Post-Traumatic Stress Disorder (PTSD) Treatment

How is PTSD Diagnosed?

PTSD is diagnosed by a psychiatrist or clinical psychologist through a detailed assessment of symptoms, trauma history, medical history and their impact on daily life. Symptoms should generally persist for more than one month and cause significant distress or impairment. Standardised interviews or questionnaires may support the assessment. Mental health professionals also evaluate for depression, anxiety disorders, substance misuse and other related conditions before planning treatment. 

How is PTSD Treated Based on Severity?

PTSD treatment depends on how severe the symptoms are. The table below summarises the treatment approach, along with clinical features of PTSD severity:

Types of PTSD and Their Treatment

PTSD can present in different forms. Treatment is adjusted for each type as shown in the table below:

Psychotherapy for PTSD

Trauma-focused psychotherapy is the first line of treatment for PTSD. Types of psychotherapy include:

• Cognitive Processing Therapy (CPT): This aims to change thoughts associated with the trauma.

• Prolonged Exposure (PE) Therapy: This aims to reduce fear through exposure to trauma memories.

• Eye Movement Desensitisation and Reprocessing (EMDR): This uses guided eye movements while addressing trauma.

• Trauma-Focused CBT: This involves using coping skills together with addressing trauma.

• Cognitive Therapy: This aims at addressing negative beliefs associated with the trauma.

• Group Therapy: This offers shared support with others who understand.

Other Treatments for PTSD

Some people require additional assistance apart from one-on-one counselling for PTSD. The following methods may contribute to recovery:

• Family Counselling: It assists family members in learning and aids in the recovery process.

• Stress Reduction: Relaxation techniques alleviate everyday symptoms.

• Mindfulness and Grounding: They assist with flashbacks and anxiety.

• Supportive Groups: Peer groups decrease isolation and improve coping mechanisms.

• Transcranial Magnetic Stimulation (TMS): Brain stimulation is used in treatment-resistant cases.

• Co-treatment for Associated Disorders: Other disorders, such as depression, anxiety and insomnia, are treated simultaneously.

Oral Medications for PTSD

Medications help treat the symptoms of PTSD along with therapy in moderate to severe cases. The following medications may be suggested by the doctor for different patients:

• Sertraline: First-line SSRI (Selective Serotonin Reuptake Inhibitors) for PTSD.

• Paroxetine: First-line SSRI for PTSD.

• Venlafaxine: SNRI (Selective Norepinephrine Reuptake Inhibitors) used when appropriate.

• Prazosin: This can be used to reduce trauma-related nightmares in selected patients.

• Escitalopram: Sometimes prescribed when clinically appropriate.

• Zolpidem: Occasionally prescribed for short-term treatment of severe insomnia under specialist supervision.

Ayurvedic and Alternative Treatments for PTSD

Some PTSD patients use complementary practices for calm and balance to support overall well-being. However, these should support, not replace, professional medical care. Some of these practices include:

• Yoga: This practice promotes relaxation and body awareness.

• Meditation: This can help create a tranquil state of mind and relieve stress.

• Ashwagandha: This herb is used to relieve stress.

• Brahmi: This is used to provide relief to the mind.

• Pranayama/Breathing Exercises: This helps calm the nervous system.

• Aromatherapy: This therapy is used to facilitate relaxation.

Home Care for Managing PTSD

Self-care on a daily basis is important for your recovery between therapy sessions. It works alongside professional treatment for PTSD and includes:

• Routine: Having a routine makes you feel safe and comfortable.

• Reach Out: Contact those people that you trust in your friends and family.

• Relaxation: Practice relaxation through breathing techniques or grounding during anxiety.

• Sleeping Right: Have a routine and an uninterrupted sleep schedule.

• Exercise: Exercise is good for mood and stress management.

• Avoiding Alcohol and Drugs: These will make your symptoms worse.

• Patience: Be patient; recovery will come slowly.

• Continued Therapy: Continue attending psychotherapy sessions even if symptoms begin to improve. 

How Long Does PTSD Treatment Take?

PTSD treatment duration varies with the person and the type of PTSD. The table below shows approximate timelines of PTSD treatments:

PTSD Treatment Side Effects

PTSD therapies are generally safe and effective. Certain therapies and medications can have side effects, which can include:

• Nausea, diarrhoea or stomach upset due to SSRIs

• Insomnia or sleepiness

• Sexual dysfunction

• Dizziness

• Low or increased blood pressure

• Temporary emotional distress during trauma-focused therapy

• Drowsiness or dependence due to short-term sleeping medicines

Lifestyle Changes for Managing PTSD

Healthy behaviours promote both treatment and recovery from PTSD. Some lifestyle changes that can be useful include:

• Maintain a Regular Routine: Follow a consistent schedule for sleep, meals, work and daily activities.

• Exercise Regularly: Walking, yoga, swimming or other moderate exercise can reduce stress and improve mood.

• Follow a Healthy Diet: Eat balanced meals and avoid skipping food, as poor nutrition may worsen fatigue and irritability.

• Maintain Healthy Sleep Habits: Go to bed and wake up at the same time each day. Limit screen use before bedtime.

• Reduce Caffeine: Excessive tea, coffee and energy drinks may worsen anxiety, restlessness, and sleep problems.

• Avoid Alcohol and Recreational Drugs: These substances may temporarily numb distress, but can worsen PTSD symptoms and interfere with treatment.

• Practice Relaxation Techniques: Deep breathing, mindfulness, meditation and grounding exercises may help manage anxiety and flashbacks.

• Build a Support Network: Stay connected with trusted family members, friends, support groups or caregivers.

• Identify and Manage Triggers: Work with a mental health professional to recognise triggers and develop safe coping strategies.

• Take Regular Breaks: Avoid excessive workload and allow time for rest, hobbies and calming activities.

• Continue Treatment: Attend scheduled therapy sessions, take prescribed medicines regularly and do not stop treatment without medical advice.

Triggers That Can Worsen PTSD Symptoms

Certain things may aggravate PTSD or hinder its recovery. Managing them is important. Some of these triggers that should be actively avoided include:

• Trauma Reminders: Places, people, sounds, smells, images or conversations linked to the traumatic event.

• Ongoing Stress: Work pressure, financial problems, family conflict or major life changes may increase anxiety and emotional distress.

• Poor Sleep: Lack of sleep can worsen irritability, nightmares, poor concentration and emotional reactions.

• Alcohol or Drug Use: These substances may worsen anxiety, depression, sleep problems and impulsive behaviour.

• Social Isolation: Avoiding family, friends or support networks may increase loneliness and slow recovery.

• Distressing News or Media: News reports, films or social media content related to violence, accidents or trauma may trigger flashbacks.

• Crowded or Unfamiliar Places: Busy environments may cause fear, hypervigilance or panic in some people.

• Relationship Conflict: Arguments, criticism or feeling unsafe in a relationship may worsen symptoms.

• Untreated Depression or Anxiety: Associated mental health conditions can increase the severity of PTSD symptoms.

• Stopping Treatment Suddenly: Missing therapy sessions or stopping prescribed medicines without medical advice may lead to worsening symptoms.

• Anniversaries of the Trauma: Specific dates or events may bring back painful memories and emotional distress.

• Physical Illness or Pain: Poor health, chronic pain or exhaustion may reduce the ability to cope with PTSD symptoms.

PTSD Treatment Cost in India

The treatment cost of PTSD in India can be expensive if it continues for a long time. While PTSD therapy sessions generally cost ₹1500 to ₹5000, psychiatrist consultations usually cost ₹800 to ₹5000, depending on the specialist and city. However, long-term treatment costs may vary according to the number of therapy sessions, medicines and follow-up visits. 

Does Health Insurance Cover PTSD Treatment in India?

Yes. Medically advised PTSD treatment is covered by most health insurance plans in India. Insurance coverage for PTSD treatments in India depends on:

• Comprehensive Health Insurance Plans: According to the Mental Healthcare Act 2017, all insurers must cover mental illness and PTSD similarly to physical illness. According to the IRDAI, the health insurance for mental illness coverage includes hospitalisation for treating psychiatric disorders.

• OPD Cover: Most treatments for PTSD are OPD-based, which include therapies and doctor consultations. Having an OPD cover in your health policy helps meet the recurring expenses of such treatments.