TREATMENT FOR POST TRAUMATIC STRESS DISORDER IN MELBOURNE

According to the American Psychiatric Association (1994), post traumatic stress disorder develops after someone is exposed to an extremely traumatic event and they reacted to the event with intense fear, horror or helplessness.

Such traumatic events include:

• war
• torture
• rape
• child sexual or physical assault
• physical assault
• being kidnapped
• terrorism
• a natural disaster (e.g. a bushfire, flood or cyclone)
• a major car accident
• being diagnosed with a potentially fatal illness e.g. cancer
• finding the body of someone who has committed suicide or been murdered

Post Traumatic Stress Disorder Symptoms

The Intrusive Symptoms include:

• Distressing thoughts or images
• Nightmares about the event
• Feeling or acting as if the traumatic event were recurring
• intense psychological distress when exposed to something that triggers memories of the traumatic event.
• Physical symptoms such as sweating, muscle tension and rapid heartbeat when exposed to things that trigger memories of the traumatic event.

The Avoidance Symptoms include:

• Trying to avoid thinking or talking about the trauma, as well as any feelings associated with the trauma.
  PTSD sufferers may resort to alcohol or illicit drugs to block out unwanted memories & feelings. According to the Australian Centre for Post Traumatic Mental Health (1999), approximately 50% of men and 25% of women with chronic PTSD have drug and alcohol issues
• Avoiding people, places and activities that trigger memories of the traumatic event.
• not remembering an important part of the traumatic event
• Losing interest in, and enjoyment of e.g. leisure activities, study, work or stop participating in such activities altogether.
• Feeling detached from other people
• Being unable to feel joy or have loving feelings
• Not be able to see a future for themselves, they don’t expect to get married, have a family , live a long time

The Physical Arousal Symptoms include:

• Sleep disturbance
• irritability or anger
• impaired concentration
• being always on the alert for signs of danger
  The PTSD sufferer may be constantly scanning their surroundings for possible threats, e.g. someone who has been in a major car accident may become a back seat driver. Someone who has been physically assaulted may always sit with their back to a wall so noone can sneak up behind them
• being easily startled
  THE PTSD sufferer may overreact to something such as a noise. E.g. a war veteran may be shaken if they hear a car backfire because of their past experience of being threatened by gun fire)

Treatment of Post Traumatic Stress Disorder

Psychological Treatment of PTSD in adults involves a number of phases, including:

• Education and information
• Learning how to manage anxiety, anger and depression
• Exposure therapy where the sufferer confronts feared situations and memories
• Cognitive therapy- where unhelpful, irrational thoughts and beliefs are replaced with more rational ones
• Relapse prevention
  (Foa, Davdison & Frances (1999).

Psychological Treatment of children with PTSD may include:

• play therapy
• information about PTSD
• anxiety, anger and depression management techniques
• cognitive therapy
  (Foa, Davidson & Frances (1999).

Other therapies used for post traumatic stress disorder include: hypnotherapy, eye movement desensitization reprocessing (EMDR) and psychodynamic psychotherapy. However, Foa, Davidson & Frances (1999) found that the experts they consulted did not favour these techniques for the treatment of PTSD.

It is common for PTSD sufferers to have other psychological disorders as well. The most common mental conditions accompanying PTSD include: drug & alcohol issues, depression, social anxiety, panic and/or agoraphobia, generalised anxiety, obsessive compulsive disorder and bipolar mood disorder.(Foa, Davidson & Frances (1999).

Melbourne clinical psychologist Catherine Madigan provides cognitive behavioural therapy for PTSD. Phone 98193671 for an appointment.

Medication Treatment for PTSD

SSRIs are commonly used to treat the disorder and it is recommended they are tried first as generally patients tolerate them well, they have proven efficacy and have less potential to be abused.

• Paroxetine
• Fluoxetine
• Sertraline
• Citalopram
• Escitalopram

Other drugs used to treat the disorder include:

• Moclobemide
• Bupropion
• Quetiapine
• Venlafaxine
• Amitriptyline
• Imipramine
• Phenelzine
• Mirtazapine
• Lamotrigine

Drugs NOT recommended

• Clonazepam
• Olanzapine
• Alprazolam
• Cyproheptadine

American Psychiatric Association (1994). Diagnostic and Statistical Manual Of Mental Disorders, Fourth Edition, Washington, DC: American Psychiatric Press.

Foa,E.B., Davidson, J.R.T.& Frances, A , Editors (1999) Expert Consensus Guidelines Series, Treatment of Posttraumatic Stress Disorder. Journal of Clinical Psychiatry; 60 (suppl 16).

Australian Centre for Post traumatic Mental Health (1999) Post Traumatic Stress Disorder (PTSD) and War Related Stress. Information for Veterans and their Families.

Anxiety Disorders Drug Treatment Guidelines August 2008. Western Australian Psychotropic Drugs Committee www.watag.org.au

Please note, it is important to consult a qualified mental health practitioner such as e.g. a psychologist or psychiatrist to confirm any diagnosis you think you might have. You must not rely on the information on this site as a substitute for professional medical advice, diagnosis or treatment. No assurance can be given that the information on this site will always include the most recent developments or research with respect to a particular topic.

Check our page about the Stress Management Workshops we run in Melbourne.