Treatment

  • The centrality of human relationships;
  • The meaning embedded in symptomatic actions; and
  • The importance of respecting the authority of individuals to direct their own lives.

Recognizing that individual troubles exist in a social context, Dove offers extensive support for family members. Patients have openings to participate in a robust therapeutic community and to study in our unique Activities Program. Each person designs his or her own treatment in collaboration with a professional interdisciplinary team to support in the whole process.

Some of the more common diagnoses our patients arrive with include:

Drug treatment is intended to help addicted individuals stop compulsive drug seeking and use. Treatment can occur in a variety of settings, take many different forms, and last for different lengths of time. Because drug addiction is typically a chronic disorder characterized by occasional relapses, a short-term, one-time treatment is usually not sufficient. For many, treatment is a long-term process that involves multiple interventions and regular monitoring.

Components of comprehensive drug abuse treatment include assessment, treatment planning, pharmacotherapy, behavioral therapy, substance use monitoring, case management, support groups, and continuing care as well as child Care, vocational, mental health, medical, educational, HIV/AIDS, legal, financial, housing/transportation, and family services.
There are a variety of evidence-based approaches to treating addiction. Drug treatment can include behavioral therapy (such as cognitive-behavioral therapy or contingency management), medications, or their combination. The specific type of treatment or combination of treatments will vary depending on the patient’s individual needs and, often, on the types of drugs they use.

Drug addiction treatment can include medications, behavioral therapies, or their combination.

Treatment medications, such as methadone, buprenorphine, and naltrexone (including a new long-acting formulation), are available for individuals addicted to opioids, while nicotine preparations (patches, gum, lozenges, and nasal spray) and the medications varenicline and bupropion are available for individuals addicted to tobacco. Disulfiram, acamprosate, and naltrexone are medications available for treating alcohol dependence,1 which commonly co-occurs with other drug addictions, including addiction to prescription medications.

Treatments for prescription drug abuse tend to be similar to those for illicit drugs that affect the same brain systems. For example, buprenorphine, used to treat heroin addiction, can also be used to treat addiction to opioid pain medications. Addiction to prescription stimulants, which affect the same brain systems as illicit stimulants like cocaine, can be treated with behavioral therapies, as there are not yet medications for treating addiction to these types of drugs.

Behavioral therapies can help motivate people to participate in drug treatment, offer strategies for coping with drug cravings, teach ways to avoid drugs and prevent relapse, and help individuals deal with relapse if it occurs. Behavioral therapies can also help people improve communication, relationship, and parenting skills, as well as family dynamics.

Many treatment programs employ both individual and group therapies. Group therapy can provide social reinforcement and help enforce behavioral contingencies that promote abstinence and a non-drug-using lifestyle. Some of the more established behavioral treatments, such as contingency management and cognitive-behavioral therapy, are also being adapted for group settings to improve efficiency and cost-effectiveness. However, particularly in adolescents, there can also be a danger of unintended harmful (or iatrogenic) effects of group treatment—sometimes group members (especially groups of highly delinquent youth) can reinforce drug use and thereby derail the purpose of the therapy. Thus, trained counselors should be aware of and monitor for such effects.

Because they work on different aspects of addiction, combinations of behavioral therapies and medications (when available) generally appear to be more effective than either approach used alone.

Finally, people who are addicted to drugs often suffer from other health (e.g., depression, HIV), occupational, legal, familial, and social problems that should be addressed concurrently. The best programs provide a combination of therapies and other services to meet an individual patient’s needs. Psychoactive medications, such as antidepressants, anti-anxiety agents, mood stabilizers, and antipsychotic medications, may be critical for treatment success when patients have co-occurring mental disorders such as depression, anxiety disorders (including post-traumatic stress disorder), bipolar disorder, or schizophrenia. In addition, most people with severe addiction abuse multiple drugs and require treatment for all substances abused.

Treatment for drug abuse and addiction is delivered in many different settings using a variety of behavioral and pharmacological approaches.

 

Mood Disorder Overview
Everyday life is a roller coaster of emotions. You may feel on top of the world one day because of a high-profile promotion or an awesome grade on a test. Another day, you may feel down in the dumps due to relationship problems, financial troubles, or because you got a flat tire on the way to work. These are normal fluctuations in mood that come and go. When your mood starts to have an impact on your daily activities and in your social, educational, and vocational relationships, you may be suffering from a mood disorder.

What is a Mood Disorder?
Mood disorders are characterized by a serious change in mood that cause disruption to life activities. Though many different subtypes are recognized, three major states of mood disorders exist: depressive, manic, and bipolar. Major depressive disorder is characterized by overall depressed mood. Elevated moods are characterized by mania or hypomania. The cycling between both depressed and manic moods is characteristic of bipolar mood disorders. In addition to type and subtype of mood, these disorders also vary in intensity and severity. For example, dysthymic disorder is a lesser form of major depression and cyclothymic disorder is recognized as a similar, but less severe form of bipolar disorder.

Depression Overview
If you are suffering from depression, feelings of negativity can affect your whole being. While different types of depression exist, most have mood, cognitive, sleep, behavioral, whole body, and weight effects. You are likely experiencing feelings of apathy, general discontent, loss of interest in things that used to be pleasurable, mood swings, or overall sadness. In addition, you may have thoughts of suicide, problems sleeping, feel excessively irritable, socially isolated, and restless. Depression often affects your weight as well – you may lose interest in eating and lose a significant amount of weight or feel overly hungry and put on excess weight.

Mania Overview
Manic moods are characterized by unusually high energy and mood. Feelings of euphoria are often present. These elevated moods typically last three days or more for most of the day. Classic mania symptoms include talking rapidly and/or excessively, needing significantly less sleep than normal, distractibility, poor judgment, impulsivity, and making reckless decisions.

Cause and Effect of Mood Disorders
What causes mood disorders? Researchers and medical professionals do not have a pinpointed answer for this question, but believe both biological and environmental factors are at play. If your family history includes individuals who have been diagnosed with mood disorders, your likelihood of experiencing them, while still low overall, is increased. Traumatic life events are also considered culprits of the onset of mood disorders as well. Mood disorders can negatively impact your work life and school life and intrude on your personal relationships. In some cases, medications and substance abuse can be the cause behind your disorder.

Prevalence of Mood Disorders
Mood disorders have been found to affect approximately 20% of the general population at any given point. More specifically, 17% of the U.S. population is thought to suffer from depression over the course of their lifetime, with bipolar disorder affecting only 1% of the general population. However, researchers agree that many instances of manic moods often go unnoticed or are deemed unproblematic, causing a significant decrease in their reported prevalence.

Diagnosis Methods
Mood disorders are diagnosed through both physical examinations and mental health evaluations. Your physician will perform a physical exam to rule out any underlying medical conditions that are causing an effect on your mood. If ruled out, a mental health provider may perform a series of assessments to determine your mood stability and mental health. Many individuals are reluctant to seek help for mood disorders due to the social stigma associated with them. Because of this, many go undiagnosed and approximately only 20% of those diagnosed receive treatment.

Treatment Options
Mood disorders are treated primarily through medications and psychotherapy. Even with treatment though, it is not uncommon for mood disorders to persist throughout a lifetime or to come and go on occasion. Education about mood disorders help individuals suffering from these conditions recognize patterns of behavior and thought that are indicative of a mood disorder resurfacing – and prompt them to seek additional treatment.

Typically, antidepressants and anti-anxiety medications are prescribed to individuals coping with mood disorders to alleviate emotional distress. Even with medications though, most mental health providers recommend them in combination with psychotherapy.

Psychotherapy, or talk therapy, is focused on changing thought patterns and behaviors. Cognitive-behavioral therapy is often considered the benchmark therapy treatment for individuals living with mood disorders. It has been found to have significant positive treatment effects, and in some cases, psychotherapy alone is enough to treat a mood disorder.

Some mood disorders, such as bipolar depression, are usually treated with lifelong medication of mood stabilizers combined with psychotherapy. In addition, the severity of some mood disorders may cause hospitalization, especially if the affected individuals has tried to inflict harm on themselves or others or have thoughts or attempted suicide.

A personality disorder is hard to deal with alone. Talking to a doctor or mental health professional is the first step towards getting support and treatment.

It can be difficult for someone with a personality disorder to learn to trust a doctor or therapist. However, establishing a positive relationship with a healthcare provider is an important step towards recovery. The treatment may vary, based on the type of personality disorder and any other conditions that might be present.

Psychotherapy
Psychotherapy is the most effective long-term treatment option for personality disorders. Psychotherapy is when a psychologist or psychiatrist helps people to understand their thoughts, motivations and feelings. These insights can help people to manage their symptoms, develop satisfying relationships and make positive behaviour changes.

Methods include:

  1. cognitive behaviour therapy (CBT)
  2. dialectical behaviour therapy (DBT)
  3. psychodynamic psychotherapy
  4. psychoeducation.

Medicine and personality disorders
There is no specific medicine to treat personality disorders. However, antidepressant medicines may be used to treat associated conditions such as anxiety and depression, or to help people cope with their symptoms. Less frequently, other types of medicines such as antipsychotics or mood stabilisers may be prescribed.

Medicine works most effectively in combination with psychotherapy.

Crisis management
Some people with personality disorders have trouble coping with stressful events, and may need support in a crisis. They may develop suicidal thoughts and behaviours and require emergency assistance. Rarely, hospitalisation may be required in severe cases to prevent the risk of self-harm or suicide, or for the treatment of other mental health conditions. This is a temporary solution to ensure safety and, in general, long-term hospital admission is not recommended for people with personality disorders.

Psychotic disorders have an unfair reputation for being difficult to treat. Fortunately, most of these conditions are responsive to a wide range of treatment modalities. Early intervention can be particularly effective.

With the right psychotic disorder treatment and supports in place, people with these conditions can learn how to manage their symptoms and live normal lives.

Medications for Treating Psychotic Disorders
Due to the significant and well-documented influence of brain chemistry on psychotic disorders, the first step in treatment is usually starting a medication regimen. The right medications can disrupt or change processes in the brain that cause or intensify psychotic symptoms. After starting medication, many people experience a complete remission of positive symptoms of many psychotic disorders, including hallucinations and delusions.

Antipsychotic Medications

The most common medications for psychotic disorders are antipsychotic medications. Nearly all of them work by blocking dopamine, which research shows is overactive in the brains of people with psychotic disorders.

First-generation antipsychotics were developed in the 1950s and effectively treat psychotic symptoms. However, they are now less commonly used due to serious side effects associated with them, such as tardive dyskinesia and other motor problems.

First-generation antipsychotic medications are also sometimes called “typical antipsychotics.” They include the following:

  • Fluphenazine (Prolixin)
  • Haloperidol (Haldol)
  • Chlorpromazine (Thorazine)

Second-generation, or atypical, antipsychotics were developed in the 1980s. This medication for psychotic disorders is just as effective as first-generation antipsychotics but with fewer side effects. Many atypical antipsychotics are associated with weight gain and increased risk of developing Type 2 diabetes, which are serious but less life-altering than are side effects of older antipsychotic drugs. An up-to-date medication list of medications for psychotic disorders will typically feature the following drugs:

  • Clozapine (Clozaril)
  • Aripiprazole (Abilify)
  • Risperidone (Risperdal)
  • Quetiapine (Seroquel)
  • Olanzapine (Zyprexa)
  • Ziprasidone (Geodon)

Antipsychotic drugs can have an impact within hours, and they can alleviate agitation and confusion within minutes. However, medications for psychotic disorders usually take several weeks to become fully effective.

As antipsychotic drugs reach therapeutic levels, they start clearing the most severe symptoms of psychotic disorders. While some people with severe psychotic disorders never experience total relief from these symptoms, many remain completely free of delusions or hallucinations as long as they continue taking these medications.

Antidepressant Medications

Antidepressant medications are often used to augment antipsychotic medications in the treatment of psychotic disorders. They are commonly used to treat resistant symptoms in schizophrenia, especially negative and mood symptoms like flat affect and anhedonia.

A 2015 study suggested that at least 25 percent of people with schizophrenia experience comorbid depression. Research shows that antidepressants not only alleviate depressive symptoms but effectively reduce negative symptoms of schizophrenia when combined with antipsychotic medications. Antidepressants shown to be effective when used in combination with antipsychotics include:

  • Mirtazapine (Remeron)
  • Citalopram (Celexa)
  • Fluoxetine (Prozac)
  • Sertraline (Zoloft)

The antidepressant medications used as part of a medication regimen depends on a range of factors, like comorbid illnesses and interactions with other medications.

Anti-Anxiety Medications

Anxiety disorders affect over 18 percent of people in the United States each year. They are even more prevalent for people with psychotic disorders. One analysis showed that nearly 40 percent of people with schizophrenia had at least one co-occurring anxiety disorder. Some antidepressants are also used to effectively treat anxiety disorders. These include:

  • Citalopram (Celexa)
  • Paroxetine (Paxil)
  • Sertraline (Zoloft)
  • Venlafaxine (Effexor)

enzodiazepines like lorazepam (Ativan) are sometimes used for people with schizophrenia and other psychotic disorders to treat symptoms of anxiety and psychotic agitation.

Therapy for Psychotic Disorders

While medications are central in the treatment of psychotic disorders, therapy can also be essential. Different therapeutic styles focus on different treatment goals and areas of concern, but many types of therapy for psychotic disorders can help people manage their mental health condition and maintain a higher quality of life.

Traditional forms of psychotherapy were insight-based and not considered to be helpful for people with even temporary cognitive deficits or distorted thought processes. Psychotherapy has since developed a strong supportive component that makes it more broadly applicable. Supportive psychotherapy focuses on the formation of a good relationship between a therapist and client, which can help people with psychotic disorders by reducing paranoia, promoting acceptance of treatment and encouraging adherence to medication and treatment plans.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is especially effective for people with psychotic disorders. Disorganized and irrational thought processes are common in these conditions and CBT targets these symptoms.

By helping clients monitor and analyze their thought processes more closely than they otherwise would, cognitive behavioral therapy for psychotic disorders helps people with these conditions make rational connections and recognize when psychotic symptoms are arising. It also helps strengthen reality testing skills when a person’s illness makes it harder for them to discern internal from external events.

Cognitive Enhancement Therapy

Cognitive enhancement therapy (CET) was developed for people with schizophrenia and focuses even more intensely on cognitive processes, especially social cognition, than CBT does. It involves a suite of connected interventions, including neurocognitive enhancement exercises done on computers, structured groups with homework assignments and individual coaching.

Research shows that this intervention yields significant positive outcomes, including improved emotional information processing, cognitive organization and functional outcomes like higher rates of employment.

Acceptance and Commitment Therapy

Acceptance and commitment therapy (ACT) is a CBT-based intervention that encourages people to accept their feelings instead of trying to change them. It incorporates mindfulness and other practices that help people experience their emotions more deeply without believing in or reacting to them. It can show people how to separate their sense of self from the ways they think and act, giving them the freedom to act in ways that don’t match their inner states.

In severe and persistent mental illnesses like schizophrenia, it is difficult, if not impossible, to control psychological processes, and trying to do so can increase instead of reduce distress. Acceptance and commitment therapy for psychotic disorders works by encouraging people to make external changes that promote internal change instead of the other way around.

This therapeutic intervention has been shown to be especially effective for people with psychotic disorders, cutting rates of rehospitalization in half.

Coordinated Specialty Care

Coordinated specialty care (CSC) has been shown to be the most effective intervention for early psychosis, or an individual’s first instance of hallucinations or delusions. Also known as first episode psychosis, early psychosis is sometimes a symptom of an underlying psychotic disorder.

Coordinated specialty care is a set of different interventions carefully selected to address different symptoms and aspects of a person’s life. The six components of CSC are:

  • Case management
  • Family support and education
  • Psychotherapy
  • Medication management
  • Supported employment and education
  • Peer support

This suite of services helps people experience improved family relationships, increased social connection and more consistent symptom management after early psychosis. Many case managers also refer clients to services needed to address other issues like underlying medical or mental health problems.

The extent to which CSC improves a person’s quality of life is related to how quickly they start receiving care. The interconnected services of CSC provide support that can allow an individual to respond to changes in their condition quickly, helping prevent rehospitalization and other potential consequences of symptom recurrence.

Family and Group Therapy

Family and group therapy provides some of the same interventions as individual therapy in a group context that facilitates learning and peer support.

In family therapy, families can learn how to change patterns of communication or behavior that can increase stress and worsen outcomes for people with psychotic disorders. Family members can gain insight into how their loved one feels and learn how to support one another.

In group therapy, clients can connect with one another in ways that reduce shame and feelings of isolation, as well as learn effective ways to cope and manage symptoms from their peers.

Treating Psychotic Disorders and Co-Occurring Conditions

Since psychotic disorders manifest in complex ways, many interventions used for them already incorporate multiple treatment modalities. This makes it easier to address co-occurring conditions.

Case managers can refer clients with psychotic disorders to additional treatment or to supportive services as needed, and psychiatrists can adjust medication regimens to address new symptoms or comorbid conditions.

The frequency with which people with psychotic disorders have co-occurring substance use disorders is high. Research shows that as many as three-fourths of people with psychotic disorders also have a substance use disorder at some point in their lifetimes.

Typically, substance use and psychotic disorders are treated with separate but integrated services. This means people with dual diagnoses see different clinicians that are part of the same treatment team. In integrated approaches, therapists, psychiatrists, case managers and other team members communicate with one another and coordinate interventions.

People with co-occurring disorders usually participate in both mental health and substance use treatment groups. Individual therapy often incorporates motivational enhancement approaches that are more effective for people with dual diagnoses. Sometimes, medication management is used to address both psychotic and substance use disorders through the use of replacement or agonist medications like buprenorphine and naltrexone.

In other cases, what initially appear to be co-occurring psychotic and substance use disorders end up being substance-induced psychosis. The symptoms of substance-induced psychosis tend to subside during professional care for addiction, once use of the substance discontinued. In cases of physical dependence, the symptoms of substance-induced psychosis can extend until the withdrawal period is complete.

Treating a person with anxiety depends on the nature of the anxiety disorder and individual preferences. Often, treatment will combine different types of therapy and medication.

Alcohol dependence, depression, and other conditions can sometimes have such a strong link to anxiety in some people that treating an anxiety disorder must wait until an individual manages any underlying conditions.

Recognizing the developing symptoms of anxious feelings and taking steps to manage the condition without medical assistance should be the first port of call.

However, if this does not reduce the impact of anxiety symptoms, or if the onset is particularly sudden or severe, other treatments are available.

Self-treatment

Relaxation techniques can help to address anxious emotions before they develop into a disorder.
In some cases, a person can manage anxiety at home without clinical supervision. However, this may be limited to shorter and less severe periods of anxiety.

Doctors recommend several exercises and techniques to cope with brief or focused bouts of anxiety, including:

  • Stress management: Limit potential triggers by managing stress levels. Keep an eye on pressures and deadlines, organize daunting tasks in to-do lists, and take enough time off from professional or educational obligations.
  • Relaxation techniques: Certain measures can help reduce signs of anxiety, including deep-breathing exercises, long baths, meditation, yoga, and resting in the dark.
  • Exercises to replace negative thoughts with positive ones: Write down a list of any negative thoughts, and make another list of positive thoughts to replace them. Picturing yourself successfully facing and conquering a specific fear can also provide benefits if the anxiety symptoms link to a specific stressor.
  • Support network: Talk to a person who is supportive, such as a family member or friend. Avoid storing up and suppressing anxious feelings as this can worsen anxiety disorders.
    Exercise: Physical exertion and an active lifestyle can improve self-image and trigger the release of chemicals in the brain that stimulate positive emotions.

Counseling and therapy

Standard treatment for anxiety involves psychological counseling and therapy.

This might include psychotherapy, such as cognitive behavioral therapy (CBT) or a combination of therapy and counseling.

CBT aims to recognize and alter the harmful thought patterns that can trigger an anxiety disorder and troublesome feelings, limit distorted thinking, and change the scale and intensity of reactions to stressors.

This helps people manage the way their body and mind react to certain triggers.

Psychotherapy is another treatment that involves talking with a trained mental health professional and working to the root of an anxiety disorder.

Sessions might explore the triggers of anxiety and possible coping mechanisms.

Medications

Several types of medication can support the treatment of an anxiety disorder.

Other medicines might help control some of the physical and mental symptoms. These include:

Tricyclics: This is a class of drugs that have demonstrated helpful effects on most anxiety disorders other than obsessive-compulsive disorder (OCD). These drugs are known to cause side effects, such as drowsiness, dizziness, and weight gain. Two examples of tricyclics are imipramine and clomipramine.

Some people require medication to manage an anxiety disorder.
Benzodiazepines: These are only available on prescription, but they can be highly addictive and would rarely be a first-line medication. These drugs tend not to cause many side effects, except for drowsiness and possible dependency. Diazepam, or Valium, is an example of a common benzodiazepine for people with anxiety.

Anti-depressants: While people most commonly use anti-depressants to manage depression, they also feature in the treatment of many anxiety disorders. Serotonin reuptake inhibitors (SSRI) are one option, and they have fewer side effects than older anti-depressants. They are still likely to cause nausea and sexual dysfunction at the outset of treatment. Some types include fluoxetine and citalopram.

Other medications that can reduce anxiety include:

  • beta-blockers
  • monoamine oxidase inhibitors (MAOIs)
  • buspirone

Stopping some medications, especially anti-depressants, can cause withdrawal symptoms, including brain zaps. These are painful jolts in the head that feel like shocks of electricity.

An individual planning to adjust their approach to treating anxiety disorders after a long period of taking anti-depressants should consult their doctor about how best to move away from medications.

If severe, adverse, or unexpected effects occur after taking any prescribed medications, be sure to update a physician.

Prevention

Although anxious feelings will always be present in daily life, there are ways to reduce the risk of a full-blown anxiety disorder.

Taking the following steps will help keep anxious emotions in check and prevent the development of a disorder, including:

  • Consume less caffeine, tea, soda, and chocolate.
  • Check with a doctor or pharmacist before using over-the-counter (OTC) or herbal remedies for chemicals that might make anxiety worse.
  • Keep up a balanced, nutritious diet.
  • Regular sleep patterns can be helpful.
  • Avoid alcohol, cannabis, and other recreational drugs.

Takeaway

Treating an anxiety disorder focuses on psychological therapy, medication, and lifestyle adjustments. Treatment will be different for each person depending on the type of anxiety disorder they have and the presence of any underlying conditions.

Self-management is the first step for managing anxious feelings and often involves relaxation techniques, an active lifestyle, and effective time management. If these measures do not bring anxious reactions under control, visit a doctor and seek other avenues of treatment.

If anxious reactions are severe from the outset, for example taking the form of panic attacks, seek treatment.

Psychological therapies, including CBT, can help a person adjust the way they react to stressful life events and triggers, as well as the scale of the reaction. They can also help to limit distorted thinking and replace negative thoughts.

Medications that can support treatment include tricyclic medications, anti-depressants, beta-blockers, and benzodiazepines. Speak to a doctor about any severe side effects or withdrawal symptoms after stopping.

Overview

Post-traumatic stress disorder (PTSD) is a disorder that develops in some people who have experienced a shocking, scary, or dangerous event.

It is natural to feel afraid during and after a traumatic situation. Fear triggers many split-second changes in the body to help defend against danger or to avoid it. This “fight-or-flight” response is a typical reaction meant to protect a person from harm. Nearly everyone will experience a range of reactions after trauma, yet most people recover from initial symptoms naturally. Those who continue to experience problems may be diagnosed with PTSD. People who have PTSD may feel stressed or frightened, even when they are not in danger.

Signs and Symptoms

While most but not all traumatized people experience short term symptoms, the majority do not develop ongoing (chronic) PTSD. Not everyone with PTSD has been through a dangerous event. Some experiences, like the sudden, unexpected death of a loved one, can also cause PTSD. Symptoms usually begin early, within 3 months of the traumatic incident, but sometimes they begin years afterward. Symptoms must last more than a month and be severe enough to interfere with relationships or work to be considered PTSD. The course of the illness varies. Some people recover within 6 months, while others have symptoms that last much longer. In some people, the condition becomes chronic.

A doctor who has experience helping people with mental illnesses, such as a psychiatrist or psychologist, can diagnose PTSD.

To be diagnosed with PTSD, an adult must have all of the following for at least 1 month:

  • At least one re-experiencing symptom
  • At least one avoidance symptom
  • At least two arousal and reactivity symptoms
  • At least two cognition and mood symptoms

Re-experiencing symptoms include:

  • Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweating
  • Bad dreams
  • Frightening thoughts

Re-experiencing symptoms may cause problems in a person’s everyday routine. The symptoms can start from the person’s own thoughts and feelings. Words, objects, or situations that are reminders of the event can also trigger re-experiencing symptoms.

Avoidance symptoms include:

  • Staying away from places, events, or objects that are reminders of the traumatic experience
  • Avoiding thoughts or feelings related to the traumatic event

Things that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms may cause a person to change his or her personal routine. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car.

Arousal and reactivity symptoms include:

  • Being easily startled
  • Feeling tense or “on edge”
  • Having difficulty sleeping
  • Having angry outbursts

Arousal symptoms are usually constant, instead of being triggered by things that remind one of the traumatic events. These symptoms can make the person feel stressed and angry. They may make it hard to do daily tasks, such as sleeping, eating, or concentrating.

Cognition and mood symptoms include:

  • Trouble remembering key features of the traumatic event
  • Negative thoughts about oneself or the world
  • Distorted feelings like guilt or blame
  • Loss of interest in enjoyable activities

Cognition and mood symptoms can begin or worsen after the traumatic event, but are not due to injury or substance use. These symptoms can make the person feel alienated or detached from friends or family members.

It is natural to have some of these symptoms for a few weeks after a dangerous event. When the symptoms last more than a month, seriously affect one’s ability to function, and are not due to substance use, medical illness, or anything except the event itself, they might be PTSD. Some people with PTSD don’t show any symptoms for weeks or months. PTSD is often accompanied by depression, substance abuse, or one or more of the other anxiety disorders.

Do children react differently than adults?

Children and teens can have extreme reactions to trauma, but some of their symptoms may not be the same as adults. Symptoms sometimes seen in very young children (less than 6 years old), these symptoms can include:

  • Wetting the bed after having learned to use the toilet
  • Forgetting how to or being unable to talk
  • Acting out the scary event during playtime
  • Being unusually clingy with a parent or other adult

Older children and teens are more likely to show symptoms similar to those seen in adults. They may also develop disruptive, disrespectful, or destructive behaviors. Older children and teens may feel guilty for not preventing injury or deaths. They may also have thoughts of revenge.

Risk Factors

Anyone can develop PTSD at any age. This includes war veterans, children, and people who have been through a physical or sexual assault, abuse, accident, disaster, or other serious events. According to the National Center for PTSD, about 7 or 8 out of every 100 people will experience PTSD at some point in their lives. Women are more likely to develop PTSD than men, and genes may make some people more likely to develop PTSD than others.

Not everyone with PTSD has been through a dangerous event. Some people develop PTSD after a friend or family member experiences danger or harm. The sudden, unexpected death of a loved one can also lead to PTSD.

Why do some people develop PTSD and other people do not?

It is important to remember that not everyone who lives through a dangerous event develops PTSD. In fact, most people will not develop the disorder.

Many factors play a part in whether a person will develop PTSD. Some examples are listed below. Risk factors make a person more likely to develop PTSD. Other factors, called resilience factors, can help reduce the risk of the disorder.

Some factors that increase risk for PTSD include:

  • Living through dangerous events and traumas
  • Getting hurt
  • Seeing another person hurt, or seeing a dead body
  • Childhood trauma
  • Feeling horror, helplessness, or extreme fear
  • Having little or no social support after the event
  • Dealing with extra stress after the event, such as loss of a loved one, pain and injury, or loss of a job or home
  • Having a history of mental illness or substance abuse

Some factors that may promote recovery after trauma include:

  • Seeking out support from other people, such as friends and family
  • Finding a support group after a traumatic event
  • Learning to feel good about one’s own actions in the face of danger
  • Having a positive coping strategy, or a way of getting through the bad event and learning from it
  • Being able to act and respond effectively despite feeling fear

Researchers are studying the importance of these and other risk and resilience factors, including genetics and neurobiology. With more research, someday it may be possible to predict who is likely to develop PTSD and to prevent it.

Treatments and Therapies

The main treatments for people with PTSD are medications, psychotherapy (“talk” therapy), or both. Everyone is different, and PTSD affects people differently, so a treatment that works for one person may not work for another. It is important for anyone with PTSD to be treated by a mental health provider who is experienced with PTSD. Some people with PTSD may need to try different treatments to find what works for their symptoms.

If someone with PTSD is going through an ongoing trauma, such as being in an abusive relationship, both of the problems need to be addressed. Other ongoing problems can include panic disorder, depression, substance abuse, and feeling suicidal.

Medications

The most studied type of medication for treating PTSD are antidepressants, which may help control PTSD symptoms such as sadness, worry, anger, and feeling numb inside. Other medications may be helpful for treating specific PTSD symptoms, such as sleep problems and nightmares.

Doctors and patients can work together to find the best medication or medication combination, as well as the right dose.

Psychotherapy

Psychotherapy (sometimes called “talk therapy”) involves talking with a mental health professional to treat a mental illness. Psychotherapy can occur one-on-one or in a group. Talk therapy treatment for PTSD usually lasts 6 to 12 weeks, but it can last longer. Research shows that support from family and friends can be an important part of recovery.

Many types of psychotherapy can help people with PTSD. Some types target the symptoms of PTSD directly. Other therapies focus on social, family, or job-related problems. The doctor or therapist may combine different therapies depending on each person’s needs.

Effective psychotherapies tend to emphasize a few key components, including education about symptoms, teaching skills to help identify the triggers of symptoms, and skills to manage the symptoms. One helpful form of therapy is called cognitive behavioral therapy, or CBT. CBT can include:

  • Exposure therapy. This helps people face and control their fear. It gradually exposes them to the trauma they experienced in a safe way. It uses imagining, writing, or visiting the place where the event happened. The therapist uses these tools to help people with PTSD cope with their feelings.
  • Cognitive restructuring. This helps people make sense of the bad memories. Sometimes people remember the event differently than how it happened. They may feel guilt or shame about something that is not their fault. The therapist helps people with PTSD look at what happened in a realistic way.

There are other types of treatment that can help as well. People with PTSD should talk about all treatment options with a therapist. Treatment should equip individuals with the skills to manage their symptoms and help them participate in activities that they enjoyed before developing PTSD.

How Talk Therapies Help People Overcome PTSD
Talk therapies teach people helpful ways to react to the frightening events that trigger their PTSD symptoms. Based on this general goal, different types of therapy may:

  • Teach about trauma and its effects
  • Use relaxation and anger-control skills
  • Provide tips for better sleep, diet, and exercise habits
  • Help people identify and deal with guilt, shame, and other feelings about the event
  • Focus on changing how people react to their PTSD symptoms. For example, therapy helps people face reminders of the trauma.

Beyond Treatment: How can I help myself?

It may be very hard to take that first step to help yourself. It is important to realize that although it may take some time, with treatment, you can get better. If you are unsure where to go for help, ask your family doctor.

To help yourself while in treatment:

  • Talk with your doctor about treatment options
  • Engage in mild physical activity or exercise to help reduce stress
  • Set realistic goals for yourself
  • Break up large tasks into small ones, set some priorities, and do what you can as you can
  • Try to spend time with other people, and confide in a trusted friend or relative. Tell others about things that may trigger symptoms.
  • Expect your symptoms to improve gradually, not immediately
  • Identify and seek out comforting situations, places, and people

Caring for yourself and others is especially important when large numbers of people are exposed to traumatic events (such as natural disasters, accidents, and violent acts).

Eating disorder treatment depends on your particular disorder and your symptoms. It typically includes a combination of psychological therapy (psychotherapy), nutrition education, medical monitoring and sometimes medications.

Eating disorder treatment also involves addressing other health problems caused by an eating disorder, which can be serious or even life-threatening if they go untreated for too long. If an eating disorder doesn’t improve with standard treatment or causes health problems, you may need hospitalization or another type of inpatient program.

Having an organized approach to eating disorder treatment can help you manage symptoms, return to a healthy weight, and maintain your physical and mental health.

Where to start

Whether you start by seeing your primary care practitioner or some type of mental health professional, you’ll likely benefit from a referral to a team of professionals who specialize in eating disorder treatment. Members of your treatment team may include:

  • A mental health professional, such as a psychologist to provide psychological therapy. If you need medication prescription and management, you may see a psychiatrist. Some psychiatrists also provide psychological therapy.
  • A registered dietitian to provide education on nutrition and meal planning.
  • Medical or dental specialists to treat health or dental problems that result from your eating disorder.
  • Your partner, parents or other family members. For young people still living at home, parents should be actively involved in treatment and may supervise meals.

It’s best if everyone involved in your treatment communicates about your progress so that adjustments can be made to treatment as needed.

Managing an eating disorder can be a long-term challenge. You may need to continue to see members of your treatment team on a regular basis, even if your eating disorder and related health problems are under control.

Setting up a treatment plan

You and your treatment team determine what your needs are and come up with goals and guidelines. Your treatment team works with you to:

  • Develop a treatment plan. This includes a plan for treating your eating disorder and setting treatment goals. It also makes it clear what to do if you’re not able to stick with your plan.
  • Treat physical complications. Your treatment team monitors and addresses any health and medical issues that are a result of your eating disorder.
  • Identify resources. Your treatment team can help you discover what resources are available in your area to help you meet your goals.
  • Work to identify affordable treatment options. Hospitalization and outpatient programs for treating eating disorders can be expensive, and insurance may not cover all the costs of your care. Talk with your treatment team about financial issues and any concerns — don’t avoid treatment because of the potential cost.

Psychological therapy

Psychological therapy is the most important component of eating disorder treatment. It involves seeing a psychologist or another mental health professional on a regular basis.

Therapy may last from a few months to years. It can help you to:

  • Normalize your eating patterns and achieve a healthy weight
  • Exchange unhealthy habits for healthy ones
  • Learn how to monitor your eating and your moods
  • Develop problem-solving skills
  • Explore healthy ways to cope with stressful situations
  • Improve your relationships
  • Improve your mood

Treatment may involve a combination of different types of therapy, such as:

  • Cognitive-behavioral therapy. This type of psychotherapy focuses on behaviors, thoughts and feelings related to your eating disorder. After helping you gain healthy eating behaviors, it helps you learn to recognize and change distorted thoughts that lead to eating disorder behaviors.
  • Family-based therapy. During this therapy, family members learn to help you restore healthy eating patterns and achieve a healthy weight until you can do it on your own. This type of therapy can be especially useful for parents learning how to help a teen with an eating disorder.
  • Group cognitive-behavioral therapy. This type of therapy involves meeting with a psychologist or other mental health professional along with others who are diagnosed with an eating disorder. It can help you address thoughts, feelings and behaviors related to your eating disorder, learn skills to manage symptoms, and regain healthy eating patterns.

Your psychologist or other mental health professional may ask you to do homework, such as keep a food journal to review in therapy sessions and identify triggers that cause you to binge, purge or do other unhealthy eating behaviors.

Nutrition education

Registered dietitians and other professionals involved in your treatment can help you better understand your eating disorder and help you develop a plan to achieve and maintain healthy eating habits. Goals of nutrition education may be to:

  • Work toward a healthy weight
  • Understand how nutrition affects your body, including recognizing how your eating disorder causes
  • nutrition issues and physical problems
  • Practice meal planning
  • Establish regular eating patterns — generally, three meals a day with regular snacks
  • Take steps to avoid dieting or bingeing
  • Correct health problems that are a result of malnutrition or obesity

Medications for eating disorders

Medications can’t cure an eating disorder. They’re most effective when combined with psychological therapy.

Antidepressants are the most common medications used to treat eating disorders that involve binge-eating or purging behaviors, but depending on the situation, other medications are sometimes prescribed.

Taking an antidepressant may be especially helpful if you have bulimia or binge-eating disorder. Antidepressants can also help reduce symptoms of depression or anxiety, which frequently occur along with eating disorders.

You may also need to take medications for physical health problems caused by your eating disorder.

Hospitalization for eating disorders

Hospitalization may be necessary if you have serious physical or mental health problems or if you have anorexia and are unable to eat or gain weight. Severe or life-threatening physical health problems that occur with anorexia can be a medical emergency.

In many cases, the most important goal of hospitalization is to stabilize acute medical symptoms through beginning the process of normalizing eating and weight. The majority of eating and weight restoration takes place in the outpatient setting.

Hospital day treatment programs

Day treatment programs are structured and generally require attendance for multiple hours a day, several days a week. Day treatment can include medical care; group, individual and family therapy; structured eating sessions; and nutrition education.

Residential treatment for eating disorders

With residential treatment, you temporarily live at an eating disorder treatment facility. A residential treatment program may be necessary if you need long-term care for your eating disorder or you’ve been in the hospital a number of times but your mental or physical health hasn’t improved.

Ongoing treatment for health problems

Eating disorders can cause serious health problems related to inadequate nutrition, overeating, bingeing and other factors. The type of health problems caused by eating disorders depends on the type and severity of the eating disorder. In many cases, problems caused by an eating disorder require ongoing treatment and monitoring.

Health problems linked to eating disorders may include:

  • Electrolyte imbalances, which can interfere with the functioning of your muscles, heart and nerves
  • Heart problems and high blood pressure
  • Digestive problems
  • Nutrient deficiencies
  • Dental cavities and erosion of the surface of your teeth from frequent vomiting (bulimia)
  • Low bone density (osteoporosis) as a result of irregular or absent menstruation or long-term malnutrition (anorexia)
  • Stunted growth caused by poor nutrition (anorexia)
  • Mental health conditions such as depression, anxiety, obsessive-compulsive disorder or substance abuse
  • Lack of menstruation and problems with infertility and pregnancy

Take an active role

You are the most important member of your treatment team. For successful treatment, you need to be actively involved in your treatment and so do your family members and other loved ones. Your treatment team can provide education and tell you where to find more information and support.

There’s a lot of misinformation about eating disorders on the web, so follow your treatment team’s advice and get suggestions on reputable websites to learn more about your eating disorder. Examples of helpful websites include the National Eating Disorders Association (NEDA), as well as Families Empowered and Supporting Treatment of Eating Disorders (F.E.A.S.T.).

Treatment

If you are ready to enter treatment, the Substance Abuse and Mental Health Services Administration offers a substance abuse treatment locator. With this simple tool, you can enter your zip code and find drug and alcohol treatment services located near you. Restore Africa® also offers local rehab resources and has full-service treatment centers in Karen, Nairobi County and Kikuyu, Kiambu County.

If you or a loved one is seeking addiction treatment, Restore Africa® has treatment centers located across the country and can create a substance abuse treatment plan that meets your unique needs. Reach out to our caring admissions department today to discuss your needs and begin the journey toward recovery.

Speak to an Intake Coordinator now.

+254 (0) 20 4403 716

Your well-being is our option.

Dr Peter Onyango
Founder & CEO, Restore Africa

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