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Post-traumatic stress disorder (PTSD) is a common, often debilitating mental health condition that occurs in some people who have experienced trauma. It can have a negative impact on mood, mimicking depression, and is characterized by petrifying episodes in which affected people re-experience the trauma. New research suggests psychotherapy may provide a long-lasting reduction of distressing symptoms.
Over the course of a lifetime, many people directly experience or witness trauma, such as sexual assault, violence, or natural disasters. Experts estimate that 10% to 20% of these people will experience acute (short-term) PTSD. Some will go on to develop chronic (long-term) symptoms. Overall, about 8% of all people will develop PTSD during their lifetime, highlighting the need for effective treatments.
What happens when people have PTSD?

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- one or more symptom of re-experiencing the trauma (sometimes called a flashback)
- one or more avoidance symptoms, such as avoiding places or objects that remind you of the original event
- two or more symptoms of arousal and reactivity, such as jumpiness, heart pounding, or sweating
- two or more symptoms of an effect on mood or cognition, such as negative thoughts or problems recalling key portions of the event.
How is PTSD treated?

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- medications, such as antidepressants known as selective serotonin reuptake inhibitors (SSRIs), and alpha-1 blockers such as prazosin (Minipress)
- certain forms of psychotherapy, such as prolonged exposure therapy and eye movement desensitization and reprocessing (EMDR).
What does new research tell us?
Rigorous new research supports using psychotherapy first, followed by medication if it fails to offer sufficient relief, or psychotherapy combined with medication from the start. This large meta-analysis, published online in JAMA Psychiatry, combined data from 12 randomized clinical trials and 922 participants. Researchers found that no particular treatment approach was superior to any other at the time of treatment. However, the benefits of psychotherapeutic approaches lasted longer. At their last documented follow up, patients with PTSD who received psychotherapy had significantly greater improvement in symptoms compared with those who received only medications. Additionally, combining both therapy and medications was significantly better in the long term than medications alone.This meta-analysis presents the strongest argument yet that evidence-based psychotherapies are superior to medications alone in helping to relieve symptoms of PTSD. Combining both approaches also holds merit and is superior to medications alone, though not statistically better than psychotherapy alone.
Which type of psychotherapy is most helpful for PTSD?

The bottom line: Advocate and seek help early

- Monitor yourself closely after a trauma.
- Be on the lookout for early symptoms, such as mood and sleep disturbances.
- Be aware of whether symptoms seem to be improving or worsening over time.
- Be willing to listen to family members, loved ones, and your healthcare team, who may identify problem areas as they arise.
- Seek treatment early, with a mental health professional who has extensive experience in treating PTSD using one of the above therapeutic approaches.
The post Psychotherapy leads in treating post-traumatic stress disorder appeared first on Harvard Health Blog.
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