The Best Treatments And Therapies For PTSD, According To Experts

Trauma can elicit a range of response in the brain and the body, both in the midst of the traumatic event and the immediate aftermath. But for some people, symptoms continue long after the traumatic event is over, potentially leading to post-traumatic stress disorder, or PTSD. 

With the right treatment and therapy, PTSD symptoms can be managed. In this piece, we explore some of the best treatment and therapy options for PTSD.

What Is PTSD?

Traumatic events can have a direct impact on mental health, and people can experience and process the same traumatic event in different ways. Post-traumatic stress disorder (PTSD) is a mental health condition that can develop after someone experiences or witnesses a traumatic event, such as experiencing  war/combat, rape, sexual assault, intimate personal violence or a natural disaster. Anyone can have PTSD, but not everyone who experiences trauma develops it. Some people may have PTSD for shorter periods, while others may need more help to feel better.

Research suggests about 10% to 20% of people who are exposed to trauma will develop symptoms of PTSD. Symptoms of the condition include flashbacks and/or troubling dreams related to the traumatic event, distressing thoughts, changes in mood or the way you view yourself and others and signs of physical stress, such as being easily startled or feeling tense.

In order to meet a PTSD diagnosis, a person must have symptoms that last longer than a month that cause distress or problems functioning day to day. PTSD can be challenging, but there are treatments available to help ease symptoms and process trauma.

How Is PTSD Treated?

One big misconception is that PTSD isn’t treatable, says James Jackson, Psy.D., director of behavioral health for the ICU Recovery Center at Vanderbilt University Medical Center in Nashville. “If people get the right therapy, they often get vastly better,” he says.

PTSD treatments focus on ways to manage symptoms and make daily life easier. A PTSD treatment plan may include one or more approaches, depending on a person’s history and the nature of the trauma. All of the treatments require guided care from a mental health professional who is experienced in treating PTSD and trauma. 

Below are common treatments for PTSD. 

Cognitive Behavioral Therapy 

Cognitive behavioral therapy (CBT) is a type of talk therapy that focuses on how thoughts and feelings lead to behavior patterns. It can help people with PTSD by identifying unhelpful thinking that’s contributing to symptoms. For example, this might look like challenging clients to re-evaluate thoughts such as overgeneralizing bad outcomes or always expecting catastrophic outcomes, notes the American Psychological Association (APA). 

“CBT helps patients understand and change how they think about their trauma,” says Avigail Lev, a clinical psychologist based in California.

The APA’s clinical practice guidelines classifies CBT as “strongly recommended” for the treatment of PTSD. 

Cognitive Processing Therapy

Cognitive processing therapy (CPT) is another type of talk therapy that’s considered a form of CBT. CPT focuses on learning different ways to think about the trauma, according to Dr. Jackson. 

During CPT, which usually takes place over 12 sessions, a therapist works with the person to identify and challenge unhelpful beliefs that resulted from a traumatic experience. The idea is that by challenging the negative beliefs, a person can create a new understanding of the traumatic event, which can lessen the event’s negative impact on daily life and experiences.

The APA notes that CPT is a specific type of cognitive behavioral therapy developed for people who have experienced trauma. Individuals are asked to complete certain steps related to formally processing the trauma, such as writing about the trauma and sharing the written statement with the therapist, who then uses questioning strategies to help the person understand and address unhelpful thoughts about the trauma.

CPT is also classified by the APA as “strongly recommended” for the treatment of PTSD. 

Prolonged Exposure Therapy

Prolonged exposure therapy (PE) is another type of talk therapy that’s similar to CBT and CPT, and aims to help you process the traumatic expereince. With PE, a therapist works with the person over the course of three or more months to slowly expose them to memories, feelings and situations they may have been avoiding due to trauma. It allows a person to gradually confront memories or experiences associated with trauma. 

For example, someone who is avoiding driving after a traumatic event may start PE by sitting in the car with a therapist while the car is turned off or driving the car for only a quarter of a mile, according to Dr. Jackson. “We’re going to lean into these fears and stop avoiding,” he says. “One of the key hallmarks of PTSD is avoiding situations and scenarios.” The goal of exposure, according to Dr. Jackson, is “to be able to move [a patient] increasingly out of their comfort zone.” 

Like CBT and CPT, PE is an APA “strongly recommended” treatment for PTSD.

“PE is considered the best intervention for treating trauma,” says Dr. Lev. “It involves gradually confronting and recounting the trauma in a safe environment, thereby helping individuals integrate memories and experiences of it without becoming entangled in the story about it.” 

Eye Movement Desensitization and Reprocessing

Eye movement desensitization and reprocessing (EMDR) is a type of therapy originally created in1987 for the treatment of PTSD. It aims to change the way a traumatic memory is stored in the brain, and does so by encouraging the client to focus on the traumatic memory while experiencing bilateral stimulations, like rapid eye movements. The goal is to reduce the vividness and emotion of those traumatic memories.  

“PTSD and many mental disorders are disorders of information processing,” says Dr. Jackson. “The notion here is that when you were being victimized in a trauma, there were some cognitive distortions that were going on; there were ways that you were processing information that were not accurate, and those distortions are hanging around in your brain and your body.” 

There is some evidence to suggest EMDR is effective, but more research on its efficacy needs to be done. EMDR is listed as “conditionally recommended” under the APA’s clinical practice guidelines for PTSD.

Medications

Medications may be used to ease PTSD symptoms. The Food and Drug Administration (FDA) has approved two selective serotonin reuptake inhibitors (SSRIs), which are antidepressant medications, for treatment of PTSD, notes the National Institute of Mental Health. These medications include: 

• Sertraline (Zoloft)
• Paroxetine (Paxil)

These medications can ease symptoms of depression and anxiety associated with PTSD. There are other medications often prescribed off-label for the treatment of PTSD. Speak with a doctor to learn about options that may be a good fit for you. 

When to See a Doctor

If you’re experiencing PTSD symptoms that interfere with your life and daily activities, that’s a good indicator to seek help. A health care professional trained in trauma care can help design a treatment program based on your individual needs.

Dr. Jackson points out that people often don’t seek treatment for PTSD because they’re managing symptoms. In this case, he recommends asking yourself if you want to just manage, or if you want to thrive in your life. “The time to get treatment for PTSD is right now if you’re having symptoms,” he says.