD.

Others may struggle with a high symptom load from PTSD after months or even years.

There is no single way that humans experience, process, or recover from post-traumatic stress disorder.

With treatment, it is possible to find relief and improve quality of life.

Symptoms

Symptoms of PTSD can vary from one person to another.

They typically start within a month after a traumatic event, though sometimes it can take months or even years before they become apparent.

PTSD symptoms may make it hard to function in daily life or to maintain balanced social, work, or personal relationships.

Symptoms of PTSD tend to be grouped into four categories:

• Avoidance: This can include altering behavior to avoid going places or being around people that remind you of the trauma, as well as avoiding any thoughts or discussion of the event.

• Intrusive memories: These can include unwanted memories of the traumatic event, flashbacks, upsetting dreams or nightmares, or emotional or physical distress if something reminds you of the traumatic event.

• Negative thoughts or mood: These can include changes to the way you think about yourself, others, or your surroundings. It can also include feeling hopeless about the future, or feeling distant or detached from family, friends, or other events you used to enjoy. You may also feel numb, have memory problems, or struggle to feel positive emotions.

• Emotional reactivity: You may be more likely to feel startled, frightened, or constantly on guard. You may have trouble sleeping, have problems with concentration, or suffer from poor memory. You may also struggle with feelings of guilt or shame, feel increasingly irritable, or have bursts of anger or aggression. You may also lose caution or feel unable to care about being safe.

Symptoms of PTSD can change over time or can worsen if you are stressed or overwhelmed by other things in life.

You may also feel fine one moment, and then feel like all your symptoms come flooding back if something reminds you or triggers you.

Causes

People of any age can experience PTSD.

Any event that is processed and perceived as traumatic to the person can lead to symptoms of PTSD, whether others would agree or not.

A person experiencing symptoms of PTSD is genuinely feeling them, and is not in control of simply making them go away.

If someone is experiencing symptoms of PTSD, it is important to believe them and validate their experience.

While there can be many causes of PTSD, there are some that tend to be associated with it more frequently, including:

• Combat exposure
• Childhood abuse
• Sexual assault
• Physical attacks
• Being threatened with a weapon
• Being in an accident
• Having anxiety or depression
• Receiving a serious or severe medical diagnosis
• The traumatic death of a loved one
• Natural disasters
• Terror attacks

Researchers and medical professionals are not sure about why some people develop PTSD after traumatic experiences while others do not.

It likely involves many factors, including genetics, other life experiences, the person’s support network, and the specifics of the traumatic event.

Diagnosis

When medical provider’s diagnose PTSD, they may do the following:

• Perform a detailed history and physical exam. They may also order imaging or lab tests to rule out or identify underlying conditions that could be a cause for symptoms.

• Use a psychological evaluation, which may include questions or discussion about your specific experiences.

• Consider the criteria for PTSD that is part of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which includes specific criteria or factors that must be present to receive a diagnosis of post-traumatic stress disorder.

To receive a diagnosis, you may need to see more than one healthcare provider.

Treatment

The most common methods of treatment include psychotherapy and, in many cases, medication.

By combining both treatment methods, you may find more and longer-lasting relief.

There are different approaches to therapy. It is important to find a therapist and a form of therapy that feels safe and accessible for the person who is dealing with PTSD.

Types of therapy for PTSD may include:

• Cognitive Behavioral Therapy (CBT)
• Cognitive Processing Therapy (CPT)
• Eye Movement Desensitization and Reprocessing (EMDR)

Medication for PTSD

In addition to therapy, medications can help alleviate distress or symptoms associated with PTSD.

Medications may help improve quality of life and help someone who has PTSD feel more in control of their thoughts and feelings.

Antidepressants

• Selective serotonin reuptake inhibitors (SSRIs) like sertraline (Zoloft) and paroxetine (Paxil) are approved by the U.S. Food and Drug Administration (FDA) for the treatment of PTSD.

• While not approved by the FDA for PTSD, Serotonin and norepinephrine reuptake inhibitors (SNRIs) like venlafaxine (Effexor) are sometimes used off-label for the treatment of PTSD.

Mood stabilizers

While not approved by the FDA for PTSD, some healthcare providers may prescribe mood stabilizers to treat other aspects of post-traumatic stress disorder symptoms.

For example, an anticonvulsant medication called lamotrigine has been shown to have antidepressant properties in people with PTSD.

Anti-anxiety medications

Beta-blockers are a type of medication that can be used to treat anxiety, and which may also be useful for treating some symptoms relating to PTSD.

They may help decrease the “fight or flight” response that can be common in people who are dealing with symptoms of PTSD.

Alpha-1 blockers

Alpha-1 blockers are a type of medication used for treating high blood pressure.

Prazosin is a type of alpha-1 blocker that may have benefits for PTSD in people whose symptoms include nightmares.

Coping and Support

Experiencing trauma can affect mental, physical, and emotional health in many ways.

Even with therapy and medication, there are other things you can do to support your well-being and improve quality of life:

• Become more informed about PTSD and how it impacts the brain. Some people feel more empowered when they understand that symptoms after trauma are related to complex biological processes that they are not able to control.

• Take care of yourself in basic ways, like eating a balanced diet and staying hydrated. Create a healthy sleep routine. If any of your triggers are associated with aspects of self-care or health, it can be challenging to overcome them, but a supportive care team can help.

• Reduce stress. PTSD symptoms can flare when your nervous system is activated to respond to “fight or flight” types of situations. By avoiding stressful situations whenever possible, you can decrease how often your nervous system must be highly activated.

• Be consistent with your treatment plan. Even if it does not immediately feel like therapy or medication is working, follow through on the plan and keep an open line of communication with your healthcare providers and therapist.

• If you feel comfortable, find a support group or a network of people who also experience what you are going through, either in person or online. Empathy from others who know how you are feeling can foster community and help you have a safe space.

When to See a Doctor

If you have experienced trauma and notice symptoms of PTSD in your life, talk with your healthcare provider.

It can be scary to bring up trauma, or it may even feel like you are not able to talk about it.

If your symptoms are affecting your quality of life, know that there is help and that your healthcare provider will work with you to find safe and effective ways to help you.

If you are too scared at the thought of having to discuss your traumatic experiences or that you will have to relive them, let your healthcare provider know.

You may be able to write down your thoughts instead of having to speak face to face.

Do not let the fear of being triggered prevent you from getting help.

Getting treatment as soon as possible helps stop symptoms from worsening.

If you ever experience thoughts of self-harm or suicidal thoughts, do not wait to reach out for help.

• Call the National Suicide Prevention Lifeline at 988.
• Call 9-1-1 or go to an emergency department.
• Tell a loved one, friend, or spiritual leader.
• Contact your healthcare provider or mental health professional.

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