Post-traumatic stress is a disorder that takes lifelong enacted methods for continual healing. To understand more about the condition and some of the optimal coping strategies and treatments, Digital Journal caught up with Dr. Prakash Masand, founder of the Centers of Psychiatric Excellence. The interview was conducted to mark PSTD day, a day officially designated in the U.S. by the senate.
Digital Journal: How can PSTD be defined?
Dr. Prakash Masand: Post-traumatic stress disorder, PTSD for short, is a mental health condition triggered by a traumatic event such as war, sexual assault, robbery, natural disasters, car accident, witnessing violence and other similar incidents. It typically includes symptoms such as extreme anxiety, nightmares and even flashbacks. For perspective, 34% of the Oklahoma City bombing survivors developed PTSD.
DJ: Who does it apply to?
Dr. Masand: Anybody who experiences a traumatic event can develop PTSD, even children. It is unknown why some people develop PTSD while others don’t. It is estimated that 7.8 percent of the population will develop PTSD at some point in their lives. Annually, 5.2 million Americans have PTSD including 30 percent of veterans who served in Iraq and Afghanistan.
DJ: Are cases increasing?
Dr. Masand: Yes, cases of PTSD are increasing dramatically especially in the military population. As veterans are returning home, more of them are seeking treatment for PTSD. In fact, a 2016 study found that PTSD cases had increased by 71% among veterans in the last five years. This is why it is very important that we continue to educate people about PTSD and reduce the stigma around mental illness.
DJ: Does PSTD receive the coverage it deserves?
Dr. Masand: PTSD gets media coverage only when there is a story of an event that can cause PTSD, like a shooting or terrorist attack. Unfortunately, it is also very unfairly portrayed in the media. The truth is, PTSD on its own won’t cause someone to commit a heinous act. Even though someone who commits a mass shooting, for example, may have a history of PTSD or another psychiatric illness, it is very unlikely that the psychiatric illness is the major contributing factor.
This unfortunately increases the stigma and makes it difficult for veterans to get jobs when they return to civilian life. Also, while more veterans experience PTSD than the general population, we need to remind everyone that there are potential triggers for PTSD in daily life, like physical and sexual abuse, that never receive the attention they deserve as causes of PTSD.
DJ: Is this a fault of the media or the medical profession?
Dr. Masand: In terms of fault, there is under-recognition and appreciation of PTSD by both the medical profession and the media. For example, PTSD in at-risk youth is missed 90% of the time. PTSD is frequently missed in clinical practice when it is not the presenting complaint. In terms of the media, it is under reported outside of veterans and again, often used to label or characterize people who have some other mental illness but not PTSD.
DJ: How can PSTD be treated?
Dr. Masand: There are a number of very effective treatments available for PTSD. Find a therapist who specializes in PTSD-specific trauma focused therapies like prolonged exposure therapy, EMDR (Eye Movement Desensitization and Reprocessing) and cognitive processing therapy (CPT). An anti-depressant knows as a selective serotonin reuptake inhibitor (SSRI) is effective for PTSD, and a drug called Prazosin can be very helpful in reducing nightmares.
DJ: Are any new treatments in development?
Dr. Masand: Yes! New treatments include mindfulness-based therapy, mindful yoga, sublingual cyclobenzaprine, intravenous ketamine infusions, engagement with dogs and exposure therapy, MDMA assisted psychotherapy, attention control treatment, and cannabidiol.
In terms of technology, virtual reality and smartphone apps are being developed to treat PTSD.
DJ: Why do treatments sometimes not work?
Dr. Masand: Treatments often do not work because the diagnosis is wrong, patients have comorbid psychiatric illness and substance abuse, patients are non-compliant with treatment, and 30-40 percent of PTSD is treatment resistant to commonly used treatments and need innovative treatments. An innovative treatment we are using for PTSD cases that don’t respond well to traditional treatments is Ketamine IV infusions. The benefits of Ketamine are substantial and obtained within just one day of treatment.