“It really is quite individualized towards the patient's goals.”
Mental health disorders, such as post-traumatic stress disorder (PTSD), are anything but simple. They may take years to develop, so it’s unrealistic to expect them to go away with one therapy session or a “quick fix.” Luckily, there are many treatment options for PTSD in veterans, and they often yield great results.
“Even though PTSD is a complex condition with many symptoms that can interfere with someone's life, it's very important for people to know that there are many treatments out there [that] they can really improve someone's experience in their life,’ says Amanda M. Spray, PhD, psychologist at NYU Langone Health.
The Goals of Treatment
As is the case with many types of anxiety disorders, the goal of treating PTSD isn’t necessarily to make negative thoughts “go away.” In reality, some people continue to have unwanted thoughts for the rest of their life. Instead, treatment teaches you to process and react to those thoughts so that they don’t disrupt your life.
“The goal of treating PTSD is for someone to live a more full life, so that typically includes decrease in symptoms of PTSD,” says Dr. Spray. “It can also include improved relationships with family [and] friends, [or] improved functioning at work. It really is quite individualized towards the patient's goals.”
Types of Therapies for PTSD
After a diagnosis, your and your provider will work together to choose the right treatment option for you. This decision will likely depend on which symptoms are the most problematic for you, according to Dr. Spray.
Treatment options for PTSD in veterans will often include psychotherapy. There are specific types of psychotherapy that are particularly effective for veterans with PTSD, such as:
- Cognitive behavioral therapy (CBT): A type of psychotherapy that focuses on recognizing and reframing negative thought patterns. In turn, this helps change unwanted behaviors. Learn more about CBT here.
- Prolonged exposure therapy: A subtype of CBT in which the therapist helps you confront the traumatic event in a safe environment.
- Cognitive processing therapy: A subtype of CBT that “helps someone to evaluate how their beliefs about the world, themselves, and other people really changed following their traumatic event,” says Dr. Spray.
Amanda Burrill, a veteran of the United States Navy, says she was initially hesitant to try therapy for PTSD because she thought it made her “weak.” However, having her therapist listen and understand her story had a powerful impact.
“It turned out to be the most empowering part of my recovery because my therapist [was] believing in the things I had to say,” says Burrill. “I was so used to not being heard.”
Medications That Can Help
Many veterans with PTSD find relief from psychotherapy alone. However, others may also need medications, according to Collin Reiff, MD, psychiatrist NYU Langone Health. The main types of medications to treat PTSD include:
- SSRIs, or selective serotonin reuptake inhibitors: “These medications increase the amount of serotonin in certain parts of the brain,” says Dr. Reiff.
- Alpha-2 agonists: These work in the adrenergic nervous system.
- SNRIs, or selective serotonin and norepinephrine reuptake inhibitors: These are similar to SSRIs except they also increase the amount of norepinephrine as well.
- Beta blockers: Traditionally a treatment for high blood pressure, these medicines can treat the somatic symptoms of PTSD. For example, they can help reduce racing heartbeat and sweating.
A Better Future
Asking for help can be daunting, and facing your trauma may be overwhelmingly intimidating. For these reasons, seeking help for your PTSD may be one of the bravest things you do. If you commit and stick to it, it may also be one of the most rewarding things you do.
Dr. Spray recalls "countless examples of individuals" who were on the verge of their relationships ending, losing their jobs, or considering taking their own life. “I think one of the most exciting things is seeing how helpful therapy can be, and seeing someone's life completely change," she says.
Amanda M. Spray, PhD, is a psychologist at NYU Langone Health in New York City and a clinical associate professor at the NYU Grossman School of Medicine.Collin Reiff
Collin Reiff, MD, is an addiction psychiatrist at NYU Langone Health and a clinical assistant professor at NYU Grossman School of Medicine.
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Even though PTSD is a complex condition
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with many symptoms that can interfere
with someone's life,
00:00:09.133 --> 00:00:11.732
it's very important for people to know that there are
00:00:11.733 --> 00:00:15.499
many treatments out there that are evidence-based
00:00:15.500 --> 00:00:18.232
to show that they can really improve
00:00:18.233 --> 00:00:21.932
someone's experience in their life.
00:00:21.933 --> 00:00:26.332
00:00:26.333 --> 00:00:30.866
The goal of treating PTSD is for someone to live
a more full life,
00:00:30.867 --> 00:00:35.866
so that typically includes decrease in symptoms
00:00:35.867 --> 00:00:39.732
It can also include improved relationships with family,
00:00:39.733 --> 00:00:41.699
improved functioning at work.
00:00:41.700 --> 00:00:46.199
It really is quite individualized towards the patient's goals.
00:00:46.200 --> 00:00:49.099
So the first step in getting treatment for PTSD
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is a very thorough assessment
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because treatments are very specific to different diagnoses.
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Following a mental health assessment,
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a treatment will be selected for the individual
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based on the symptoms that are most problematic for them,
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as well as the treatment that they are most interested in.
00:01:05.833 --> 00:01:09.999
So first-line treatment for PTSD includes psychotherapies.
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We have cognitive behavioral therapy.
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Within cognitive behavioral therapy are two main
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One is prolonged exposure therapy.
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The other is cognitive processing therapy.
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Prolonged exposure is a therapy in which someone
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is helped through, guided through,
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exposing themselves to their traumatic event.
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Cognitive processing therapy helps someone
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to evaluate how their beliefs about the world,
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themselves, and other people really changed
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following their traumatic event.
00:01:45.033 --> 00:01:49.732
I saw going to a therapist as almost, ugh, I'm weak.
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It turned out to be the most empowering part of my recovery
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because my therapist, understanding my story,
00:01:57.100 --> 00:01:59.532
believing in the things I had to say,
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I was so used to not being heard over time
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that to have someone truly hear me,
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and coach me through my anger.
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Post-traumatic stress disorder is often treated
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with psychotherapy and/or medication.
00:02:15.800 --> 00:02:18.332
The medications used to treat PTSD are
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selective serotonin reuptake inhibitors.
00:02:20.933 --> 00:02:24.499
That's a fancy way of saying that these medications
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increase the amount of serotonin
in certain parts of the brain.
00:02:28.400 --> 00:02:30.999
Another medication that's used for PTSD
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is one that's a alpha-2 agonist.
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That's just a fancy way of saying that it works
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in the adrenergic system.
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There's some other medications that are used:
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the SNRIs, selective serotonin and norepinephrine
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There's some evidence that those are effective
for treating PTSD.
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As a psychologist who treats individuals with PTSD
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on a daily basis, I think one of the most exciting things
00:02:55.333 --> 00:02:58.632
is seeing how helpful therapy can be,
00:02:58.633 --> 00:03:02.166
and seeing someone's life completely change.
00:03:02.167 --> 00:03:04.632
There are countless examples of individuals
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that have come in really struggling with work, home life,
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on the verge of relationships ending,
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on the verge of jobs being terminated,
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on the verge of considering taking one's own life,
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to really, completely changed following treatment.
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- Approach to treating posttraumatic stress disorder in adults. Waltham, MA: UpToDate, 2020. (Accessed on July 22, 2020)
- Pharmacotherapy for posttraumatic stress disorder in adults. Waltham, MA: UpToDate, 2020. (Accessed on July 22, 2020)
- Brunet A et al. Reduction of PTSD symptoms with pre-reactivation propranolol therapy: A randomized controlled trial. Am J Psychiatry. 2018 May;175(5):427-433.