Special treatment concept for patients with posttraumatic stress disorder and trauma sequelae.
Posttraumatic stress disorders result from stresses of exceptional magnitude or catastrophic extent. There is a sense of helplessness and a shattering of the understanding of the ego and the world. Sleep disturbances, increased vegetative tension, concentration disorders, affectability, depression, anxiety and avoidance behavior follow. Many patients withdraw socially, drug abuse increase, along with suicidality. Chronic pain syndromes are often the result of a posttraumatic stress disorder.
Conventional therapy approaches with antidepressants are usually unsuccessful. Specific psychotherapeutic techniques, e.g. EMDR (Eye Movement Desenzitization and Reprocessing) are often successful; However, qualified therapists are only available to a limited extent. In addition, different patients respond differently to the respective procedures.
We offer a special program for Traumapatients at Clinica Luz. This program lasts three weeks and combines a variety of proven procedures that complement each other and strengthen each other.
Ketamine – actually a long-established and safe narcotic agent – has a clear effect on mood in depressed patients within 24 hours of administration in a low dose and leads to a reduction in suicide ideation. In addition, it improves remembrance and memory. We administer ketamine as an infusion over about 40 minutes under medical supervision. The patient remains fully conscious.
Feder et al: Efficacy of Intravenous Ketamine for Treatment of Chronic Postraumatic Stress Disorder. JAMA, 2014
2. Neurofeedback and HRV-Biofeedback
After creating a quantitative EEG and measuring the heart rate variability, an individual training plan is created for the patient. In neurofeedback, the electrical activity of the brain is measured and selectively inhibited or stimulated in certain regions of the brain via a biofeedback system. In HRV biofeedback, the vegetative basal excitement, which is usually increased in trauma patients, is reduced.
Tan et al: Heart Rate Variability an Posttraumatic Stress Disorder. Appl Psychophysiol Biofeedback. 2011
Bessel et al: A Randomized Controlled Study of Neurofeedback for Chronic PTSD. 2016 http://dx.doi.org/10.1371/journal.pone.0166752
Reiter et al.: NeurofeedbackTreatment and Posttraumatic StressDisorder: Effectiveness of Neurofeedback on Posttraumatic StressDisorder and the Optimal Choice of Protocol. J Nerv Ment Dis. 2016
Eye-Movement-Desensitation-and-Reprocessing is a therapy method especially developed for trauma patients, which is based on the reciprocal stimulation of both brain hemispheres by fast eye movements or other stimuli. The procedure leads to a clear symptom improvement after only a few sessions in most patients. The high efficiency of the process is proven.
Chen et al: Efficacy of eye-movement desensitization and reprocessing for patients with posttraumatic-stress disorder: a meta-analysis of randomized controlled trials.2014 https://www.ncbi.nlm.nih.gov/pubmed/25101684
Mindfulness based Stress Reduction is a program for stress management by means of targeted control of attention, mindfulness and relaxation techniques. During his stay the patient learns the procedure to be able to apply it later in daily life for stress reduction.
Polysny et al: Mindfulness-Based Stress Reduction for Posttraumatic Stress Disorder Among Veterans. A Randomized Clinical Trial. JAMA, 2015
Both in case of anxiety disorders and depression, regular sports activities lead to marked symptomatic improvement, as well as to the improvement of neurogenesis. This effect also affects, in particular, the area of the hippocampus, a brain area which is impaired in the case of anxiety disorders and depressions. An individualized training program is developed and carried out with the patient by sports scientists and personal trainer.
Anderson et al: Effects of Exercise and Physical Activity on Anxiety. 2013 Front Psychiatry
The treatment is carried out by experienced and qualified specialists, psychologists and sports scientists. Interdisciplinary care by doctors from all relevant specialist areas (traumatologists, pain therapists, internists, gynecologists) is ensured at the clinic.
The aim of the treatment is to enable the patient to return to normal life and without any permanent drug intake.