From the Guidelines
Post-traumatic stress disorder (PTSD) symptoms after a natural disaster typically include intrusive memories, avoidance behaviors, negative mood changes, and heightened reactivity, and the most effective treatment approach is a combination of specific manualized psychotherapies, such as prolonged exposure, cognitive processing therapy, or eye movement desensitization and reprocessing psychotherapy, as recommended by the 2023 U.S. Department of Veterans Affairs and U.S. Department of Defense clinical practice guideline 1.
Understanding PTSD Symptoms
The symptoms of PTSD can be understood in four main categories:
- Intrusion: repeated distressing memories and/or dreams (nightmares) about the traumatic event, loss of awareness of present surroundings (dissociation), and acting as if the traumatic event is reoccurring (flashbacks) 1.
- Avoidance: attempting to avoid distressing memories, thoughts, feelings, activities, and/or places that remind the individual of the traumatic event 1.
- Negative alterations in cognitions and mood: problems remembering important aspects of the traumatic event, negative beliefs or expectations about oneself, others, or the world, and negative emotional states such as depression 1.
- Increased arousal and reactivity associated with the traumatic event: irritable and angry outbursts, reckless or self-destructive behavior, hypervigilance, exaggerated startle response, problems with concentration, and sleep disturbance 1.
Treatment of PTSD
The treatment of PTSD usually involves a combination of therapy and sometimes medication.
- Effective therapies include:
- Medication options may include:
Self-Help Strategies
Self-help strategies include:
- Establishing routines
- Practicing relaxation techniques
- Connecting with support systems
- Avoiding alcohol and drugs which can worsen symptoms If symptoms persist beyond one month and significantly impact daily functioning, professional help should be sought immediately.
From the Research
Understanding PTSD Symptoms After a Natural Disaster
- Posttraumatic stress disorder (PTSD) is a complex disorder associated with an intricate biological and psychological symptom profile and various common comorbidities 2.
- The clinical management of PTSD is complex, since it is associated with high rates of comorbid psychiatric disorders, particularly major depression, other anxiety and panic disorders, substance abuse, and antisocial behavior 3.
- Almost all individuals who experience a severe trauma will develop symptoms of PTSD shortly after the traumatic event, although most people do not develop enduring PTSD, and in many of those who do, it resolves within 1 year without treatment 4.
Treatment Approaches for PTSD
- There are two main approaches to treatment: pharmacotherapy and cognitive or behavioral therapy 3.
- Psychotherapy research provides substantial support for cognitive behavioral therapies and eye movement desensitization and reprocessing for chronic PTSD 2.
- The use of selective serotonin reuptake inhibitors (SSRIs) is supported by evidence as a first-line therapy for PTSD, as they can alleviate the core symptoms of PTSD and common comorbidities such as depression, panic disorder, and social anxiety disorder 3, 5.
- The American Psychological Association (APA) recommends the use of certain psychotherapies, including cognitive-behavioral therapy, cognitive processing therapy, cognitive therapy, and prolonged exposure therapy, as well as certain medications, such as fluoxetine, paroxetine, sertraline, and venlafaxine, for the treatment of PTSD in adults 6.
Assessment and Evaluation of PTSD
- Screening and assessment tools for posttrauma mental health problems, particularly PTSD, are essential for identifying individuals at increased risk for developing PTSD 4.
- Self-rated instruments are most appropriate for assessing PTSD, but the choice of instrument will depend on the local situation and availability of appropriately validated questionnaires 4.