The WHO mental health survey shows that approximately 70 percent of all people experience a trauma, such as the loss of a loved one, a life-altering injury, or direct exposure to violence. All of these triggers lead to a higher risk of post-traumatic stress disorder, PTSD. The available therapies have evolved to handle the spectrum of responses and associated conditions, but there is more to learn about their processes and the symptoms they treat.
Beta-blockers are blood pressure medications that cause the heart to beat with less force. Researchers discovered was that these same drugs can help some people with PTSD by reducing anxiety, a common symptom, and even dampening the fear response associated with certain memories. Because these beta-blockers can pass through the blood-brain barrier, doctors believe they inhibit the synthesis of certain proteins during those reexperienced fear memories, which causes partial memory erasure.
Developed in 1987, eye movement desensitization and reprocessing or EMDR therapy changes the way the memory is stored instead of changing the emotions surrounding the memory. It accomplishes this by using rhythmic bilateral stimulation, such as tapping, while the patient focuses on the traumatic memory. One study showed that after EMDR, individuals displayed lower trauma-related cognitive bias, meaning they were better able to consider the whole story and not just a few selected outcomes.
Monoamine oxidase inhibitors (MAOIs) are antidepressants. Enzymes they deliver break down the amino acids from food and separate the neurotransmitters that affect mood and emotions, namely serotonin and dopamine. This particular characteristic makes MAOIs viable treatments for psychiatric disorders. Results from a randomized clinical trial showed that certain MAOIs improved PTSD symptoms, such as avoidance and reexperiencing.
PCT or present-centered therapy can help individuals with PTSD who are less open to trauma-focused therapies. PCT focuses on the client's current life while acknowledging the link between their PTSD symptoms and the struggles they cause. This therapy can be conducted in individual and group settings. While researchers admit that improvements are needed to make this therapy more widely viable, one review shows that in three of the five clinical trials, PCT has a lower dropout rate than other forms of treatment.
Cognitive processing therapy or CPT is a subset of cognitive-behavioral therapy. It aims to help people identify any automatic negative thoughts and the relationship between those thoughts and the resulting emotions. In a study of individuals who survived military sexual trauma, CPT reduced trauma-associated negative cognitions, leading to less self-blame and less severe PTSD symptoms.
Selective serotonin reuptake inhibitors, SSRIs, and serotonin-norepinephrine reuptake inhibitors, SNRIs, are pharmacotherapies doctors may prescribe for persistent and severe depression and anxiety. SSRIs block the reabsorption of serotonin, while SNRIs block both serotonin and norepinephrine. As a result, the neurotransmitters are more available to provide relief and regulate mood. People respond better to one type than the other, depending on their constitutions. While SSRIs are more prevalent and have been proven effective, they may have negative side effects. In those cases, SNRIs are the alternative.
Stress inoculation training (SIT) is a form of cognitive-behavioral therapy some practitioners use to help veterans with PTSD and traumatic brain injuries.The four-phase program involves identifying stress reactions and responses and learning about coping techniques. Tests show that not only does SIT reduce PTSD and depression symptoms, but people also experience better stress tolerance and improved ability to handle social and occupational situations.
Dr. Edna Foa developed prolonged exposure (PE) therapy as a way of treating those with PTSD who also exhibit other conditions, such as suicidality, substance abuse, and depression. The therapy repeatedly engages people in the instances they avoid due to trauma, while providing the means to process the traumatic memory differently. Data shows that for those with PTSD and severe co-existing conditions, PE therapy is a safe and effective treatment, even when combined with pharmacotherapy.
Narrative exposure therapy or NET is a short-term therapy where the individual constructs their life story with special emphasis on its traumatic events. Experts designed this technique for use in low-income countries, but it has broader applications today. KIDNET is a version of NET for children with PTSD. Studies show that when used with those traumatized by organized violence, NET was successful when conducted in volatile environments.
PTSD affects millions of people around the world, and the future therapeutic options include understanding more about the changes in the body during fear memories, how to personalize and vary interventions to make them more effective, and how to prevent PTSD from manifesting soon after trauma. A 2019 study is looking at the genetic components that may give insight into the heritability of PTSD. Understanding this relationship means formulating specific, holistic solutions.
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