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vivabest psychiatry

PTSD

A condition triggered by witnessing or experiencing a terrifying event, causing flashbacks, nightmares, and severe anxiety that interferes with daily functioning.

What is Post-Traumatic Stress Disorder (PTSD)?

PTSD is a mental health condition that can develop after experiencing or witnessing a traumatic event (e.g., combat, sexual assault, serious accident, natural disaster, or the sudden death of a loved one). Feeling fear and hyper-alert right after trauma is normal. Most people improve over time; in PTSD, distress and danger signals persist or return and interfere with daily life.

Who is at higher risk?

  • PTSD can occur at any age. Risk increases with:
  • Prior trauma—especially during childhood
  • Experiencing intense horror, helplessness, or prolonged/repeated trauma
  • Limited social support after the event
  • Added stressors (injury, bereavement, housing/job loss)
  • History of anxiety, depression, or substance use
  • Female sex (on a population level)

Other Conditions

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Symptoms (four DSM-5 clusters)

Symptoms vary by person and may start soon after trauma or be delayed. They often fluctuate over time.

1. Intrusion (re-experiencing)

  • Flashbacks, nightmares, intrusive memories/thoughts

2. Avoidance

  • Avoiding reminders (places, people, activities)
  • Avoiding thoughts/feelings about the event

3. Negative changes in mood and thinking

  • Gaps in memory about the event
  • Persistent negative beliefs (“I’m unsafe,” “It’s my fault”)
  • Guilt, shame, detachment, loss of interest, difficulty concentrating

4. Arousal/reactivity

  • Hypervigilance, exaggerated startle
  • Irritability/anger outbursts
  • Sleep disturbance, feeling “on edge,” difficulty relaxing

If symptoms last >4 weeks, cause significant distress/impairment, and are not better explained by another condition, PTSD may be present.

Diagnosis

  • PTSD is a clinical diagnosis made by a qualified clinician using history, symptom assessment, and rule-outs (including consideration of sleep disorders, depression, anxiety, substance use, and medical issues). Tools often used include:
  • Structured interviews: CAPS-5 (gold standard), SCID
  • Self-report scales: PTSD Checklist (PCL-5) to monitor severity and change over time
  • Screening questionnaires flag possible PTSD but do not make the diagnosis. A thorough assessment may include collateral input (with permission) and typically takes from 30–120 minutes depending on purpose (e.g., clinical care vs. legal evaluations).
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N/A

  • There is no single test for ADHD. Diagnosis is clinical and includes:
  • Comprehensive medical, developmental, and family history and a physical exam (with vision/hearing screening as indicated) to rule out other causes (e.g., anxiety, depression, sleep disorders, learning disorders).
  • Standardized rating scales and/or structured interviews completed by the individual and informants (parents, teachers, partners) to document symptoms and impairment across settings.
  • Neuropsychological testing may be helpful in complex cases or to evaluate co-occurring learning issues, but it is not required for diagnosis.
  • Confirmation that:

Yes, we understand the "invisible wound," where trauma manifests as severe emotional, cognitive, and behavioral changes.

We are committed to delivering outstanding care and empowering you to regain control of your mental health.

Treatment for PTSD

Traumatic events and PTSD are treatable. Effective care is individualized and may combine psychotherapy, medication, and lifestyle strategies.

1. Trauma-focused psychotherapies (first-line):

  • Cognitive Processing Therapy (CPT) – reframes unhelpful trauma-related beliefs
  • Prolonged Exposure (PE) – gradual, supported exposure to memories/cues
  • Eye Movement Desensitization and Reprocessing (EMDR) – processing traumatic memories using bilateral stimulation. Typical courses run ~8–16 sessions.

 

2. Medication:

  • SSRIs: sertraline and paroxetine (FDA-approved for PTSD)
  • SNRI: venlafaxine (strong evidence; commonly used off-label)
  • Targeted options may help specific symptoms (e.g., sleep/nightmares) per clinician judgment. Benzodiazepines are generally not recommended for core PTSD symptoms.

 

3. Complementary supports (adjuncts):

  • Sleep hygiene, regular exercise, mindfulness, yoga, breathwork, nutrition, and stress-reduction practices. These support—not replace—evidence-based therapies.

 

4. Resilience factors / secondary prevention:

  • Early connection with supportive others
  • Clear coping plans and problem-solving skills
  • Constructive meaning-making about the event
  • Access to timely, evidence-based care

Vivabest Psychiatry PLLC: Our Approach

  • We provide measurement-based, trauma-informed care:
  • Comprehensive evaluation using validated screens (e.g., PCL-5) and structured interviews when indicated
  • Evidence-based psychotherapy (CPT/PE/EMDR) provided in-house or via trusted referrals
  • Medication management focused on SSRIs/SNRIs when appropriate, with careful monitoring of benefits, side effects, sleep, and comorbidities
  • Integrated supports: psychoeducation, skills training, and lifestyle optimization (sleep, exercise, nutrition, stress management)
  • Collaborative follow-up to track progress and adjust the plan

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