PTSD: If you have PTSD, the treatment of choice is really therapy including both CBT and EMDR as optimal modalities. A benzodiazepine (Clonazepam) used prn can ameliorate the symptoms of hypervigilance and panic. Try to find a therapist with experience in treating trauma related disorders as this is likely your best bet. In my experience, the other co-morbid symptoms generally recede and disappear with effective treatment of the PTSD which is quite treatable. There has been recent research showing efficacy for propranolol to treat PTSD, even in older traumas, so that might be something to discuss with your doc. It is still an off-label use of the med, but the results of recent studies are promising. Here's a link to the 60 Minutes website which did an excellent piece on it: http://60minutes.yahoo.com/segment/21/me… Good Luck!
Source(s): 20 years as a psychotherapist with specialization in trauma treatment and dissociative disorders & Propranolol is used to treat anxiety at times, particularly stage fright, and has recently been found to show potential in preventing the development of PTSD in people exposed to trauma. It decreases the physiologic hyperarousal associated with anxiety and hence the source of its effectiveness. There is an excellent 60 Minutes segment on it on their website about the recent findings in regard to trauma and how it may prevent the memory from being stored as a trauma memory by decreasing the arousal associated with it. It seems that it blocks epinephrine, one of the hormones released under stressed, which is implicated as one of the mechanisms responsible for why trauma memories seem to be stored with all their original intensity (fear). When epinephrine is blocked, the memory is retained of the event, but not with all the attendant anxiety and hyperarousal. Source(s): 20 years as a psychotherapist Here's the link to the 60 Minutes video/transcript: http://www.cbsnews.com/stories/2006/11/2… & What you describe is not uncommon with EMDR, particularly if you have a history of traumatic experiences versus a single event trauma. Old trauma memories are often "feeders" that shape our reactions to present experiences and EMDR will often "follow the trail" of breadcrumbs back to the original traumatic experiences, so it may feel as though it gets worse before it gets better, but it does get better. Some therapists will use EMDR almost exclusively, and continue plugging away until all memories are cleared, however I think that there is value in using other approaches combined with EMDR that allow you to process trauma in different ways and also to slow down the process when it becomes overwhelming. I think it is important to slow down and absorb the impact before moving ahead as it is more tolerable and offers opportunities for people to make other kinds of connections and to deal with the unexpected. There are also conditions that need to be met for EMDR to be appropriate which involve the use of techniques aimed at stabilization and resource installment before initiating EMDR so that there is already an arsenal of coping techniques available when the emotional intensity escalates. Some of the criteria for EMDR include an already established ability to access and tolerate emotions and self-soothe without resorting to self-destructive behavior and the existence of a stable social support system. Dissociative symptoms are not necessarily a rule/out for using it, but a definite red flag and require expertise by the therapist in order to proceed. EMDR should not be done in such a way as to destabilize a person beyond the limits of their coping skills, but some temporary exacerbation of the symptoms is to be expected when there is an extensive history of abuse, though that is not always known or disclosed at the time of initiating it. Therapists need to be well-versed in a number of techniques and prepared to switch gears and handle major abreactions when they occur which is why the training for EMDR is rather extensive. EMDR is very powerful, but shouldn't be applied in a vacuum of other skills. & A psychiatrist will likely only give you meds to help decrease some of the hyperarousal symptoms, although if you are depressed you are likely on an SSRI anyhow and their effectiveness in this area is sorely limited. I suggest that you see a counselor, particularly one trained in EMDR who can help you reprocess the trauma. It is especially effective in instances of specific incident trauma. Good Luck!
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ The above came from Opester, ( http://au.answers.yahoo.com/my/profile;_ylt=ApBgZvX0DuJpT6UBYgp1Q2IW6Qt.;_ylv=3?show=GMgsaFFBaa ) at Y!A, with an amazing 67% best answers! I scanned 30 pages of her answers, looking for PTSD posts (and got sidetracked, again, as often happens); I suggest checking out a smattering of her answers, sometime. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ On the other hand, there is Cynthia Lubow, ( http://www.womenspsychotherapy.com ) who regards CBT as being inhumanely harsh, at least in the early stages of treatment and much prefers EMDR, and psychotherapy. I suggest that you view her FAQ on EMDR at http://www.womenspsychotherapy.com/EMDR.html and scan the rest of her website. ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Recovering from and Overcoming Trauma Preventing the Development of PTSD By Matthew Tull, PhD, About.com Guide About.com Health's Disease and Condition content is reviewed by the Medical Review Board See More About:ptsd resiliencycoping with stresstraumatic eventsptsd risk factorsptsd treatments
It is important to understand what factors contribute to a person overcoming trauma, especially given that many people are exposed to traumatic events at some point in their lives. However, not everyone who has experienced a traumatic event has developed or will develop PTSD. So, what differentiates those people exposed to a traumatic event who do not develop PTSD from those who do?
Resiliency and Recovery Many people have conducted research that attempts to identify what characteristics increases the likelihood that someone will develop PTSD following a traumatic event. A number of risk factors have been identified, including the type of traumatic event, history of mental illness, and a person's response at the time of the event.
Fewer people have examined what characteristics protect someone from PTSD and other problems after the experience of a traumatic event. These researchers have been interested in identifying characteristics that promote resiliency and recovery.
A Review of Characteristics Linked to Resiliency In a review all of the research on resiliency and recovery following a traumatic event, a number of factors connected with resiliency and recovery in the face of and following a traumatic event were identified. These factors are:
The ability to cope with stress effectively and in a healthy manner (not avoiding).
Being resourceful and having good problem-solving skills.
Being more likely to seek help.
Holding the belief that there is something you can do to manage your feelings and cope.
Having social support available to you.
Being connected with others, such as family or friends.
Self-disclosure of the trauma to loved ones.
Spirituality
Having an identity as a survivor as opposed to a victim.
Helping others.
Finding positive meaining in the trauma. All of these characteristics distinguished those who were able to recover from a traumatic experience and those who may have developed PTSD or other problems following a traumatic experience.
Building a Foundation for Recovery Think of these protective or resiliency factors as a foundation for recovery. The stronger these factors, the more likely they will be able to shore you up during times of extreme stress.
It is important to realize that the majority of the factors identified above are under your control. That is, you can develop these characteristics. Establish close and supportive relationships with others. Learn new healthy ways of coping with stress. Start helping others in your community. Seek help for any difficulties you may be experiencing.
Experiencing a traumatic event can have a major disruptive impact on a person's life. You can be a survivor and start taking the steps to take your life back.
Source:
Agaibi, C.E., & Wilson, J.P. (2005). Trauma, PTSD, and resilience: A review of the literature. Trauma, Violence, and Abuse, 6, 195-216.
Related Articles Risk for PTSD - Risk Factors for PTSD Traumatic Events Lead to PTSD - What Traumatic Events Lead to PTSD Risk for PTSD - Who is at Risk for PTSD Post-Traumatic Stress Disorder - Post-Traumatic Stress Disorder Description... Trauma and PTSD - Trauma and PTSD Development ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ My current post on PTSD:
There is a quiz for the presence of P.T.S.D., via http://psychcentral.com. Some of the symptoms include "flashbacks", hypervigilance, sleep disorders, especially nightmares, and just staring blankly. View the http://1-800-therapist.com/ & http://www.metanoia.org/choose/ websites, and Google:"therapists; EMDR; (your location)" or use the phone book, and/or various associations for psychiatrists and psychologists, to find the nearest one using EMDR (Eye Movement Desensitization and Reprocessing therapy). In EMDR, a therapist will ask you to revisit a traumatic event and remember the feelings, negative thoughts, or memories associated with it. While you are doing this, the therapist may hold up two fingers about eighteen inches from your face and move them from side to side. You may be asked to track the movement of the therapist’s fingers with your eyes. As you concentrate on the traumatic event during therapy, you are trying to bring its memory to life. The mental imagery you are able to conjure up during the therapy session is then processed, aided by your eye movements, facilitating the processing of painful memories, enabling some of the powerful emotional states involved to be discharged to some degree, and helping to achieve resolution and a state involving less painful emotions.
EMDR has 8 stages. Professional EMDR is always much preferable, and Opester, (who gives it a glowing recommendation) a therapist with more than 20 years experience, and a former contributor, here, stated that it was one of only two disorders which can be completely cured. Sometimes, a beta blocker, such as propranolol, or atenolol is administered prior to being asked to recount the traumatic event, reducing the emotional charge associated with it, as it is re-recorded in your memory (which has been shown to be plastic, at least to some extent, with many people). I suggest trying something milder, such as valerian, (some people get "valerian hangovers") or "Tension Tamer", or chamomile herbal tea (no milk, or cream!) from supermarket tea, vitamin, or health food aisles, at least at first, to see if sufficient, otherwise (SHORT TERM ONLY, as a risk minimisation strategy - potentially ADDICTIVE) a benzodiazapene, like Xanax. Check out medications first at: www.drugs.com and www.rxlist.com/ and http://crazymeds.us/ and www.askapatient.com/ If unable to afford it, or to locate one nearby, contact the county/local mental health agency: any therapy on offer may prove helpful, particularly if combined with appropriate medication. Contact your county/local mental health agency, and find out what help they can offer. (U.S.A.) Try phoning 211, or 411, and Google: "clinics; mhmr; (your city); (your state)" Cognitive Behavioural Therapy is also recommended, and has been used successfully, with PTSD. Some people, however, may benefit more from psychotherapy, or counselling, at least until they are some way along the path to wellness, and feeling psychologically robust enough for the harsher CBT (a free E course in it, which can help reduce the time spent in therapy sessions, is at: http://moodgym.anu.edu.au/welcome ).
Use a relaxation method daily, and when needed, like http://www.drcoxconsulting.com/managing-stress.html or http://altmedicine.about.com/cs/mindbody/a/Meditation.htm or http://www.wikihow.com/Meditate or Tai Chi, Qi Gong, or yoga. Give the EFT a good tryout, to see if it helps you. It is free via the searchbar at http://www.mercola.com "EFT" & "EFT therapists", or http://www.emofree.com Professional is best. - There is a version for use in public places, (if you want to, you can claim to have a headache, as you use the acupressure massage/tapping on your temples, but you would then be restricted to subvocalising: saying it to yourself in your mind: "Even though I suffer from PTSD, I deeply and completely accept myself." Most people are suggestible, to some degree, so you could either seek professional hypnotherapy, or, quicker, cheaper, and more conveniently: http://www.asktheinternettherapist.com Defeat Post-Traumatic Stress Disorder (PTSD) CD - MP3 or http://www.hypnotictapes.com POST TRAUMATIC STRESS SYNDROME (DISORDER) PTSD, OVERCOME _____________________________________________________________________________________ "The signature cluster of symptoms for PTS is the "re-experiencing" that takes the form of spontaneous repetitive flashbacks, nightmares and/or intrusive thoughts. These are not coming from the part of the brain where normal memories are stored, but are stuck in a more primitive, survival-based section of the brain, where they neither fade nor shift, but stay contemporaneous and current and terrifying. And you can't talk your way out of them with the best counselor or therapist in the world. Wrong chunk o' brain. You need imagery, hypnosis, acupoint release, energy work, etc etc. The other 2 symptom clusters of PTS - avoidance/numbness and alarm/ hypervigilance - can be symptoms of other conditions as well. But this is not so with re-experiencing. _____________________________________________________________________________________ Some Ideas about the Fort Hood Shooter, PTSD, Vicarious Trauma & Multiple Rotations….http://belleruthnaparstek.com/update-from-belleruth/some-ideas-about-the-fort-hood-shooter-ptsd-vicarious-trauma-multiple-rotations.html
Well, as you might imagine, since the Fort Hood shootings, the phones have been ringing off the hook and emails have been pouring in. People want to know why the Dept. of Defense and the V.A. aren’t using portable, digitized guided imagery in a more systematic way to combat PTSD in our troops, given the research results we’ve been seeing with it.
It’s hard to know where to begin, so I’ll just start with some random thoughts. Hopefully they’ll come across as sequential.
First of all, it’s always good to have public discussion about posttraumatic stress and our troops, but I’m not at all sure these particular horrific murders had anything to do with PTSD.
I don’t have enough detail to diagnose this guy, but off the top of my head, he’s more likely to be a paranoid schizophrenic under extra pressure from an imminent deployment than somebody suffering from vicarious trauma.
Vicarious trauma is the result of a caregiver’s or reporter’s or bystander’s compassion. In fact, it’s been called “compassion fatigue”. People loaded up on too much identification with the suffering of others are the least likely bunch to go around shooting innocents. Mostly, they suffer and smile less.
People with PTS rarely shoot anyone, period, and on the rare occasion that they do, it’s most likely to be themselves. (Secretary Shinseki has already reported that as many service people from Iraq and Afghanistan have committed suicide as have been killed thus far in these wars – and that’s now over 4,000, folks. Do the math and be horrified.)
Although it’s certainly possible that this was part of some radical, extremist, Islamicist, terrorist plot, it’s far more likely (again, given the limited info) that, like most paranoid schizophrenics, this guy is using the content of his religion as part of his psychotic delusional system. It’s possible that both are true, but that would be highly unusual.
If we want to get rid of PTSD, the first thing we need to do is stop the cruel, multiple rotations. We’re sending some of our service people out on their 8th rotation, people. Do you know what kind of havoc this wreaks on anyone’s psyche, let alone what it does to their families’?
We already know from a very decent pile of accruing research that the things that work quickly and efficiently on posttraumatic stress are the image-based, body-based and energy-based interventions - guided imagery, hypnosis, healing touch, biofeedback, EMDR and the like. This is because PTSD sits in the primitive, survival based parts of the brain, and you need techniques that go straight to those structures to get the job done.
The V.A. has to get over its singular love affair with Prolonged Exposure Therapy and start looking for other kinds of therapy as well - methods that don’t create as much distress, that don’t require 12 sessions with a highly trained therapist and that the troops and vets will actually use – like audio self-help, for instance – shown to be their top choice in two separate studies.
The DoD has to stop throwing frantic money at unproven (for combat stress) methods and start seeing what’s actually out there and working reliably for this population of combat-stressed service people. BG Loree K. Sutton MD at the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury (DCoE) is drowning in proposals for every possible ‘cure-all’ scheme – but we have solid results in multiple studies with imagery downloads from Duke/Durham V.A. Hospital; with imagery and biofeedback from Bethesda Naval Hospital in Maryland; from imagery and Healing Touch from Scripps Hospital in La Jolla. This is where they need to look, for heavens sake.