Posted by: jedwardswright | May 3, 2011

When the Past Hurts: Posttraumatic Stress Disorder Part 2

While PTSD may follow a devastating event or series of events in the life of an individual, this mental health condition does not exempt the sufferer from other problems. PTSD may aggravate pre-existing health issues, or trigger other medical illnesses that person is prone to develop.

Co-morbidity

When more than one health problems co-exist, it is said that they are “co-morbid.” Certain medical issues are more likely to be co-morbid with PTSD. These include:

  • Alcoholism or other substance abuse
  • Anxiety Disorder
  • Panic Disorder
  • Major Depressive Disorder (MDD)
  • Auto-immune diseases including Rheumatoid Arthritis, thyroid disease, or lupus
  • Gastrointestinal complaints
  • Musculoskeletal conditions including fibromyalgia
  • Cardiovascular disease
  • Learning disabilities
  • Phobias including social phobia
  • Bipolar Disorder
  • Obsessive Compulsive Disorder (OCD)
  • Eating disorders including: overeating, anorexia, bulimia

Further treatment may be required if you are diagnosed with PTSD and also have symptoms of another condition, so be sure to inform your doctor of any new or additional symptoms. Don’t just assume that it must be caused by Posttraumatic Stress Disorder. Be safe and check.

Treatment Options

While you will probably start out by describing your symptoms with your family doctor, if PSTD is suspected, it would be best to consult with a psychiatrist. Don’t be alarmed by this possibility: a psychiatrist is simply a doctor with a specialty in mental health conditions in the same way that a cardiologist has specialized training in dealing with the cardiovascular system. If you had a heart attack you would certainly expect to be evaluated by a specialist, and the same principle applies here.

1.       Medication

While many people are reluctant to consider taking medication for PTSD, because there is an actual physical/biochemical change that has occurred as a result of trauma, willpower and positive thinking are unlikely to be enough on their own. The physical aspects of the illness need to be treated.  Other treatments are likely to be more effective if the appropriate medication for the patient is in place. Medication for PTSD is usually prescribed for at least a year.

Prescription medications that your doctor may consider to treat PTSD include:

Antidepressants may be used to treat symptoms of depression and anxiety, improve concentration, or help with insomnia.  Aggressive or impulsive behavior, and most importantly, suicidal thoughts, are often reduced or eliminated in people taking antidepressants. A selective serotonin reuptake inhibitor (SSRI) like Zoloft, Prozac or Paxil would be a logical choice.

Anti-anxiety medications (tranquilizers) such as Klonopin or Xanax are sometimes prescribed to relieve severe periods of extreme anxiety or panic attacks, but are not recommended for long-term use as they can be habit-forming and have been associated with overdoses. Patients with a history of substance abuse should not take this type of prescription medication, and caution is advised when considering this option.

Antipsychotics are usually prescribed for short-term treatment of severe anxiety, emotional outbursts, paranoia, disassociation or persistent insomnia.  Brief breaks with reality may also be treated with an antipsychotic medication. Risperdal, Zyprexa and Seroquel are common combined antipsychotics and mood stabilizers and these may be used along with SSRIs.

Mood stabilizers like Lamictal, Gabitral or Depakote are also sometimes taken for PTSD.

Another medication which has been shown to have considerable benefit for PTSD patients may reduce or repress nightmares is called Minipress.  It blocks the brains response to norepinephrine, a chemical that is similar to adrenaline. This medication has a history of use for hypertension, so although its use for PTSD is newer, the drug itself has a known track record in the treatment of another condition.

(Note: Medications have been referred to here by their American brand names. Look up the generic names of these drugs and access further information about them here.)

2.       Psychotherapy

Also known as counseling, “talk therapy” or simply “therapy,” psychotherapy concentrates on helping people with PTSD cope with the original trauma or traumas that they have experienced.  By discussing the event(s) with a trained therapist (usually a psychologist), and learning possible ways to cope with symptoms through changing thought patterns, a person suffering from PTSD can develop new coping skills for managing the condition.

A psychotherapist also acts as an educator by helping patients to better understand PTSD, its origin and effects.

Cognitive Behavioral Therapy (CBT) is a particular type of psychotherapy that has helped many people with PTSD.  Therapists assist patients in exploring inaccurate or negative thoughts and changing patterns of thinking of and responding to past, present and future situations.

Eye Movement Desensitization and Reprocessing (EMDR) is a form of CBT that involves the patient following a rapidly moving object while describing traumatic experiences and feelings.

Exposure Therapy very gradually exposes patients to what they fear in a safe environment in order to reduce feelings of panic and allow practice coping strategies before using them in the real world.

Psychotherapy may be conducted privately or in a group environment, the latter being a less costly alternative to access treatment that also has proven successful.

Other forms of counseling that may be of benefit to PTSD patients and their loved ones include couple’s counseling, family counseling, parenting classes, anger management and conflict-resolution education. Mental health problems affect relationships between couples and within families too, so everyone may benefit from some help at times to cope with related problems.

3.       Alternative treatments

Medical professionals usually advise their PTSD patients that the best treatment involves both medication and psychotherapy.  However, if you would like to add other treatments to enhance your recovery, these are avenues to explore.

Acupuncture is mentioned by the Mayo Clinic as possibly having some benefit in relieving symptoms of PTSD.

A healthy lifestyle is always important when dealing with any mental health condition. What we eat and drink, how much exercise we get, and whether we follow positive daily routines such as getting enough sleep can affect our ability to deal with life.

Staying active can be particularly difficult for people living with phobias, anxiety and panic attacks, but being engaged in work,  hobbies and volunteer work can help draw us out of ourselves for a time and provide a sense of accomplishment. Isolation only reinforces negative thought patterns, so try to maintain meaningful relationships as much as possible.

However, most people with PTSD benefit from limiting their exposure to unnecessary stress. If a job or activity involves a great deal of pressure to meet deadlines, deal with other people’s emotions or put in long hours, consider making changes. A different type of employment, or work place, or hobby may be a better choice.

Join a support group. For example, Emotions Anonymous provides a 12-step approach to living with difficult feelings and thoughts. Check with your local government health office, the United Way, or the Salvation Army to see if they can recommend resources. Your doctor may also have suggestions for helpful organizations.

Relaxation techniques can be remarkably helpful, not only when in the grip of a panic attack, but as a regular antidote to the physical impact of fear, anxiety and stress. There are books and recordings available through Amazon and other retailers that can guide you through the process of relaxing your breathing, muscles and thoughts in a peaceful way.

Listening to music can also be a terrific stress-buster. I like to lie down and listen to classical music or dance to positive, upbeat tunes that lift my spirits.

Taking control of our lives again is not easy, but people suffering from Posttraumatic Stress Disorder do have options and support available to help.

Resources Consulted

Canadian Mental Health Association

Mayo Clinic

MedicineNet.com

National Institute of Mental Health

WebMD

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