"It's hard to let people in on your private thoughts. A professional is a great listener, and if you can let them in, when you talk about your flashbacks, they understand that they're not some random thoughts." - Hurricane Katrina survivor Marvin Turner

There are many types of treatment for post-traumatic stress disorder (PTSD). You and your doctor will discuss the best treatment for you. You may have to try a number of treatments before you find one that works for you.

A type of counseling called cognitive-behavioral therapy and medicines known as SSRIs appear to be the most effective treatments for PTSD.^{2, 1} Treatment can help you feel more in control of your emotions and result in fewer symptoms, but you may still have some bad memories.

Counseling means talking with a therapist on your own or in a group about the traumatic event and PTSD. You will talk with your therapist about your memories and feelings to help you change how you think about your trauma. You will learn how to deal with painful feelings and memories, so you can feel better.

Counseling

There are different types of counseling for PTSD. Cognitive-behavioral therapy appears to be the most effective.^{2, 1} This type of therapy includes:

• Cognitive therapy, in which you learn to modify thoughts about the trauma that are not true or that cause you stress. For example, survivors of hurricane Katrina may feel guilty for not evacuating their families sooner from their New Orleans homes. Cognitive therapy can help them see that they did the best they could at the time. No one knew that the levees would break.
• Exposure therapy, in which you talk about the traumatic event over and over, in a safe place, until you have less fear.
• Eye movement desensitization and reprocessing (EMDR), in which you focus on distractions like hand movements and sounds while talking about the traumatic event.

Finding a therapist you trust is important. A good therapist will listen to your concerns and help you make changes in your life. Your doctor can help you find one. If you are a veteran, the VA is a good place to start. Churches sometimes offer services that help people get counseling. Or you can call your state Health and Welfare office.

SSRI medicine

SSRIs (selective serotonin reuptake inhibitors) are a type of antidepressant medicine. These can help you feel less sad and worried. They appear to be helpful, and for some people they are very effective. SSRIs include citalopram (Celexa), fluoxetine (such as Prozac), paroxetine (Paxil), and sertraline (Zoloft).

Other types of treatment

Your doctor also may suggest you try other types of medicines and other forms of counseling. People with PTSD have benefited from these other therapies.

• Other types of counseling include group treatment, brief psychodynamic psychotherapy, and family therapy.
• Other types of medicines include:
  • Tricyclic antidepressants such as imipramine (Tofranil) and amitriptyline (Elavil, for example).
  • Atypical antidepressants such as mirtazapine (Remeron) and venlafaxine extended release (Effexor XR). One study has shown that venlafaxine XR reduced PTSD symptoms.¹³
  • Monoamine oxidase inhibitors (MAOIs) such as phenelzine (Nardil) and isocarboxazid (Marplan).
  • Mood stabilizers such as carbamazepine (Tegretol, for example) and lithium (Lithane, Lithobid, or Eskalith, for example). Mood stabilizers are sometimes taken with other medicines used for PTSD.
  • Antipsychotics such as imipramine (Tofranil). These medicines may help with symptoms like nightmares or flashbacks. More research is needed to find out how well these drugs work.
  • Prazosin (Minipress), which is used for nightmares and sleep problems related to PTSD.