There are several therapies, or practises that many have found to be useful in combating or reducing PTSD symptoms. The suggestions below are from a variety of sources, and some are unproven in their effectiveness, but many people find that they can go some way to alleviating the symptoms of PTSD, particularly anxiety related ones.
Antidepressants such as paroxetine, mirtazapine, amitriptyline or phenelzine are sometimes used to treat PTSD in adults.
Of these medications, paroxetine is the only one licensed specifically for the treatment of PTSD. However, mirtazapine, amitriptyline and phenelzine have also been found to be effective and are often recommended as well.
These medications will only be used if:
- you choose not to have trauma-focused psychological treatment such as EMDR or CBT.
- psychological treatment would not be effective because there is an ongoing threat of further trauma (such as domestic violence)
- you have gained little or no benefit from a course of trauma-focused psychological treatment such as EMDR or CBT
- you have an underlying medical condition, such as severe depression, that significantly affects your ability to benefit from psychological treatment
Antidepressants can also be prescribed to reduce any associated symptoms of depression and anxiety and to help with sleeping problems.
If medication for PTSD is effective, it will usually be continued for a minimum of 12 months before being gradually withdrawn over the course of four weeks or longer.
Before prescribing a medication, your doctor should inform you about possible side effects that you may have while taking it, along with any possible withdrawal symptoms when the medication is withdrawn.
For example, common side effects of paroxetine include feeling sick, blurred vision, constipation and diarrhoea. Possible withdrawal symptoms associated with paroxetine include sleep disturbances, intense dreams, anxiety and irritability.
(The information above is taken from the NHS website)
Bessel A. van der Kolk, author ofrauma victims cannot recover until they become familiar with and befriend the sensations in their bodies. Being frightened means that you live in a body that is always on guard. Angry people live in angry bodies. The bodies of child-abuse victims are tense and defensive until they find a way to relax and feel safe. In order to change, people need to become aware of their sensations and the way that their bodies interact with the world around them. Physical self-awareness is the first step in releasing the tyranny of the past.
In my practice I begin the process by helping my patients to first notice and then describe the feelings in their bodies—not emotions such as anger or anxiety or fear but the physical sensations beneath the emotions: pressure, heat, muscular tension, tingling, caving in, feeling hollow, and so on. I also work on identifying the sensations associated with relaxation or pleasure. I help them become aware of their breath, their gestures and movements.
All too often, however, drugs such as Abilify, Zyprexa, and Seroquel, are prescribed instead of teaching people the skills to deal with such distressing physical reactions. Of course, medications only blunt sensations and do nothing to resolve them or transform them from toxic agents into allies.
The mind needs to be reeducated to feel physical sensations, and the body needs to be helped to tolerate and enjoy the comforts of touch. Individuals who lack emotional awareness are able, with practice, to connect their physical sensations to psychological events. Then they can slowly reconnect with themselves.”
Counselling or Talking Therapies
It is suggested that counselling or talking therapies are more likely to address mental health conditions that can are entwined with PTSD, include depression, phobias and anxiety, rather than PTSD itself.
While choosing your PTSD recovery path you need to address both sides of your brain. Talk therapy and counselling can be a great base to allow you to find words to express what you’re thinking and feeling, but can’t treat PTSD alone. When you feel you’ve got a significant amount of talking done and are ready to look for additional support there are many processes to choose. NICE guidance from 2005 and 2011 recommends the use of trauma focused psychological treatments for post traumatic stress disorder in adults, specifically the use of Eye Movement Desensitisation Reprocessing (EMDR) and trauma focused cognitive behavioural therapy (CBT).
It’s worth noting that talking therapies and counselling can infact cause a ‘retraumatisation’ by talking your trauma story over and over again.
As well as undergoing the treatment recommended by their GP, some PTSD sufferers also find that hypnotherapy treatment is beneficial. Though there is no solid evidence to support the efficacy of hypnotherapy for post-traumatic stress disorder, many sufferers have experienced success with the treatment.
The aim of hypnotherapy is to unlock stored emotion so that the trauma can be revisited and explored from a different perspective.
There are various forms of hypnotherapy a practitioner may use and in order to determine which is the most suitable for you, a practitioner will usually begin by performing an assessment of your personal circumstances.
In most cases practitioners will tend to use cognitive hypnotherapy or analytical hypnotherapy, both of which function on a deeper level than suggestion hypnotherapy and are able to work with the unconscious mind so that negative beliefs which were built up during the trauma can be explored and alleviated.
A hypnotherapy practitioner will treat you and your problems with sensitivity and understanding and will discuss and explain any decisions regarding you treatment plan with you thoroughly before treatment begins or any changes are implemented.
If you would like to find out more about how hypnotherapy could help you to over come post-traumatic stress disorder, you can contact a qualified hypnotherapy practitioner in your local area.
There are preliminary positive findings for acupuncture in the treatment of chronic anxiety associated with PTSD. A systematic review of acupuncture for PTSD found that the evidence of effectiveness is encouraging (Kim 2013): all four reviewed randomised controlled trials (RCTs) indicated that acupuncture was equal to or better than orthodox treatments, or that it added extra effect to them when used in combination. Three of the four are Chinese studies that used earthquake survivors and one similar RCT (Wang 2012) was too recent to be included in the review. It found that both electroacupuncture and paroxetine resulted in significantly improved scores for PTSD, but that the improvement was greater with electroacupuncture. There is also some evidence that the acupuncture effects may continue for at least a few months after the treatment course is finished (Hollifield 2007).
A review that looked at the effects of combining brief psychological exposure with the manual stimulation of acupuncture points in the treatment of PTSD and other emotional conditions found evidence suggesting that tapping on selected points during imaginal exposure quickly and permanently reduces maladaptive fear responses to traumatic memories and related cues (Feinstein 2010).
Kim’s review (Kim 2013) also included two uncontrolled trials (they too had positive outcomes). A more recent uncontrolled pilot study found that acupuncture appeared to be a therapeutic option in the treatment of sleep disturbance and other psycho-vegetative symptoms in traumatised soldiers (Eisenlohr 2012).
Although more high quality trials are needed to substantiate these results, the overall evidence does lie promisingly in a positive direction, and, given the very low level of side effects and lack of demonstrably superior outcomes from other interventions, acupuncture could be considered as one possible therapeutic option alongside the existing repertoire.
In general, acupuncture is believed to stimulate the nervous system and cause the release of neurochemical messenger molecules. The resulting biochemical changes influence the body’s homeostatic mechanisms, thus promoting physical and emotional well-being.
Research has shown that acupuncture treatment may specifically benefit anxiety disorders and symptoms of anxiety and stress by:
- Acting on areas of the brain known to reduce sensitivity to pain and stress, as well as promoting relaxation and deactivating the ‘analytical’ brain, which is responsible for anxiety and worry (Hui 2010);
- Regulating levels of neurotransmitters (or their modulators) and hormones such as serotonin, noradrenaline, dopamine, GABA, neuropeptide Y and ACTH; hence altering the brain’s mood chemistry to help to combat negative affective states (Lee 2009; Zhou 2008);
- Stimulating production of endogenous opioids that affect the autonomic nervous system (Arranz 2007). Stress activates the sympathetic nervous system, while acupuncture can activate the opposing parasympathetic nervous system, which initiates the relaxation response;
- Reversing pathological changes in levels of inflammatory cytokines that are associated with stress reactions (Arranz 2007);
Taken from British Acupuncture Website
A study, which was a collaboration between the Guildhall School and East London Foundation NHS Trust, utilised a randomised controlled trial design. The study measured whether music therapy had an effect on post-traumatic stress disorder (PTSD) symptoms. Results showed a significant reduction in PTSD symptoms after music therapy and interviews indicated that patients viewed music therapy as both positive and helpful.
Carr, C., d’Ardenne, P., Sloboda, A., Scott, C., Wang, D. and Priebe, S. (2012), Group music therapy for patients with persistent post-traumatic stress disorder: an exploratory randomized controlled trial with mixed methods evaluation. Psychology and Psychotherapy: Theory, Research and Practice, 85 (2) pp. 179-202.
Traumatized people have great difficulty in self-regulating, have high levels of sympathetic nervous system activation and low heart rate variability. Yoga teaches individuals how to self-regulate and gain control over their bodies once more. Asana, meditation and relaxation can reduce autonomic sympathetic activation, reduce blood pressure, muscle tension, improve hormonal activity and decrease the physical symptoms and emotional distress.
With PTSD, it’s easy to numb or dissociate. Successful treatment, however, requires that you stop both of those threat reactions and develop a new response.
Research has proven that meditation increases immune function, positive emotion, social connection, emotional intelligence, compassion, ability to self-regulate emotion, ability to be introspective, cortical thickness in areas related to attention, grey matter of your brain, brain volume in areas related to self-control, emotional regulation, positive emotions, ability to be productive, ability to focus, ability to think creatively, problem-solve, memory, ability to multi-task and happiness – all of which are great additions to your arsenal for treating PTSD. Details from Healthy Place.
Energy Processing Therapy
Energy Processing Therapy works with the energy median pathways in your body, also used in acupuncture, which can become imbalanced from the impact of a traumatic event. Rebalancing the energy system as you think of the traumatic event can change your emotions and thus your behaviors. Popular energy processing techniques include Emotional Freedom Technique and Thought Field Therapy.
Clara Williams, owner of the skinnyskinny line of soaps and serums has found that the power of scent, can help symptoms of post traumatic stress disorder. “I wasn’t looking for an alternative therapy for PTSD,” Williams explains. “I was using the essential oils in the products and I realized when I was working with them that I was genuinely felt calmer. I genuinely felt good on a deep level. It opened the psychological space for me to relax and not feel like I was trapped in a psychological pattern where I was expecting more trauma to occur. I had a calm space.”
“It’s been amazing the amount of transformation I’ve been able to experience for myself. Just being able to generally calm me down, alleviating anxiety and stress, and making me feel confident. Those are incredibly powerful things. Aromatherapy should definitely get more credit for the ability to help people.”
Williams acknowledges that the link between aromatherapy and healing serious mental traumas is a new one. “ I’ve read many many case studies of people who have claimed to be helped, and as a certified aromatherapist, I’ve formulated products that seemed to have genuinely positive effects. These are compelling but ultimately anecdotal,” Williams states.
She is happy to recommend the products that her clients, family, and she personally have found transformative. “For anxiety, I definitely recommend the Lavender Peppermint Tea Tree Bath Soak or our Mandarin Eucalyptus Cypress Bath Soak,” Williams says. “Our bath soaks are all made from a blend of exceptional sea salts that help the body produce serotonin, which leads to feelings of well-being. Most of our candles have a calming or grounding aspect to them, but my favorite candle to use when I am feeling anxious is the Cardamom & Pink Peppercorn because the scent combination is exotic and complex enough that it always distracts me from whatever it was that was making me anxious, giving me mental space to calm down.”
Many Post Traumatic Stress Disorder sufferers find that talking therapies, such as counselling, can help them to understand their PTSD and the symptoms they are experiencing. It helps to appreciate how a changes in the brain have been triggered and how the physical and psychological effects that follow are a result of that imbalance. At times, this simple understanding of the condition can help immeasurably.
Several PTSD sufferers use writing as their own form of therapy – whether that be a diary of thoughts, notes on a scrap of paper, or by writing a novel.
For more information, please see our blog post – How writing can help PTSD symptoms here.