Treatment Options for Trauma Survivors with PTSD

This article is part of the Traumatic Birth Prevention & Resource Guide by PATTCh. Access the complete guide to learn more about traumatic birth and find resources for women and families.

By Kathleen Kendall-Tackett, PhD, IBCLC, FAPA

Traumatic events can have a long-term impact on both your mental health and the overall quality of your life. Fortunately, you have a wide range of possible treatment options available to you. Comprehensive trauma treatment involves patient education, peer support, trauma-focused psychotherapy, and medications.

Education and Peer Counseling

The role of both patient education and peer counseling is to help you understand your experiences and reactions after trauma. Education and support lets you know that your reactions are both normal and predictable, and your symptoms are not your fault (Friedman, 2001; Kendall-Tackett, 2010).

Trauma-focused Psychotherapy

The two most effective therapies for PTSD and trauma symptoms are cognitive behavioral therapy and EMDR.

• Cognitive-Behavioral Therapy (CBT) -- CBT includes several modalities, including cognitive therapy, exposure therapy, and stress-inoculation therapy. All types of therapy address beliefs caused by trauma (e.g., that you are helpless) and also helps counter conditioned-fear responses. If treatment has been successful, you will be able to confront your traumatic past without triggering PTSD symptoms (Friedman, Cohen, Foa, & Keane, 2009).

• Eye Movement Desensitization and Reprocessing (EMDR) -- EMDR is highly effective and considered a frontline treatment for PTSD. In EMDR, you are instructed to think about your traumatic experience while moving your eyes back and forth following the therapist's fingers as they briefly move across your field of vision (Friedman, 2001; Friedman, et al., 2009; van der Kolk, 2002). It is based on the hypothesis that saccadic eye movements can reprogram the brain, and therefore can be used to help alleviate the emotional impact of trauma (Friedman, et al., 2009). EMDR reduces symptoms after just a few sessions. Certified practitioners of EMDR can be found at the EMDR Institute or the EMDR International Association

Medications

There are several classes of medications that can be used to treat PTSD.

• Antidepressants -- Antidepressants are a key part of treatment for PTSD. The Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin/Norepinephrine Reuptake Inhibitors (SNRIs) are frontline medication choices in that they treat all types of PTSD symptoms, and include medications like Zoloft, Paxil, Lexapro, Prozac, and Effexor (International Society for Traumatic Stress Studies, 2009).

• Adrenergic Agents and Atypical Antipsychotics -- Other medications that may be added if the SSRIs/SNRIs and/or psychotherapy are not bringing you sufficient relief of symptoms. These include adrenergic agents and atypical antipsychotics.'  These can be helpful for symptoms such as nightmares and intrusive thoughts (International Society for Traumatic Stress Studies, 2009).

• Benzodiazepines -- In the past, trauma survivors were often been prescribed benzodiazepines, such as Valium, to help them cope their trauma symptoms. These medications are no longer considered appropriate for patients with trauma because they can make depression worse, and are also addictive (International Society for Traumatic Stress Studies, 2009).

For information on all of these types of medications that can be safely used while you are pregnant or breastfeeding, visit the InfantRisk Center Website.

Summary

If you have experienced trauma, you do not need to continue to suffer in silence. You have many treatment options. And in most cases, these treatments can be safely used while you are pregnant or breastfeeding. For more information, visit the National Center for PTSD, or the International Society for Traumatic Stress Studies.

References

Friedman, M. J. (2001). Posttraumatic stress disorder: The latest assessment and treatment strategies. Kansas City, MO: Compact Clinicals.

Friedman, M. J., Cohen, J. A., Foa, E. B., & Keane, T. M. (2009). Integration and summary. In E. B. Foa, T. M. Keane, M. J. Friedman & J. A. Cohen (Eds.), Effective treatments for PTSD: Practice guidelines from the International Society for Traumatic Stress Studies (pp. 617-642). New York: Guilford.

International Society for Traumatic Stress Studies (Ed.). (2009). Effective Treatments for PTSD: Psychopharmacology for adults (Guideline 6). New York: Guilford.

Kendall-Tackett, K. A. (2010). Depression in new mothers: Causes, consequences and treatment options, 2nd Edition. London: Routledge.

van der Kolk, B. A. (2002). Assessment and treatment of complex PTSD. In R. Yehuda (Ed.), Treating trauma survivors with PTSD (pp. 127-156). Washington, DC: American Psychiatric Association Press.' 

Kathleen Kendall-Tackett, PhD, IBCLC, is a health psychologist and board-certified lactation consultant. Dr. Kendall-Tackett is a Fellow of the American Psychological Association in both health and trauma psychology, and is a clinical associate professor of pediatrics at Texas Tech University School of Medicine in Amarillo, Texas. She is the owner of' Praeclarus Press, a small press focusing on women's health and is editor-in-chief of the journal' Clinical Lactation.' Dr. Kendall-Tackett also can be found at' Uppity Science Chick,' Breastfeeding Made Simple, and' www.facebook.com/kathleen.kendalltackett. She' is a board member of PATTCh.

PATTCh is a not-for-profit, multidisciplinary organization dedicated to the prevention and treatment of traumatic childbirth. Our mission is to develop cross-disciplinary relationships, research, and programs that:

• prevent PTSD following childbirth through education, interdisciplinary collaboration, and multidisciplinary research;
• educate perinatal care providers and paraprofessionals in the prevention and treatment of birth and reproduction related trauma;
• encourage the development of culturally appropriate therapeutic approaches to post-traumatic stress symptoms following childbirth;
• promote healthy birth practices for all women and families;
• promote evidence-based research regarding PTSD secondary to childbirth;
• increase global awareness of the prevalence, risk factors, and effects of PTSD secondary to childbirth; and
• support collaboration and understanding among all stake-holders, including: researchers, policy makers, medical and mental health care providers, educators, community members, volunteers, women, and families.