Using CBT and Medications for PTSD

Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is a highly promising PTSD treatment. It involves working with a person's awareness and reasoning to change emotions, thoughts, and behaviors.
Exposure therapy is one form of CBT that is unique to trauma treatment. It uses careful, repeated, detailed imagining of the trauma in a safe, controlled environment to help the survivor face and gain control of the fear and distress that was overwhelming during the trauma.
In some cases, trauma memories or reminders can be confronted all at once (known as "flooding"). For other individuals, it is preferable to work up to the most severe trauma gradually by using relaxation techniques and by starting with less upsetting life stresses, or by taking the trauma one piece at a time (known as "desensitization").
Along with exposure therapy, CBT for PTSD treatment includes:
  • Learning skills for coping with anxiety (such as breathing retraining or biofeedback) and dealing with negative thoughts ("cognitive restructuring")
  • Managing anger
  • Preparing for stress reactions ("stress inoculation")
  • Handling future trauma symptoms
  • Addressing urges to use alcohol or drugs when trauma symptoms occur ("relapse prevention")
  • Communicating and relating effectively with people (social skills or marital therapy).
Medications as part of a treatment plan for PTSD can help reduce the anxiety, depression, and insomnia often experienced with the condition. In some cases, medications may also help relieve the distress and emotional numbness caused by memories of the trauma.
Several kinds of antidepressant drugs have contributed to patient improvement in most (but not all) clinical trials, and some other classes of drugs have shown promise. At this time, no particular drug has emerged as a definitive treatment for PTSD. However, medication is clearly useful for symptom relief, which makes it possible for survivors to participate in psychotherapy.
The most widely used medications for PTSD are the selective serotonin reuptake inhibitors (SSRIs), such as Prozac® and Zoloft®.
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