Post-Traumatic Stress Disorder (PTSD)
What is PTSD?
Post-traumatic stress disorder/PTSD is an anxiety disorder caused by incredibly stressful, distressing, or frightening events. The person you love may seem like a different person than you knew before the trauma — angry and irritable, and depressed. PTSD triggers are traumatic events that may be life-threatening. Such as natural disasters, combat, car accident, or sexual assault. But sometimes, the event is not necessarily a dangerous one. For example, the sudden, unexpected death of a loved one can also cause PTSD. As PTSD can significantly strain the emotional and mental health of loved ones and friends, it is best to find a proper PTSD treatment.
According to the National Center for Biotechnology Information (NCBI) , exposure to traumatic experiences, especially those happening in childhood, has been linked to substance use disorders (SUDs), including dependence and abuse. SUDs are also highly comorbid with Posttraumatic Stress Disorder (PTSD) and other mood-related psychopathology. Ideally, people with PTSD and addiction should have both issues treated simultaneously. Moreover, PTSD treatment may consist of both therapy and medication.
Overall, 3.6% of U.S. adults have PTSD . However, this rate is more crucial among military veterans and those whose occupations increase the risk of exposure to traumatic events, such as emergency medical personnel, firefighters, and police. About one-half of all U.S. adults will experience at least one traumatic event in their lives, but most do not develop PTSD. Women who are victims of a trauma that leads to PTSD often hesitate to ask for help from a mental health professional, and it is not uncommon for them to wait years to receive treatment. Unfortunately, PTSD symptoms in women are often misdiagnosed or undiagnosed by health professionals because of a lack of training or time spent treating PTSD.
PTSD can develop from emotional abuse. This is because emortional abuse is often not a single event, but a recurring cycle of behavior. PTSD from emotional abuse often does not follow the standard cycle, but instead falls into the category of “complex PTSD,” or PTSD that stems from multiple traumatic instances, rather than just one.
What is Complex PTSD?
Complex post-traumatic stress disorder, commonly known as C PTSD occurs when someone has dealt with long-term trauma. This means the trauma happened over a long period of time or covered repeated events. Examples might include being a soldier during times of war or being a prisoner of any type: either of war, in a concentration camp, or in the world of human trafficking.
Child physical or sexual abuse, which can go on for many years, is another example of complex trauma that could result in C-PTSD, as is being in an abusive relationship as an adult. Usually, the events that lead to C-PTSD involve either metaphorical or actual captivity. The victim is under the control of another and is unable to easily escape the situation.
C PTSD is a specific diagnosis originating from deficits that PTSD fails to cover. PTSD includes exposure to a single isolated traumatic event, while those who repeatedly witnessed traumatizing events often have more severe or different symptoms. While diagnosis can have an important role in treatment, what really matters is getting the help that addresses the Complex PTSD symptoms. Working with a therapist who offers compassionate support that helps reduce or eliminate symptoms may, in the end, matter more than having a specific diagnosis.
Symptoms of PTSD usually begin soon after the traumatic event, but they may not appear until months or years later. They also may come and go over many years. However, if the symptoms last longer than four weeks, cause great distress, or interfere with work or home life, an individual might have PTSD.
There are four types of PTSD symptoms, but they may not be the same for everyone. Each individual may experience symptoms in their own way.
- Reliving The Event (also called re-experiencing symptoms): Thoughts or memories of the traumatic event can come back at any time. They can feel very real and scary. For example:
- A person may have nightmares
- A person may feel like you are going through the event again, also known as a flashback
- A person may hear, see, or smell something that causes to relive the event. This is called a trigger. For example, news reports, seeing an accident, or hearing fireworks are examples of triggers.
2. Avoiding Things That Remind You Of The Event: A person may try to avoid places or people that remind them about the trauma event. For example:
- A person may avoid crowds because they feel dangerous
- May avoid driving if a person were in a car accident or if the military convoy was bombed
- If in an earthquake, a person may avoid watching movies about earthquakes
- May keep very busy or avoid getting help so a person doesn’t have to think or talk about the event
3. Having More Negative Feelings And Thoughts Than Before The Event: The way individuals think about themselves and others may become more negative because of the trauma. For example:
- Feeling Numb: Unable to have loving or positive feelings toward other people
- Forgetting about parts of the traumatic event or not being able to talk about them
- Thinking the world is downright dangerous, and no one can be trusted
- Feeling shame or guilt about the event
4. Feeling On Edge Or Keyed Up (also called hyperarousal): Jittery, or always alert and on the lookout for danger. A person might suddenly become irritable or angry. For example:
- Hard time sleeping
- Finding it hard to concentrate
- Getting startled by a loud noise or surprise
- Acting in unhealthy ways, like smoking, abusing alcohol or drugs, or driving aggressively
C PTSD Symptoms
C PTSD symptoms are among the factors that distinguish it from PTSD. Some C PTSD symptoms are common: panic attacks caused by C-PTSD can happen, just as they can with PTSD. But complex traumas can dig even deeper into mental and emotional scars than singular traumas .
A person who is experiencing C PTSD symptoms may encounter precise changes in the way they see themselves and others. This can include:
Problems Controlling Emotions: An individual struggling with C PTSD symptoms may have a hard time managing their emotions. This can lead to issues controlling anger, depression, and even suicidal thoughts.
Repression of Memories: A person experiencing C PTSD symptoms may avoid thinking about places or people that are connected to the events.
Dissociation or Flashbacks Experiences: In some circumstances, a person with C PTSD symptoms may undergo flashbacks that relate to memories that are beyond their understanding or control; they might respond to a specific situation instinctively because of those repressed memories and not fully understand their reaction.
Forgetfulness: A person may react or take action in times of extreme stress and not fully remember how and why they did so.
Negative Feelings: A person may feel detached, helpless, or guilty, or they may struggle with the feeling of being unable to connect with others or always feeling different from people around them.
Obsessive Thoughts: A person may become distracted by the individual or people who caused their trauma; with regular PTSD, they may feel a loss of power associated with that individual, but C PTSD can lead to an obsessive passion for revenge.
Difficulty Trusting Others: Someone may have a problem trusting others, so they self-isolate and avoid relationships and friendships.
Feeling of Hopelessness: Someone may not be able to acknowledge that people, overall, are good or enjoy positive thoughts about the future.
Loss of Motivation: Because people with C PTSD can’t maintain hope in the future, they may be unmotivated to do anything for themselves—even if they intellectually want to—today.
Is PTSD a Disability?
PTSD can be considered a disability by the SSA if the criteria for Listings 12.15 or 112.15 Trauma- and stressor-related disorders are met by the applicant.
If your symptoms of PTSD are so severe that you are unable to work, the SSA will consider you disabled and you will be able to get disability with PTSD.
For your PTSD to be considered a disability by the SSA, the first thing that you need to do is to meet the medical requirements outlined in the SSA’s Blue Book.
The SSA’s Blue Book is the list of conditions that the SSA considerers to be disabilities and that qualifies for Social Security disability benefits.
The listing that PTSD can be considered a disability for is under Trauma- and stressor-related disorders, which is in Listing 12.15 in the Blue Book for adults and Listing 112.15 in the Blue Book for children.
Within the sections of the Blue Book listing, applicants need to match sections A and B, or sections A and C in the listing for Trauma- and stressor-related disorders.
If you have PTSD and you can match one of those 2 sections, the SSA can consider you disabled, and you will be able to earn disability benefits with PTSD.
For PTSD to be considered a disability by the SSA, you will need to meet the work requirements outlined by the SSA, as SSDI benefits are for those who at one point could work, but now can no longer because of a disability like PTSD.
Work credits are calculated by your age and how long you have worked. If you have paid taxes into Social Security, you can earn work credits. You can earn up to four work credits for each year that you work.
If you meet both the work and medical requirements outlined by the SSA for PTSD, you may be considered disabled and you may be able to start to earn disability benefits.
To diagnose post-traumatic stress disorder, your doctor will likely:
- Perform a physical exam to check for medical problems that may be causing your symptoms
- Do a psychological evaluation that includes a discussion of your signs and symptoms and the event or events that led up to them
- Use the criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association
Diagnosis of PTSD requires exposure to an event that involved the actual or possible threat of death, violence, or serious injury. Your exposure can happen in one or more of these ways:
- You directly experienced the traumatic event
- You witnessed, in person, the traumatic event occurring to others
- You learned someone close to you experienced or was threatened by the traumatic event
- You are repeatedly exposed to graphic details of traumatic events (for example, if you are a first responder to the scene of traumatic events)
You may have PTSD if the problems you experience after this exposure continue for more than a month and cause significant problems in your ability to function in social and work settings and negatively impact relationships.
Assessment for PTSD Treatment
Assessments apply if you have had symptoms for more than 4 weeks and if the symptoms are severe. You may see several mental health specialists for your PTSD. Such as a psychological therapist, psychologist, community psychiatric nurse, or psychiatrist.
An approach called active monitoring may be recommended if you have mild symptoms of PTSD. Likewise, if you have had symptoms for less than 4 weeks. Active monitoring involves monitoring your symptoms to see whether they improve or get worse.
PTSD Treatment Options
The main PTSD treatments are psychological therapies and medication.
Firstly, if you have PTSD that requires treatment, psychological therapies are usually recommended.
Secondly, if you have severe or persistent PTSD, a combination of psychological therapy and medicine may be recommended. Cognitive-behavioral therapy or CBT is one of the most effective mental illness therapies as well. Trauma-focused CBT uses a range of psychological techniques to help you come to terms with a traumatic event. Your therapist may ask you to face your traumatic memories and help you gain control of your fear and distress.
We Level Up rehab centers treat the entirety of behavioral health disorders including secondary corresponding illnesses to improve long-term recovery outcomes. Get a free substance abuse and or mental health assessment and find out what treatment options are most suitable for you. Call to learn more.
Programs, services, and treatments vary. We Level Up rehab facilities do not provide EMDR therapy. Because patient stability should come prior to EMDR treatment. That’s why EMDR therapy to process trauma for patients actively drinking and abusing drugs should await their stability phase of treatment. EMDR phases 3 – 8 therapy is best enacted for patients that feel and experience a safer, trustful connection with their treatment team.
Additionally, eye movement desensitization and reprocessing/EMDR have been found to reduce the symptoms of PTSD as well. It’s not clear how EMDR works, but it may help you change the way you think about a traumatic event.
Types of antidepressants medication for PTSD:
- SSRIs (selective serotonin reuptake inhibitors)
- SNRIs (serotonin-norepinephrine reuptake inhibitors)
PTSD Treatment Medications
Several types of medications can help improve symptoms of PTSD:
- Antidepressants. These medications can help with symptoms of depression and anxiety. They can also help improve sleep problems and concentration. The selective serotonin reuptake inhibitor (SSRI) medications sertraline (Zoloft) and paroxetine (Paxil) are approved by the Food and Drug Administration (FDA) for PTSD treatment.
- Anti-anxiety medications. These drugs can relieve severe anxiety and related problems. Some anti-anxiety medications have the potential for abuse, so they are generally used only for a short time.
- Prazosin. While several studies indicated that prazosin (Minipress) might reduce or suppress nightmares in some people with PTSD, a more recent study showed no benefit over a placebo. But participants in the recent study differed from others in ways that potentially could impact the results. Individuals who are considering prazosin should speak with a doctor to determine whether or not their particular situation might merit a trial of this drug.
CBT for PTSD Treatment
Therapists use a variety of techniques to aid patients in reducing symptoms and improving functioning. For example, therapists employing CBT may encourage patients to re-evaluate their thinking patterns and assumptions in order to identify unhelpful patterns (often termed “distortions”) in thoughts, such as overgeneralizing bad outcomes, negative thinking that diminishes positive thinking, and always expecting catastrophic outcomes, to more balanced and effective thinking patterns. These are intended to help the person reconceptualize their understanding of traumatic experiences and their understanding of themselves, and their ability to cope.
CPT for PTSD Treatment
Cognitive processing therapy (CPT) is a specific type of cognitive-behavioral therapy that has been effective in reducing symptoms of PTSD that have developed after experiencing a variety of traumatic events including child abuse, combat, rape, and natural disasters.
Treatment begins with psychoeducation regarding PTSD, thoughts, and emotions. The patient becomes more aware of the relationship between thoughts and emotions and begins to identify “automatic thoughts” that may be maintaining the PTSD symptoms. The patient writes an impact statement that details the current understanding of why the traumatic event occurred and the impact it has had on beliefs about self, others, and the world.
New Jersey PTSD Treatment and Dual Diagnosis
Substance abuse or addiction is commonly connected to co-occurring disorders like PTSD, depression, and anxiety. According to the National Center for PTSD at the U.S. Department of Veterans Affairs, veterans looking for treatment, in the range of 60 and 80 percent additionally require addiction treatment.
According to the US National Library of Medicine National Institutes of Health, people seeking treatment for PTSD are 14 times more likely to also be diagnosed with a substance abuse disorder.  Attempting to self-medicate can be a cause to why many people with PTSD also develop an addiction. The thought is that by abusing substances, a person with PTSD can null or avoid PTSD symptoms.
The We Level Up NJ treatment center provides world-class care with round-the-clock medical professionals available to help you cope. All working as a team providing primary SUD treatment along with primary substance abuse and co-occurring secondary PTSD Treatment for successful recovery. Make this your opportunity to reclaim your life. Call today to speak with one of our treatment specialists. Our counselors know what you are going through and will answer any of your questions. Your call is private and confidential and there is never any obligation.
 NCBI – PTSD And Addiction https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3051362/
 NIH – ps://www.nimh.nih.gov/health/statistics/post-traumatic-stress-disorder-ptsd
 US Department of Veterans Affairs – https://www.ptsd.va.gov/understand_tx/tx_basics.asp
 NCBI – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3811127/