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Help For Ptsd And Depression

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How Are Depression And Trauma Related

PTSD, depression and healthcare workers: They need help and fast

Depression can sometimes seem to come from out of the blue. It can also be caused by a stressful event such as a divorce or a trauma. Trouble coping with painful experiences or losses often leads to depression. For example, Veterans returning from a war zone may have painful memories and feelings of guilt or regret about their war experiences. They may have been injured or lost friends. Disaster survivors may have lost a loved one, a home, or have been injured. Survivors of violence or abuse may feel like they can no longer trust other people. These kinds of experiences can lead to both depression and PTSD.

Many symptoms of depression overlap with the symptoms of PTSD. For example, with both depression and PTSD, you may have trouble sleeping or keeping your mind focused. You may not feel pleasure or interest in things you used to enjoy. You may not want to be with other people as much. Both PTSD and depression may involve greater irritability. It is quite possible to have both depression and PTSD at the same time. To find out more about the symptoms of PTSD, see What is PTSD?.

Ptsd Treatment And Therapy

Treatment for PTSD can relieve symptoms by helping you deal with the trauma youve experienced. A doctor or therapist will encourage you to recall and process the emotions you felt during the original event in order to reduce the powerful hold the memory has on your life.

During treatment, youll also explore your thoughts and feelings about the trauma, work through feelings of guilt and mistrust, learn how to cope with intrusive memories, and address the problems PTSD has caused in your life and relationships.

The types of treatment available for PTSD include:

Trauma-focused cognitive-behavioral therapy involves gradually exposing yourself to feelings and situations that remind you of the trauma, and replacing distorted and irrational thoughts about the experience with a more balanced picture.

Family therapy can help your loved ones understand what youre going through and help you work through relationship problems together as a family.

Medication is sometimes prescribed to people with PTSD to relieve secondary symptoms of depression or anxiety, although they do not treat the causes of PTSD.

EMDR incorporates elements of cognitive-behavioral therapy with eye movements or other forms of rhythmic, left-right stimulation, such as hand taps or sounds. EMDR therapy techniques work by unfreezing the brains information processing system, which is interrupted in times of extreme stress.

Signs And Symptoms Of Ptsd

PTSD develops differently from person to person because everyones nervous system and tolerance for stress is a little different. While youre most likely to develop symptoms of PTSD in the hours or days following a traumatic event, it can sometimes take weeks, months, or even years before they appear. Sometimes symptoms appear seemingly out of the blue. At other times, they are triggered by something that reminds you of the original traumatic event, such as a noise, an image, certain words, or a smell.

While everyone experiences PTSD differently, there are four main types of symptoms.

  • Re-experiencing the traumatic event through intrusive memories, flashbacks, nightmares, or intense mental or physical reactions when reminded of the trauma.
  • Avoidance and numbing, such as avoiding anything that reminds you of the trauma, being unable to remember aspects of the ordeal, a loss of interest in activities and life in general, feeling emotionally numb and detached from others and a sense of a limited future.
  • Hyperarousal, including sleep problems, irritability, hypervigilance , feeling jumpy or easily startled, angry outbursts, and aggressive, self-destructive, or reckless behavior.
  • Negative thought and mood changes like feeling alienated and alone, difficulty concentrating or remembering, depression and hopelessness, feeling mistrust and betrayal, and feeling guilt, shame, or self-blame.
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    Treatment For Children And Teenagers With Ptsd

    For children and teenagers who are struggling to recover after a traumatic event, the recommended treatment is trauma-focussed cognitive behavioural therapy . This treatment involves:

    • learning about the type of traumatic event experienced and common reactions to trauma
    • teaching how to relax and manage anxiety
    • helping to create a coherent story of the traumatic event, and correct any unhelpful beliefs about the event such as self-blame
    • gradual exposure to trauma-related objects or situations that are feared or avoided
    • helping to get back into everyday activities.

    Can Psilocybin Help Treat Ptsd

    Depression treatment: PTSD Treatment to Help You Get By

    While therapy, antidepressants, and antipsychotics help many patients, these methods often fall short. Studies have suggested that antidepressants do not work well for people who have had multiple traumas over the course of years or chronic PTSD. A new study found that the antipsychotic risperidone worked no better than a placebo in alleviating typical PTSD symptoms in patients who had the disorder long-term or who continued to experience symptoms after being treated with antidepressants.

    Because these drugs can also cause intolerable side effects, many patients are left to experience PTSD with no sign of relief. Many of these patients turn to substance abuse, develop anger management issues, or commit suicide. A study analyzing data from the National Comorbidity Survey showed that out of six anxiety diagnoses, PTSD was significantly associated with suicide attempts.

    Stephen Ross, MD, a psychiatrist at NYU Langone, conducted a study on terminally ill cancer patients , and found that one-time treatment with psilocybin very quickly brought relief from distress that had lasted more than 6 months in 80 percent of study subjects.

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    What Does A Primary Care Physician Do

    A primary care physician is a medical doctor . They can treat common medical problems, and may also be trained to recognize and help with common psychological problems, such as depression and anxiety.

    A primary care physician can help you with:

    • Medical attention
    • A prescription to help with depression or sleep problems
    • A referral to a psychologist, social worker, or psychiatrist

    You can find a primary care physician:

    • Through the public health care
    • In the Canadian military
    • Through people you know

    Emotional And Psychological Trauma

    If youve experienced an extremely stressful eventor series of eventsthats left you feeling helpless and emotionally out of control, you may have been traumatized. Psychological trauma often has its roots in childhood, but any event that shatters your sense of safety can leave you feeling traumatized, whether its an accident, injury, the sudden death of a loved one, bullying, domestic abuse, or a deeply humiliating experience. Whether the trauma happened years ago or yesterday, you can get over the pain, feel safe again, and move on with your life.

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    Cognition And Mood Symptoms Include:

    • Trouble remembering key features of the traumatic event
    • Negative thoughts about oneself or the world
    • Distorted feelings like guilt or blame
    • Loss of interest in enjoyable activities

    Cognition and mood symptoms can begin or worsen after the traumatic event, but are not due to injury or substance use. These symptoms can make the person feel alienated or detached from friends or family members.

    It is natural to have some of these symptoms for a few weeks after a dangerous event. When the symptoms last more than a month, seriously affect ones ability to function, and are not due to substance use, medical illness, or anything except the event itself, they might be PTSD. Some people with PTSD dont show any symptoms for weeks or months. PTSD is often accompanied by depression, substance abuse, or one or more of the other anxiety disorders.

    Evidence Supporting Ptsd/mdd Comorbidity As An Artifact Of Symptom Overlap

    PTSD and Depression Benefits for Veterans

    The diagnostic criteria for a major depressive episode have remained essentially constant across versions of the DSM from 1980 to 2013. There are 9 diagnostic criteria, and 5 must be present in order to meet diagnostic threshold. A DSM-III5 diagnosis required that 1 of the 9 criteria include depressed mood. In DSM-III-R6 and later versions,79 the criteria were revised such that the symptom of anhedonia could substitute for depressed mood. In contrast, the diagnostic criteria for PTSD have changed substantially over the same time period. Table I presents the symptom lists for the different versions of DSM. Note that the DSM-IIIR, DSM-W, and DSM-TV-TR versions are presented together in one column, as the criteria did not change appreciably across these three versions. The PTSD symptoms that overlap with MDD are presented in red text and include anhedonia, sleep disturbance, and concentration difficulties three symptoms that appear in the PTSD diagnosis across all versions of the DSM. The number of possible PTSD symptoms expanded from 12 in DSM-III to 20 in DSM-5. New symptoms that appear with iterations of the PTSD diagnosis are shown in blue text. The changes to the PTSD diagnosis in DSM-5 also brought forth a new symptom that overlaps between the two disorders, as guilt was added to the PTSD diagnostic criteria. Note that this symptom was present in the original diagnostic description of PTSD in DSM-III.

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    Ptsd Treatments That Work

    Four psychotherapeutic interventions are strongly recommended, all of which are variations of cognitive behavioral therapy and are trauma-focused:

    • Cognitive Behavioral Therapy focuses on changing patterns of behaviors, thoughts and feelings that lead to difficulties in functioning.
    • Cognitive Processing Therapy focuses on thoughts developed as a result of the trauma and helps the person learn how to modify and challenge unhelpful thoughts related to the trauma.
    • Cognitive Therapy entails analyzing distorted thinking and reshaping beliefs and thoughts in relation to the trauma that have been interfering with daily life.
    • Prolonged Exposure therapy teaches individuals to gradually approach trauma-related memories, feelings and situations and learn that the trauma-related memories and cues are not dangerous and do not need to be avoided.

    Three psychotherapies are also recommended although less strongly:

    • Brief Eclectic Psychotherapy combines CBT techniques with psychodynamic strategies and focuses on changing the emotions of shame and guilt.
    • Eye Movement Desensitization and Reprocessing Therapy encourages the person to briefly focus on the trauma memory while simultaneously experiencing bilateral stimulation , which is associated with a reduction in the vividness and emotion associated with the trauma memories.
    • Narrative Exposure helps individuals establish a coherent life narrative in which to contextualize traumatic experiences.


    Supporting Someone With Ptsd

    Research has shown that support from family and friends is important in helping someone overcome the debilitating effects of PTSD. Couples or family therapy can help to fix damaged relationships. In some cases, family members may need to seek support of their own.

    For detailed information on the most effective treatments for PTSD, see The Australian Guidelines for the Treatment of Acute Stress Disorder and Posttraumatic Stress Disorder.

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    The Benefits Of Medication

    There are four main reasons for why medication may help with PTSD:

    • medication can help to reduce PTSD symptom clusters, such as avoidance or hyperarousal
    • medication can help improve sleep problems, decrease nightmares, and help with panic attacks and issues with concentration
    • medication helps with mental health disorders that may occur with PTSD, such as depression or anxiety
    • medication may reduce clinical symptoms such as impulsive, aggressive, or suicidal behaviours that can frequently complicate the management of PTSD.

    Where & When To Find Ptsd Treatment

    Dealing with Depression, Anxiety, & PTSD

    When seeking help for PTSD, people should first see their primary care physician to address any physical causes for the symptoms. While there is no specific timeframe for getting help, patients are encouraged to seek help as soon as they identify that the problem is persistently affecting their lives negatively. After addressing any health issues with a PCP, patients should seek help from a mental health provider. Look for someone who has experience in trauma-informed care, and dont be afraid to ask ahead of the first meeting whether they specialize in recovery from trauma.

    People might begin the search for a therapist by asking their family and friends for recommendations or checking with their insurance provider to find an in-network therapist this often helps lower therapy costs. Alternatively, they could begin with an online therapist directory, which allows filtering by insurance coverage, location, gender, specialty, and more.

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    Acceptance & Commitment Therapy

    Acceptance and commitment therapy is a newer model of CBT. It focuses on acknowledging and accepting ones thoughts and emotions surrounding the stress-related stimuli and memories of the traumas instead of necessarily controlling or challenging ones thoughts.

    While it does involve CBT techniques, ACT reduces the power that the trauma event has on the individual. ACT is an offshoot of mindfulness-based and CBT-based specific treatments that continues to be developed. Mindfulness techniques help to provide coping skills to reduce anxiety related to PTSD.1,3,6,9

    Tip : Support Ptsd Treatment With A Healthy Lifestyle

    The symptoms of PTSD can be hard on your body so its important to take care of yourself and develop some healthy lifestyle habits.

    Take time to relax. Relaxation techniques such as meditation, deep breathing, massage, or yoga can activate the bodys relaxation response and ease symptoms of PTSD.

    Avoid alcohol and drugs. When youre struggling with difficult emotions and traumatic memories, you may be tempted to self-medicate with alcohol or drugs. But substance use worsens many symptoms of PTSD, interferes with treatment, and can add to problems in your relationships.

    Eata healthy diet. Start your day right with breakfast, and keep your energy up and your mind clear with balanced, nutritious meals throughout the day. Omega-3s play a vital role in emotional health so incorporate foods such as fatty fish, flaxseed, and walnuts into your diet. Limit processed food, fried food, refined starches, and sugars, which can exacerbate mood swings and cause fluctuations in your energy.

    Get enough sleep. Sleep deprivation can trigger anger, irritability, and moodiness. Aim for somewhere between 7 to 9 hours of sleep each night. Develop a relaxing bedtime ritual and make your bedroom as quiet, dark, and soothing as possible.

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    Support Is Important For Recovery

    Many people experience some of the symptoms of PTSD in the first two weeks after a traumatic event, but most recover with the help of family and friends. For this reason, for a diagnosis of PTSD is not made until a month after the event. Treatment does not usually start for at least two or more weeks after a traumatic experience. However if the event is very distressing and emotions and reactions are intense, it is advisable to seek help as early as possible to understand what is happening and help recovery to start.

    It is important during the first few days and weeks after a traumatic event to get whatever help is needed. This may include accessing information, people and resources that can help you to recover. Support from family and friends may be all that is needed. Otherwise, a doctor is the best place to start to get further help.

    Cbt For Ptsd Caused By Abuse

    Transcranial Magnetic Stimulation | PTSD, Anxiety & Depression Treatment | TMS Therapy | theSITREP

    Bill, a 40-year-old who was physically abused by his parents until he was 18, reports a history of PTSD symptoms beginning in his early 20s. He experienced a heightened startle reflex to any sudden movement, avoidance of talking about the abuse he experienced, constant tenseness in his body, and significant anger with people in his life.

    At around 17 years old, Bill began drinking alcohol to cope with the abuse he was experiencing at home. This led to alcohol charges for a minor for which he was placed in juvenile detention. He now drinks daily, generally at least twelve 16-oz cans of beer in a day, and has been arrested for disorderly conduct. He works infrequently but in the last three months has been unsuccessfully attempting to cut back on drinking and find regular work.

    Bill agrees to complete an assessment with a local therapist who is trained in trauma and substance use treatment. The therapist diagnoses Bill with PTSD and an alcohol use disorder and informs Bill that they would like to try applying acceptance and commitment therapy in their sessions. Bills therapist helps him by encouraging him to accept feelings or thoughts that come up during sessions he hopes that Bill will begin to be able to do this at home, becoming accepting of himself in and out of session.

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    Next Steps For Ptsd Research

    In the last decade, progress in research on the mental and biological foundations of PTSD has lead scientists to focus on better understanding the underlying causes of why people experience a range of reactions to trauma.

    • NIMH-funded researchers are exploring trauma patients in acute care settings to better understand the changes that occur in individuals whose symptoms improve naturally.
    • Other research is looking at how fear memories are affected by learning, changes in the body, or even sleep.
    • Research on preventing the development of PTSD soon after trauma exposure is also under way.
    • Other research is attempting to identify what factors determine whether someone with PTSD will respond well to one type of intervention or another, aiming to develop more personalized, effective, and efficient treatments.
    • As gene research and brain imaging technologies continue to improve, scientists are more likely to be able to pinpoint when and where in the brain PTSD begins. This understanding may then lead to better targeted treatments to suit each persons own needs or even prevent the disorder before it causes harm.

    Is Cbt Effective For Ptsd

    While cognitive behavioral therapy research continues to grow, it is one of the most widely-researched psychotherapy treatments and has been found to be effective in short- and long-term approaches as well as with a variety of populations, ranging from PTSD in young children to older adults.2,4

    Here are several studies highlighting the effectiveness of CBT for PTSD:

    • CBT has been researched and observed to be as effective as a number of other therapy types, and research indicates that it has been culturally validated across a variety of populations.4
    • Compared to a placebo, CBT was reported to be moderately helpful in treating anxiety-related disorders. The researchers did note that drop out rates were higher in PTSD samples, especially in the exposure therapy group, which infers a need for more specialized types of CBT for PTSD.11
    • A research review notes that CBT can be an appropriate, safe, and helpful intervention in the presentation of acute and chronic PTSD for people of any age.4
    • Research noted a significant improvement and significant reduction in symptoms of PTSD, in addition to feelings of depression and anxiety.12
    • After reviewing clinical trials ranging from 1980 to 2005, researchers noted that CBT had significantly maintained healthy behaviors after treatment in comparison to EMDR and therapies that are more supportive. CBT was equal to exposure therapy and cognitive therapy in reducing PTSD symptoms and the maintenance of healthy behaviors.13

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