What is post-traumatic stress disorder (PTSD)?

Post-traumatic stress disorder, also known as PTSD, occurs as a result of an event involving impending death or severe injuries, or posing a massive threat to one’s own physical integrity or that of others. Typical triggers are accidents, attacks or rapes, but they can sometimes also include giving birth, surgery or incorrect information given in the event of life-threatening illnesses. A feeling of utter helplessness or horror develops, and this in its turn leads to sleep problems, increased vegetative arousal and often social withdrawal.

Posttraumatische Belastungsstörung Behandlung Psychosomatik ptbs. ptsd

Foto: Tyler Sturos / Pixabay

How does PTSD affect a person?

If a person is affected by a traumatic event and cannot defend himself against it, the processing takes place during sleep. This often creates nightmares and sleep disorders. If the processing of the trauma is successful, a memory remains, but it is not accompanied by violent emotions or vegetative reactions such as rapid heartbeat, sweating, nausea or the like.
Post traumatic stress disorder develops If the brain is overwhelmed with the processing of the trauma, memories and feelings cannot be separated. Certain triggers revive the images of the trauma, including the violent feelings and vegetative reactions. This often leads to permanent vegetative tension and a social withdrawal.

Sometimes a first trauma is processed relatively well and only a new traumatization leads to a post-traumatic stress disorder (PTSD).

It is now assumed that between 5 and 10% of the population will be severely traumatized at some point during their lives and will develop PTSD, post-traumatic stress disorder.

Symptoms of post-traumatic stress disorder

Alongside sleep problems there are frequently flashbacks, in which certain images or smells resurrect the traumatic situation. For many affected patients, this leads to attempts of treating their own symptoms with alcohol, cannabis, opiates, benzodiazepines or other drugs. Chronic pain may also occur as a result of a traumatic event, as well as depression and anxiety disorders. Unfortunately, the causative traumatisation is not always identified, which can lead to improper treatment.

Many people who appear to be suffering from addictions or chronic pain syndromes actually suffer from an undetected and untreated PTSD. It is not uncommon for this to occur in persons who do not want to admit to being “weak”: soldiers, firefighters, emergency doctors. Sometimes it is the relatives who first notice how the person gradually changes. Social withdrawal, partnership problems, increasing alcohol and drug use can also be symptoms of post-traumatic stress disorder. The risk of suicide is significantly increased in people who suffer from PTSD.   

Treatment of PTSD

The sooner PTSD is treated, the better the prognosis, though old traumas can be treated successfully as well.

The EMDR therapy method (Eye Movement Desensitization and Reprocessing) has proven particularly useful in the treatment of post-traumatic stress disorder. It is considered the world’s most effective treatment for PTSD.
Before treating post-traumatic stress disorder with EMDR, a trusting relationship between patient and therapist needs to be established and a safe environment needs to be created. The therapist then asks the patient to remember certain events while making rapid eye movements from left to right. These eye movements typically occur in REM sleep (hence the name REM: rapid eye movement), in which we dream and process experiences. In therapy, this method makes treatment of the trauma possible and the associated negative feelings are weakened. In addition to rapid eye movements, other bilateral stimulations can also be performed.

Hypnosis and exposure therapy in virtual reality can also be used, during which the traumatic events can be remembered, controlled and the emotions can be changed in a safe environment.

Relaxation techniques such as auto relaxation training, progressive muscle relaxation and mindfulness based stress reduction are also an important part of therapy, as they help to reduce the vegetative state of arousal and ensure better sleep.

In addition to intensive, trauma-specific psychotherapy, pharmacological treatments and brain stimulation therapies such as rTMS or tDCS are used in the treatment of post-traumatic stress disorders. Antidepressants are traditionally used, but usually this shows only moderate improvement of the PTSD.

Treatment of post-traumatic stress disorder with Ketamine infusion therapy

Recent studies prove the effectiveness of Ketamine infusion therapy in combination with neurofeedback, HRV biofeedback and repetitive transcranial magnetic stimulation.
The antidepressant and dissociative effects of ketamine help to “overwrite” traumatic memory, similar to how the ketamine treatment works with the addictive memory of patients with addictions. Neurofeedback and HRV biofeedback help to reduce vegetative arousal. RTMS reduces the depressive parts of the disorder and helps against addiction pressure and chronic pain.
However, the Ketamine infusion therapy should only be done as part of psychotherapy and with a psychotherapist experienced in this kind of therapy. The Instituto Dr. Scheib is one of the few clinics in Europe who has long  been using the Ketamine-combination therapy successfully for pathologies like PTSD, severe depression, addiction and anxiety, amongst others.

All of these forms of therapy serve to complement the psychotherapeutic treatment and should not be used alone.

It is important for all traumatized patients to avoid triggering renewed traumatization during the treatment. That is why a trusting therapist-patient relationship is paramount.
Patients who suffer from post-traumatic stress disorder should always be given a specialized therapy with trained therapists!

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