Posttraumatic stress disorder (PTSD)

Posttraumatic stress disorder (PTSD) is a set of reactions that can occur after someone has been through a traumatic event. About 5-10% of Australians will suffer from PTSD at some point in their lives.

Treatment options: PTSD

Effective treatments for PTSD are available and include counselling, medication or a combination of both. These treatments can work even if your traumatic experience was long ago.

Counselling for PTSD

It is generally best to start with counselling rather than use medication as the first and only solution to the problem. Recommended counselling approaches for PTSD include Trauma-focused Cognitive Behavioural Therapy (TF-CBT) and Eye Movement Desensitisation and Reprocessing.

  • Learn ways to confront and come to terms with painful memories, thoughts and images, so you don’t feel as distressed by them.
  • Learn strategies to help you get back into activities or visit places that you have avoided since the trauma because they have been too distressing.
  • Learn tools to help you relax when you start getting too anxious or wound up.
  • Explore thoughts that may be making your memories of the event more painful.

Counselling can involve around eight to 12 sessions, though in some cases it might take longer.

The most important thing when getting help for PTSD is to face, and deal with, the memory of the traumatic event, rather than pushing it to the back of your mind. This is the main aim of TF-CBT or EMDR.

Because the memory of a traumatic event can cause intense fear, anxiety and distress, people often want to avoid anything associated with the trauma. Although avoiding reminders of the trauma provides some relief at the time, it is one of the main reasons why some people don’t recover. When people rely on avoiding certain things to cope, they don’t have the opportunity to come to terms with what happened to them or to develop skills that will help them feel safe when thinking about the traumatic event. The anxiety and avoidance can then affect other areas of their lives.

During treatment for PTSD you will learn ways to face traumatic memories and confront situations that you have avoided since the event so that you don’t feel so distressed by them. Your counsellor will take things slowly, help you gain control of your fears step by step and teach you skills to manage any distress you might experience so that you never become overwhelmed by your feelings.

You will be encouraged to examine how your thoughts about the event may be making the memory of it more painful. Many people blame themselves for what happened or start seeing the world as a dangerous place after a traumatic event and need help to deal with these thoughts.

Medication for PTSD

The medications usually used to treat PTSD are antidepressants. Even if you don’t have depression, antidepressants can help make feelings associated with trauma more manageable. There are different kinds of antidepressants, but research has shown that selective serotonin reuptake inhibitors (SSRIs) are most likely to help.

Before you start taking medication, you should be given information about possible side effects. It is also important to understand what you might experience if you stop taking the medication suddenly, forget to take a dose or reduce the amount you are taking. Remember that antidepressants take a few weeks to reach their full effect, so do not expect immediate results.

If antidepressants are working, it is recommended that you take them for at least 12 months. After this period of time, you can stop by gradually reducing the dose. This should only be done after discussion with your GP and should be carefully monitored.

Remember, not all medication works in the same way for everybody. If a particular type of medication is not working for you, your doctor may ask you to try another type, increase the dose or suggest that you try counselling.

  • How does this medication work
  • What can I expect to feel like if it works?
  • Does it have any side effects and how long will they last?
  • How long will it take before I start to feel better?
  • How long will I have to take it?
  • What do I do if I forget to take my medication?
  • When it’s time, how do I go about stopping the medication?
  • What will happen when I stop taking it?

Some people with PTSD improve quickly, while others take more time to get better. PTSD can also feel manageable for a while but worsen at times of stress or when a particularly strong reminder of the trauma triggers a reaction.

Sometimes things that happen during treatment can get in the way of your recovery, such as not receiving enough information about what to expect or not feeling comfortable with your GP or counsellor. It takes time to develop trust in someone, but if you continue to feel uncomfortable, discuss it with the person you are seeing or give yourself permission to look for the right person to provide you with help. Feeling overwhelmed by emotions during treatment can also get in the way of recovery. Let the person treating you know how you feel and talk with them about slowing down the process.

If you’re not sure if treatment is helping you, ask your GP or mental health counsellor these questions:

– My sleep, nightmares and mood aren’t improving. What else can we do?
– I had expected to feel better. Can we talk about my progress?
– Can we talk about other treatments? What else is available?
– Can you give me some strategies to help me to manage my sleep or panic attacks better?


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