PTSD TREATMENT: MEDICATION AND ITS ROLE IN RECOVERY Though it can be an extremely useful component in PTSD treatment, medication is not in and of itself a solution to post-traumatic stress disorder. Recovery from this debilitating mental condition depends upon thorough and intensive psychological treatment. UNDERSTANDING PTSD Post-traumatic stress disorder (PTSD) is a mental condition that results from the residual effects of profoundly disturbing, or traumatic, experiences. Because trauma is an internal phenomenon, it is dictated not by the outer descriptors of an event, but rather by the individual’s personal response to it. Accordingly, traumatic experiences vary dramatically from case to case, but tend to share a theme of fundamental violation. Types of trauma typically associated with PTSD are physical abuse, sexual abuse, and involvement in violent situations, such as combat. Less physically intrusive experiences like verbal and emotional abuse, neglect, and untimely loss of a loved one can also cause an individual to develop PTSD. No matter the specific incident or incidents that cause the disorder, the sense of violation that they produce unifies them in a way that allows a protocol to exist for PTSD treatment. Medication works alongside an arsenal of varied therapeutic approaches to give each patient as many tools as possible in PTSD recovery. Symptoms of PTSD fall into three categories: Re-experience, avoidance, and hyper-arousal. The first of these categories, re-experience, is the predominant, other symptoms stemming from this problematic pattern of returning mentally to the scene of trauma. Upsetting and persistent thoughts about a traumatic event are common, as well as recurring nightmares about the event. More intense “flashbacks” are a key symptom of PTSD, in which the individual actually feels and acts as though they are reliving the original traumatic experience. The body may also physically respond to reminders of past trauma with increased heart rate or sweating. The second category, avoidance, encompasses PTSD symptoms that display an individual’s wariness of situations that may trigger distressing memories or flashbacks, both consciously and unconsciously. Individuals with PTSD often make a conscious effort to avoid talking, thinking or feeling emotions about past trauma. Accordingly, they also commonly choose to avoid people and places that remind them of a traumatic event. The mind of an individual with PTSD may also act of its own accord to aid in avoiding the re-experience of a traumatic event. This often manifests as an inability to remember important details about a traumatic event. When a person’s brain begins to grow accustomed to patterns of avoidance, depressive side effects begin to develop. Loss of interest in activities that were once enjoyable, feelings of isolation, and difficulty connecting with positive emotions like affection or happiness are examples of this phenomenon. Hyper-arousal symptoms, such as insomnia, irritability, and “jumpiness” can also be interpreted as attempts at self-protection. Sleeping is an activity that requires complete vulnerability, a prospect that can be terrifying to a person suffering from PTSD. Inability to fall or remain asleep, difficulty concentrating, and constant vigilance are all attempts, however misdirected, at protecting one’s self from further harm. All of these varied symptoms are addressed in an effective program of PTSD treatment. Medication is used in combination with therapeutic methods to alleviate symptoms, allowing the patient to resume living normally. HOME-BREWED PTSD TREATMENT: MEDICATION VS. SELF-MEDICATION The rate of substance abuse problems amongst people with PTSD is shockingly high, with 31% having struggled with drug abuse or dependence and 40% with alcohol abuse or alcoholism. This abnormally high co-occurrence can be explained by the phenomenon of self-medication. Many who suffer from PTSD are unaware that their problems are in fact a legitimate diagnosable disease. Those who do have some understanding of the fact that their woes are the result of past traumatic experiences often feel that they are responsible for their dysfunctional state, or do not see it as something that can be cured. Unaware that PTSD treatment, medication, and therapy are all options that can improve their situations, many individuals who suffer from PTSD turn instead to alcohol and illegal drugs as emotional pain-killers. For those whose lives are impeded on a day-to-day basis by symptoms of PTSD, alcohol and drugs present a welcome escape route. Specifically, substances that fall into the depressant category function as “medication” for hyper-arousal symptoms of PTSD. Drugs that create a feeling of emotional numbness allow a person with PTSD to expose themselves to situations that might otherwise trigger an intense emotional reaction. While drug and alcohol consumption may initially reduce PTSD symptoms, it is counterproductive as a long-term treatment strategy. When substances wear off, PTSD symptoms often return even stronger, and drug and alcohol abuse brings its own set of problems when it becomes a regular activity. People who self-medicate for PTSD with alcohol and drugs increase the risk of incurring many undesirable consequences, such as depression, suicide, legal difficulties, medical complications, relationship problems, and psychiatric hospitalization. PTSD TREATMENT: MEDICATION When combined with other methods of PTSD treatment, medication (when taken as prescribed by a licensed professional) can be of great help in alleviating PTSD symptoms, and can help patients become more receptive to therapy. Recognized by the U.S. Food and Drug Administration as effective in PTSD treatment, medication that falls into the category of selective serotonin reuptake inhibitors (SSRIs), are widely prescribed for this application. Medications in this family (e.g. Prozac, Zoloft, and Paxil) reduce anxiety and depression in PTSD patients. Though still being evaluated by the FDA, D-cylcloserine (DCS) may be even more effective in alleviating PTSD symptoms. Known to separate memories from stimuli once associated with them, it may be effective as a means of decreasing the fear and panic PTSD patients experience when remembering a traumatic event. Propanolol, a beta-blocker, may also be useful in PTSD treatment, as it has the potential to curb hyper-arousal symptoms like restlessness and insomnia. TREATING PTSD: THE DUAL APPROACH Though it can be quite helpful in PTSD treatment, medication alone will not free an individual from PTSD. Therapy must be used in tandem with medication if true progress is to be made. Medication is a fast-acting remedy that can lessen PTSD symptoms while other treatment continues, but PTSD sufferers must work thoroughly and gradually through the therapeutic aspect of treatment. When used appropriately and as a supplement to therapy, medication is effective in treating PTSD, but it cannot stand on its own as a cure.