June is Posttraumatic Stress Disorder (PTSD) Awareness Month. It is estimated that one in 11 people will be diagnosed with PTSD in their lifetime, according to the American Psychiatric Association, and it disproportionately affects U.S. Latinos, African Americans and American Indians.
Sophia Albott, MD, MA, an assistant professor of psychiatry and behavioral sciences at the University of Minnesota Medical School and an adult psychiatrist at University of Minnesota Physicians St. Louis Park Clinic, discusses the origins of PTSD, common misconceptions of the disorder and today’s treatment options.
Q: What is PTSD, and how does it develop?
Dr. Albott: Posttraumatic Stress Disorder is a mental health condition that develops in some people after they have lived through or witnessed a potentially life-threatening event, such as a natural disaster, sexual assault, a car accident or military combat.
It is normal for many people to experience difficulty with sleep, to have upsetting memories or dreams of the event or to feel on edge after they have lived through a traumatic event. It is also normal for these feelings to diminish as time passes after a traumatic experience.
For some people, however, the intrusive memories, difficulties with sleep or nightmares and feeling on edge do not diminish. For people with PTSD, these feelings can get stronger as more time passes, and these symptoms can generalize to situations where there is no danger.
Q: Who is at risk for developing PTSD?
Dr. Albott: Unfortunately, trauma is very common. It has been estimated that up to 90 percent of the adult American population will experience a severe traumatic event at some point in their lives. Fortunately, only about 7 percent of people will develop the lingering symptoms that we associate with PTSD. Although it is not possible to predict who will go on to develop PTSD, studies have shown that PTSD is more common in women, people with co-occuring mental health problems, such as depression, and people who have had repeated traumatic experiences.
We also know that increased life stressors — for example, low social support, conflict at home, and problems at work — can contribute to the development of PTSD. For this reason, I have concerns that rates of PTSD may increase as we monitor the long-term mental health effects of the COVID-19 pandemic and social unrest.
Q: How can a family member or friend recognize symptoms of PTSD in their loved ones and encourage them to seek help?
Dr. Albott: Living through a traumatic experience can have long-lasting effects, which can be quite varied depending on the person. If a family member or friend has been through or witnessed a traumatic event, it is important to remember that it is normal for them to feel changed by these experiences. Some common symptoms following a traumatic event include having nightmares or intrusive memories of the event, feeling constantly on edge or on guard, avoiding situations that remind one of the event, feeling numb or detached from important people or activities and feeling guilty or blaming oneself for the event.
If your loved one’s behavior seems to be changed, if they seem to have difficulty doing their regular activities or if these symptoms last more than a couple of weeks or months, it may be wise to encourage them to get evaluated by a mental health professional. They can help with selecting an appropriate therapy or treatment to better enable recovery following a traumatic experience.
Q: What are some common treatment options for those with PTSD?
Dr. Albott: Several different forms of psychotherapy have the most evidence for treating PTSD. Most of these therapies involve gradually re-exposing someone to memories of the traumatic event to help their brain learn that they are no longer in danger.
There are also some medications that have been shown to treat aspects of PTSD, such as nightmares or depressive symptoms. Most recently, my work and the work of others have shown that a novel rapid-acting antidepressant, called ketamine, is effective for treating PTSD when it co-occurs with depression in a controlled clinical environment. Noninvasive brain stimulation (transcranial magnetic stimulation) has also been shown to be effective in managing PTSD.
Q: How has your research helped advance the understanding of PTSD?
Dr. Albott: Unfortunately, outside of psychotherapy and a few medications, there are not many evidence-based treatments for PTSD. My research has demonstrated that ketamine is effective for treating PTSD under the supervision of a proper health care professional. Unfortunately, the effects of treatment with ketamine are transient, and long-term treatment with ketamine can be logistically onerous. For this reason, my research seeks to understand what brain networks are active in people who have recovered from PTSD. It is a long-held assumption that “recovery” involves the brain returning to “normal.” However, subjectively, we know that traumatic experiences can have profound effects on our lives and that the memories of these experiences are often indelible. Understanding how brain networks compensate after recovering from PTSD will allow us to develop more precise and longer-lasting treatments for this difficult illness.
Sophia Albott, MD, MA, is an assistant professor of psychiatry and behavioral sciences at the University of Minnesota Medical School and an adult psychiatrist at University of Minnesota Physicians St. Louis Park Clinic. Her clinical focus is on neuromodulation, transcranial magnetic stimulation (TMS), treatment-resistant depression, mood disorders, translational neuroscience, women's mental health and trauma-related psychiatric disorders. She is board-certified by the American Board of Psychiatry & Neurology and a member of the American Society of Hispanic Psychiatry.
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