Posttraumatic Stress Disorder
How Common Is PTSD?
About 3.6% of adult Americans -- about 5.2 million people -- suffer from PTSD during the course of a year, and an estimated 7.8 million Americans will experience PTSD at some point in their lives. PTSD can develop at any age, including childhood. Women are more likely to develop PTSD than are men. This may be due to the fact that women are more likely to be victims of domestic violence, abuse, and rape.
How Is PTSD Diagnosed?
PTSD is not diagnosed until at least one month has passed since the time a traumatic event has occurred. If symptoms of PTSD are present, the doctor will begin an evaluation by performing a complete medical history and physical exam. Although there are no lab tests to specifically diagnose PTSD, the doctor may use various tests to rule out physical illness as the cause of the symptoms.
If no physical illness is found, you may be referred to a psychiatrist, psychologist, or other mental health professional who is specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for an anxiety disorder. The doctor bases his or her diagnosis of PTSD on reported symptoms, including any problems with functioning caused by the symptoms. The doctor then determines if the symptoms and degree of dysfunction indicate PTSD. PTSD is diagnosed if the person has symptoms of PTSD that last for more than one month.
How Is PTSD Treated?
The goal of PTSD treatment is to reduce the emotional and physical symptoms, to improve daily functioning, and to help the person better cope with the event that triggered the disorder. Treatment for PTSD may involve psychotherapy (a type of counseling), medication, or both.
Doctors use antidepressant medications to treat PTSD -- and to control the feelings of anxiety and its associated symptoms -- including selective serotonin reuptake inhibitors (SSRIs) such as Paxil, Celexa, Luvox, Prozac, and Zoloft; and tricyclic antidepressants such as Elavil and Doxepin. Tranquilizers such as Ativan and Klonopin; mood stabilizers such as Depakote and Lamictal; and neuroleptics such as Seroquel and Abilify are sometimes used. Certain blood pressure medicines are also sometimes used to control particular symptoms. For example prazosin may be used for nightmares, or propranolol may be used to help minimize the formation of traumatic memories.
Psychotherapy for PTSD involves helping the person learn skills to manage symptoms and develop ways of coping. Therapy also aims to teach the person and his or her family about the disorder, and help the person work through the fears associated with the traumatic event. A variety of psychotherapy approaches are used to treat people with PTSD, including:
- Cognitive behavioral therapy, which involves learning to recognize and change thought patterns that lead to troublesome emotions, feelings, and behavior.
- Exposure therapy, a type of cognitive behavioral therapy that involves having the person re-live the traumatic experience, or exposing the person to objects or situations that cause anxiety. This is done in a well-controlled and safe environment. Exposure therapy helps the person confront the fear and gradually become more comfortable with situations that are frightening and cause anxiety. This has been very successful at treating PTSD.
- Psychodynamic therapy focuses on helping the person examine personal values and the emotional conflicts caused by the traumatic event.
- Family therapy may be useful because the behavior of the person with PTSD can have an affect on other family members.
- Group therapy may be helpful by allowing the person to share thoughts, fears, and feelings with other people who have experienced traumatic events.
- Eye Movement Desensitization and Reprocessing (EMDR) is a complex form of psychotherapy that was initially designed to alleviate distress associated with traumatic memories but is now also used to treat phobias.