Post-Traumatic Stress Disorder

PTSD is diagnosed through comprehensive psychiatric evaluation assessing: exposure to a traumatic event (experienced, witnessed, or learned about); presence of symptoms from all four clusters (intrusion, avoidance, negative cognitions/mood, and arousal/reactivity); symptom duration of more than one month; and significant distress or functional impairment. We may use validated tools like the PCL-5 or CAPS-5 to assess severity. You don't have to share detailed trauma narratives for diagnosis—we work at your pace. We also screen for complex PTSD, which may develop from prolonged, repeated childhood trauma or captivity.

PTSD develops after experiencing or witnessing traumatic events—combat exposure, sexual assault, serious accidents, natural disasters, childhood abuse or neglect, domestic violence, sudden violent death of a loved one, or other life-threatening situations. Not everyone who experiences trauma develops PTSD. Risk factors include: severity and duration of trauma; personal history of trauma or mental health conditions; lack of social support after the event; experiencing additional stress after trauma; and biological factors affecting stress response. PTSD involves changes in how the brain processes threat, memory, and emotion—it's not a sign of weakness but a response to overwhelming experience.

Evidence-based treatments include trauma-focused psychotherapies recommended by major clinical guidelines: Cognitive Processing Therapy (CPT) helps examine and change unhelpful beliefs about the trauma; Prolonged Exposure (PE) involves gradually facing trauma-related memories and situations; EMDR (Eye Movement Desensitization and Reprocessing) uses bilateral stimulation during trauma processing. Medication can help manage symptoms: SSRIs (sertraline, paroxetine) and SNRIs (venlafaxine) are first-line; prazosin helps with nightmares. We coordinate with therapists providing these evidence-based treatments while managing medication to help you engage in therapy effectively.

Yes, many people with PTSD achieve significant recovery or complete remission with appropriate treatment. Evidence-based trauma-focused therapies (CPT, PE, EMDR) have strong research support showing that most people improve substantially. Recovery doesn't mean forgetting what happened or never being affected by reminders—it means traumatic memories no longer intrude on daily life, the past no longer controls your present, and you can function, connect with others, and experience positive emotions again. Some people recover without any lasting symptoms; others may have occasional difficulties but manage well. With proper treatment, you don't have to remain trapped in the past.

SSRIs sertraline (Zoloft) and paroxetine (Paxil) are FDA-approved for PTSD and considered first-line medications. The SNRI venlafaxine (Effexor) is also effective. These medications help with intrusive symptoms, avoidance, emotional numbing, and depression. Prazosin is particularly helpful for trauma-related nightmares and sleep disturbance. Medication can help stabilize symptoms so you can engage effectively in trauma-focused therapy—the combination of medication and therapy is often most effective. We avoid benzodiazepines for PTSD as they may interfere with trauma processing and carry risks of dependence.

Yes, PTSD very commonly co-occurs with other conditions. Major depression affects approximately 50% of people with PTSD. Substance use disorders are common—many people use alcohol or drugs to cope with PTSD symptoms. Anxiety disorders including panic disorder, generalized anxiety, and social anxiety frequently co-occur. Chronic pain, sleep disorders, and traumatic brain injury may accompany PTSD. Complex PTSD from prolonged childhood trauma may include additional features like emotional dysregulation and relationship difficulties. Comprehensive evaluation identifies all conditions requiring treatment.

Seek help if you experience: intrusive memories, flashbacks, or nightmares about a traumatic event; avoidance of reminders that significantly limits your life; emotional numbness or feeling disconnected from others; persistent negative beliefs about yourself or the world; hypervigilance, difficulty sleeping, or being easily startled; difficulty functioning at work, in relationships, or daily life. Symptoms lasting more than a month after trauma warrant evaluation. If you're having thoughts of suicide or self-harm, seek immediate help—call 988 (Suicide & Crisis Lifeline), go to the ER, or call 430-288-5800. Many people wait years to seek treatment—but earlier treatment leads to better outcomes. You don't have to keep suffering.