Therapies for Post Traumatic Stress Disorder (Ptsd) 1

THERAPIES FOR POST TRAUMATIC STRESS DISORDER (PTSD) 1

ISSUE EVALUATION

Final Draft

English 1010-78

Nathan Cole

Matt Jensen

April 26, 2012

ABSTRACT

Many veterans returning from war encounter Post Traumatic Stress Disorder (PTSD). There are four therapies that have proven to be beneficial for relieving symptoms related to this disorder. Virtual Reality Exposure Therapy (VERT) recreates the environment where the veteran’s trauma occurred. With the use of technology, patients regain control of their fears by confronting the situation repeatedly. Cognitive Processing Therapy (CPT) provides veterans with skills to handle distressing thoughts and negative behaviors to understand and process past events. Drug Therapy uses medications, in various combinations, to relieve disabling symptoms and related maladies such as anxiety, depression, insomnia and emotional detachment. Psychotherapy works with veterans in individual and group sessions to discuss and strategize how best to transform their negative feelings into positive behaviors. Group sessions provide instant feedback and build constructive relationships vital for emotional recovery. For treatment, veterans should work closely with their therapists to determine which treatment most effectively relieves symptoms and produces long-term results.

Therapies for Post Traumatic Stress Disorder (PTSD)

When many soldiers return home from deployments in Iraq or Afghanistan, they face another battle no one trained them to fight. The National Institute of Mental Health VAA (2012) the silent enemy is Post Traumatic Stress Disorder (PTSD) which assaults more than 20% of veterans. Even though these men and women are afflicted with symptoms of the disorder, such as depression, episodes of violence and insomnia, less than half ever seek treatment. However, there are four major therapies that can arm veterans with weapons to confront this enemy and live more productive lives. I will discuss each of these therapies:Virtual Reality Exposure Therapy (VERT), Cognitive Processing Therapy (CPT), Drug Therapy and Psychotherapy.

PTSD was previously identified by many different titles, such as shell shock, battle fatigue and traumatic war neurosis. Veterans demonstrated the same or similarsymptoms after exposure to a terrifying event where grave physical harm occurred. The National Center for PTSD (2006) verifies that it wasn’t until the 1970’s that a technical understanding of the disorder was realized as result of the Vietnam War. Several studies identified that PTSD symptoms began within 3 months, although some veterans did not manifest symptoms until years later. With treatment some veterans recovered within 6 months with minimal side-effects. Others suffered for the remainder of their lives, showing that severity and duration of the disorder varies. However, the purpose of therapy, according to researchers at the Mayo Clinic (2012), is to decrease the intensity of the aggravating problems and defuse the underlying disorder so veterans can find inner peace.

Virtual Reality Exposure Therapy (VERT) attempts to recreate the environment where the veteran’s trauma occurred. According toDr. Barbara Rothbaum, Director of the Trauma and Anxiety recovery program at Emory University of Medicine (2012) she believes that“veterans do not seek treatment because places they go or things they see dredge up traumatic memories. But the exact thing they don’t want to confront is what most needs to happen.” VERT treatment uses 3D goggles, headphones, medications and familiar smells to reintroduce the patient back into the source of the trauma. Under close clinical supervision, the patient’s mind is purposefully triggered with memories of painful experiences, forcing him to face his fears. Using this technology helps patients gradually gain control of their fears through confronting the situation repeatedly.

Another type of treatment is Cognitive Processing Therapy (CPT) which gives veterans the skills they need to handle distressing thoughts and help them understand events that have taken place in the past. Researchers at the Mayo Clinic, (2012) describes CPT as a four step program which is supervised and supported by a psychiatrist or clinical psychologist. The first step is to educate patients about their specific symptoms and how treatment can reduce or diminish them. The second step is to make the patient more aware of thoughts and feelings that occurred during the trauma. The third step provides patients with skills that challenge or question their thinking processes with the use of worksheets. The worksheets allow patients to determine their true feeling about specific traumas and how to avoid them in the future. The fourth step of the CPT process is to guide patients to change their perspective about the traumatic event and realign thoughts and behaviors for more productive results. Several case studies from the National Center for PTSD (2012) have shown that CPT can change a patient’sunderstanding of essential issues: safety, trust, control, self-esteem and relationships. By doing this, patients can find a better balance between their past and the lives they are building for tomorrow.

Some veterans respond well to medications or Drug Therapy. Many medications can reduce anxiety, depression, insomnia and emotional detachment, which are all symptoms of PTSD. Prescribed by a knowledgeable therapist, medications can be used in different combinations and doses to not only ease trauma but reduce drug side-effects. The FDA has approved 2 medications for treatment of PTSD in adults: serrtaline and paroxetine. Both are selective serotonin reuptake inhibitors, which means they canhelp patients feel less sad and worried as well as gain some control over their everyday lives, according to a web site on the Treatment of Post Traumatic Stress Disorder (2012). However, not everyone treated with these drugs has shown improvement. Other medicationshave proven to be effective in relieving accompanying maladies: antidepressants (which affect the neurotransmitter, serotonin), benzodiazepines (which function on gamma amino butyric acid (GABA)), anticonvulsants (which increase overall response to treatment) and antipsychotics (when patients only partially respond to other medications).

Maybe the most effective treatment for PTSD is the use of Psychotherapy because it treats the patient and specific symptoms. Psychotherapy can be performed individually or in a group. The “PTSD—Anxiety, Panic & Health” (2012) site advocates the group approach because it allows the patient to communicate and connect with others who are going through similar experiences. This shared experience builds relationships with those who understand the patient’s background and supports him in learning and building more effective methods of reducing the trauma. Vocalizing personal feelings with the group, allows individuals to learn how to process shame, guilt, rage, anger and fear. Through the process, patients build self-confidence and trust allowing them to focus on their present lives and put overwhelming feelings from the past behind them.

My view on the four types of therapies is that each has its own definite advantages. Of course, any PTSD treatment is most effective when implemented during the earliest stages of manifestation. Veterans who do not seek early treatment at the onset may demonstrate severe symptoms or destructive behaviors. Cognitive applications, used in VERT therapy, may be the only way to help these veterans by reconstructing similar situations inherent in the traumatic event. This therapy allowspsychologically handicapped individuals to gain control of their feelings and physical reactions. Utilizing the worksheets of CPT therapy, patients identify emotions generated by the trauma. They write out a plan of action to replace negative thoughts and reactions with constructive ones which, over time, can reduce symptoms and change how they feel about the past. Some patients may find that certain medications, or a combination of drugs, can reduce symptoms. Howeverthis may be a trial-and-error process and can take time to find prescriptions that work best without generating negative side-effects. The focus of psychotherapy encourages veterans to work in groups. These small social networks, allow veterans to open up and discuss their tragic feelings. Bydeveloping trust in others, they can rebuild their self-esteem, improve relationships and vanquishing their personal ghosts.

The best therapy, in my opinion, is basically up to the patient and therapist. By working together, they can find which treatment is most effective and pursue actions that will allow the veteran to steadily gain control of his life.

References

Barbara Rothbaum Ph.D., ANPP, professor of Psychiatry and Director of the Trauma and Anxiety recovery program at Emory University School of Medicine.

Web. 14 March 2012. Retrieved from

Facts about Post-Traumatic Stress Disorder, MentalHelpo.net

Web. 27 March 2012

http:/mentalhelp.net/poc.view/doc.php/

National Center for PTSD. Treatment of PTSD. 12 Dec. 2006. From Psych Central.

Web. 22 March 2012. Retrieved from

National Institute of Mental Health. Veterans Affairs Administration.

Web. 14 March 2012.

Post-traumatic stress disorder (PTSD): Treatment and Drugs-MayoClinic.com

Web. 30 March 2012. Retrieved from

PTSD—Post Traumatic Stress Disorder – Anxiety, Panic & Health

Web. 27 March 2012. Retrieved from

Treatment of Post Traumatic Stress Disorder

Web. 29 March 2012. Retrieved from

http:/ treat.php/

United States Department of Veterans Affairs. National Center for PTSD.

Web. 16 March 2012. Retrieved from