How the drug D-cycloserine (DCS) can enhance Cognitive Behavioral Therapy

Posted on August 27, 2016 by JmaC
Exposure therapy is a well-known treatment for phobias and anxiety disorders, and recent research seeks to make exposure therapy even more effective through DCS, a drug that boosts learning in order to strengthen and speed up the effects of the therapy.
PUBLISHED: 02/10/2016


from Boston University


from Boston University

If you are familiar with Cognitive Behavioral Therapy (CBT) used to treat anxiety disorders, you might also be familiar with exposure therapy, a CBT technique that confronts the cause of anxiety in order to re-evaluate the actual danger present, and learn healthy ways to deal with the resulting fear. For example, if you are afraid of heights, exposure therapy might gradually expose you to different height levels, while teaching you better strategies to manage the stress it creates. Exposure therapy can be very effective – in a successful exposure, fear could begin with a high distress measurement of 80% to 90% and end significantly lower, at 10 to 20%. Ideally, this learning process should continue to lead patients to report a lowered distress rating whenever confronted by the feared object or event.

While effective, using exposure therapy to learn that a feared event or object is not dangerous takes time, as a patient will typically need to successfully confront the feared stimuli repeatedly to see lowered distress ratings. However, recent research has uncovered that there may be a way to speed up the benefits of exposure therapy, or even enhance the results.

This Drug Can Boost Learning and Reduce Anxiety Symptoms Faster

D-cycloserine (DCS), a memory enhancing drug that acts on specific nerve-cell receptors in the brain, can be used to improve the learning that takes place during exposure practices. DCS can help your cells respond to the neurotransmitter glutamate, which is important in a process integral to anxiety treatment called extinction learning. Extinction learning is the basis for exposure therapy: it allows anxious patients to learn that feared outcomes are unlikely to occur. After a patient with a phobia of spiders is exposed repeatedly to spiders without any negative consequences, the patient learns that the feared stimulus does not result in the feared outcome, and is able to overcome his or her fear.

The use of DCS can also lead to a faster reduction in anxiety symptoms over the course of treatment, and can even decrease the number of treatment sessions needed overall. The same holds true for symptoms of other anxiety-related problems, such as Social Anxiety Disorder, panic disorder, Obsessive-Compulsive Disorder, and Post-Traumatic Stress Disorder.

Because DCS is a memory enhancer and not an anxiolytic drug (a drug that reduces anxiety), taking DCS alone will not reduce anxiety. DCS only works to reduce anxiety symptoms in conjunction with exposure procedures, as it works to enhance the learning that takes place during therapy (i.e., by acting to boost the memory).

DCS Side Effects are Minimal, but Dose Timing Remains Uncertain

When used as a cognitive enhancer in conjunction with exposure therapy, doses of 50 and 250 milligrams of DCS are used, usually just for a few weeks. At this dose, DCS side effects are comparable to that of a placebo, with no known or recorded side effects.

However, scientists don’t yet fully understand the optimal dosing and dose timing (before or after fear subsides). As a recent study suggests, DCS’s effectiveness may depend on the success of the exposure itself. In other words, only patients who react with anxiety during the exposure therapy and then experience a significant decrease in anxiety by the end of the exposure may benefit from the medication. The study suggests that in an unsuccessful exposure (i.e., when the patient’s anxiety does not peak and then decrease), DCS may instead reinforce the anxious response.1

Next Steps in Using DCS to Enhance Exposure Therapy

Given that DCS has not yet been approved by the FDA as a drug used to enhance CBT for anxiety, it is currently unavailable to the public. However, a new research study examining DCS’s role in exposure therapy is being conducted at three universities: Boston University, University of Texas at Austin, and Rush University. The study will examine the effectiveness of giving DCS to patients only when fear subsides after an exposure.

If you feel anxious in social situations and live near one of the universities, please reach out to the appropriate contact for more information regarding possible participation in the clinical trial.

  • Boston University: nofear@bu.edu
  • University of Texas at Austin: s.witcraft@utexas.edu
  • Rush University: elizabeth_kaiser@rush.edu
Date of original publication: June 22, 2015
Updated on: February 10, 2016
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10 Truths About Panic Attacks

Posted on August 27, 2016 by JmaC
Your mind starts to race, your heart begins to pound, and you feel dizzy, shaky, and numb all at once. Panic attacks can be a horrifying experience – check out what Anxiety.org readers have to say about panic attacks and how to get through them.

Whether you’re alone in your room, surrounded by a crowd, or just going through your typical day, it can hit you like a sudden storm. Your mind starts to race, your heart begins to pound, and you feel dizzy, shaky, and numb all at once. You struggle through the fear, fighting away the dread as you try to keep your thoughts together. And all you want, all you long for, is to just… breathe.

What you’ve just gone through is a panic attack, and we here at Anxiety.org want to make sure that our visitors avoid, or at least are prepared for, debilitating situations like the one described above. We do this in several ways. First, we strive to deliver the most beneficial insights from renowned experts and specialists in the field of anxiety and mental health. Second, our staff works diligently to bring you information by combing the most up-to-date research materials and sharing their findings on noteworthy topics meant to aid you in finding your cure for anxiety. Lastly, we provide an outlet for our Anxiety.org community, meaning readers like you, to share their personal stories and offer their support. It’s from this last resource that we offer some personal perspectives into understanding panic attacks and how to get through them.

The Basics of a Panic Attack

Let’s start by getting to the very core of panic attacks: what do panic attacks feel like? We asked our Facebook followers that very question, and the majority described emotions similar to the description at the start of the article:

  • “You lose complete control of your mind and body. Heart pounding, hands shaking, heart beating out of your chest. Scared! But, because most people do not understand. You have to continue to function. While you are in a fog, you function.”

Others, however, experienced more dire and emotional events:

  • “Instant fear of dying! Like you wanna run. Everything you are looking at looks like it’s running together. Heart racing, short of breath. Feels like your in a bubble, you can see out but can’t be seen.”

There were also a few readers who couldn’t put the experience into words, but wanted to offer their own viewpoint:

  • “Hard to explain. Everyone’s different. But I will tell you something truthfully. They cannot harm you and you are stronger than them!”

No matter how panic attacks were described though, there was one thing the majority of our community had in common: the belief that no matter what happens or how they felt, they eventually came to the realization that they would always get through it:

  • “For me, not understanding what was happening created a more desperate panic in me. I really did research and did talk to a therapist and realized the more I learned about them, the less the servarity… When I feel one coming on I just dont panic, I just go with it and stay calm and it goes away.”

The Effects of a Panic Attack

Experiencing such complex emotions so frequently had us wondering what kind of impact panic attacks had on the average person. With this in mind, we next asked our followers how panic attacks affected them. Their answers ranged in severity, but many mentioned how damaging it was to their personal, everyday lives:

  • “Ummmm I don’t have a social life. It’s kind of hard to hang out with people when I never know how I’m going to feel from day to day and then feel incredibly awkward once I am around people”

For some, the fear of a possible attack coming on with no possible warning even had them avoiding normal activities:

  • “Just the thought of going out in public gets me going sometimes. I wouldn’t wish these feelings upon anyone. I have panic attacks out of no where, sitting at home reading a book or watching TV, “bam” it rears it’s ugly face!”

To add to that, the emotional and mental impact panic attacks caused could be just as devastating:

  • “I’m pretty much a hermit. I’m fine most of the time but on those days where I could really use a friend, it hurts deeply to be so alone.”

Tips for Surviving a Panic Attack

After reading about the emotional rollercoaster panic attacks can cause, and learning about the significant effects they have on everyday life, we at Anxiety.org wondered how we could possibly help our readers through these difficult experiences. Although we knew extensive research on your behalf, or asking a knowledgeable expert for guidance, would offer a valuable amount of information, we felt that the best source for advice would come from first-hand experience. So, we again turned to the Anxiety.org community to share their stories and advice about what they do when experiencing a panic attack.

For the most part, many people believed that deep breaths and talking yourself through the attack really helps:

  • “Isolate yourself from distracting surroundings/people and find a nice, quiet place to shut your eyes and focus on your breathing. I find this difficult to do right away after it begins, so I usually pace or go for a walk until I’ve tired myself out and then do this. Keep repeating to yourself that you’ve been through this before, survived and can do it again. And make yourself BELIEVE IT. Once you believe it, you start to realize that you can get through it like any other time. That you will survive. Other tips include shutting the lights off, lighting some candles and taking a warm bath once you feel yourself getting anxious. Drink lots of water and chamomile tea. And practice yoga regularly to help with the controlled breathing!”

There were also those who shared their experience and success with alternativetreatments, like relaxation and medication:

  • “I learned relaxation techniques from a CD given to me by a psychologist. I fortunately “grew out” of them after high school. By adulthood I found the right perscription for me for GAD. Xanax (.5mg) is great for anxious triggers like traveling.”

Although there was some debate on whether certain treatments and therapies worked over others, the consensus was that the best thing to do for those who suffer panic attacks is to find a method that works for them. One reader gave a simple yet helpful way to look at it:

  • “Once you know it won’t kill you it makes it easier to deal with.”

Help Us Help You

Hopefully these insights have given you a better understanding of the gravity of panic attacks and the methods that can be used to deal with them. If you are interested in learning more about what readers like you have to say, please follow us on Facebook orTwitter.

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A less traditional class of drugs could offer effective treatment for PTSD

Posted on August 27, 2016 by JmaC

Post-traumatic Stress Disorder (PTSD) is a serious anxiety disorder that results from exposure to a traumatic experience or from witnessing a life-threatening event such as violence, abuse, accident, war, disaster, or any situation that seriously threatens the integrity of a person. PTSD is known to be common among veterans, but is also highly prevalent in women. The affliction is currently a very serious burden in the U.S., with high associated mortality rates and healthcare costs.

A spate of treatments are available for those with PTSD, ranging from mental psychotherapy to antidepressants. There’s also exciting news in the area of PTSD treatment: the healthcare community has its eye on a different class of drugs that offers the potential to be highly effective at treating PTSD symptoms.

A Possible New Treatment Method for PTSD Sufferers

Research on PTSD is steadily increasing year by year, which has drawn me to investigate current and potential treatments for the affliction. The first line of treatment for the disorder generally consists of psychotherapy, such as cognitive therapy, exposure therapy, stress inoculation training, and pharmacotherapy with antidepressants, specifically selective serotonin reuptake inhibitors (SSRIs) such as Sertraline and Paroxetine.

Atypical antipsychotics (AAs), which have traditionally been used to treat schizophrenia, are in a different class of drugs from antidepressants, the common standard for PTSD medication. AAs can affect several neurotransmitter systems which have been proven to be involved with the psychophysiology of PTSD. AAs have gotten a lot of attention from the scientific community, but current data proving its efficacy for PTSD is still insufficient. Thus, my team and I set out to conduct a meta-analysis in order to further clarify the effectiveness of AA therapies on PTSD.

Atypical Antipsychotics Reduce PTSD Symptoms

Our meta-analysis included the findings from 455 patients in eight studies: 231 were allocated to AA groups that received medication, and 224 were allocated to placebo groups. The results indicated that AAs were more effective than a placebo in treating PTSD patients. When the effects of pharmacotherapy were compared with placebo treatment, we found significant decreases in PTSD symptoms.

The Side Effects of AAs are Comparable to a Placebo

People with PTSD frequently have to be concerned about how to manage the side effects of their medication, which can often include muscle spasms and other movement disorders. In addition, the metabolic side-effects of AAs, which can lead to weight gain and diabetes, are also a critical concern for long-term use.

In order to analyze these possible drawbacks, we conducted a meta-analysis on dropout rates. Surprisingly, the results showed no statistical difference between AAs and placebo on acceptability and side effects. This finding may be explained by the low doses of AAs used to treat PTSD: somewhere between one-third and one-half of the dosage used to treat schizophrenia is given to people with PTSD.

Pharmacotherapy Shows Strong Potential in PTSD Treatment

AAs could be an effective new choice for treating PTSD, offering the benefits of reduced side effects when compared to other current mediations. We hope that our research and the search for better treatments will allow more people who suffer from PTSD to find greater peace of mind.

Date of original publication: June 18, 2015
Updated on: February 10, 2016
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How To Treat Anxiety in 6 Steps Using Mindfulness Meditation

Posted on August 27, 2016 by JmaC

Mindfulness meditation, a holistic mind-body treatment based in Buddhist psychology, is a powerful tool clinically proven to treat anxiety. This technique works by stopping the cycle of negative thoughts and helping you manage your feelings. The process of mindfulness meditation can be boiled down using these six essential steps:

  1. Stop yourself from obsessive thinking. Obsessing can make it difficult to let go of negative thoughts. Escaping this mental cycle is the goal of mindfulness meditation.
  2. Use an anchor to still the mind. Focusing on a single point can trigger physical relaxation, which will help you through the meditation process.
  3. Calm the body using the breath. A simple breathing exercise described below will help you relax and get in touch with your emotions.
  4. Focus on the sensations in the body. Every emotion has a sensation signal in the body. Find one sensation signal in the present moment and focus on it.
  5. Explore the qualities of the sensation signal you chose.
  6. Build up your ability to meditate for longer periods of time. Like any ability, meditation is a skill that takes practice. The longer you are able to meditate, the more benefit you will get from this exercise in mental control and emotional tolerance.

Read on to learn more about the process of mindfulness meditation – by fully understanding and utilizing these six steps, you can be on your way to practicing mindfulness meditation, and achieving all the mental health benefits that accompany it.

Mindfulness meditation has become nearly as recognizable and popular in mainstream Western culture as yoga. From ancient origins in the contemplative science of India and Tibet1, to the research laboratories of Ivy League medical schools, and from the conference rooms of elite corporations like Google2 to the VA hospitals of the US military3, there seems to be no discipline or sphere of life that isn’t taking an interest in mindfulness.

The healthcare community agrees that research outcomes support its efficacy – so how can you begin to utilize mindfulness meditation in your own life? You still need clear instructions and competent mentors to guide your experience. What follows are some easy steps to get a basic mindfulness practice started, with specific attention given to managing difficult or overwhelming emotions such as anxiety. While mindfulness meditation is very safe, please consult your therapist when starting any new regime and do not try the following instructions when you are having a panic attack.

1. Get out of the spin cycle of your thinking mind.

You may already be aware that the intensity and duration of negative emotions is driven or exacerbated by excessive rumination. That is – you can’t seem to let go of negative thoughts and instead , to your own detriment, obsess over and indulge worst-case scenarios that only compound shame, sadness, fear or anger. Quick hint, trying to suppress negative thoughts does not solve ruminations. When you’re caught in the grips of a spin cycle, use the following mindfulness technique.

2. Use an anchor to stabilize the turbulent mind.

The mind needs an anchor, or a single point of focus, to direct it away from ruminations and elicit the body’s natural relaxation response. Dr. Herbert Benson, a Harvard Medical School cardiologist who specializes in mind-body medicine, coined the term “the relaxation response” to describe the physical state of deep rest that changes the body’s response to stress. Many objects or anchors of attention are useful in stabilizing the mind and achieving this relaxation response. These anchors could include attending to sounds in the present moment, focusing on your breath passing in and out of the nostrils, repeating a prayer or affirmation, or any of the four foundations used in traditional Buddhist training.1

For those who struggle with anxiety, I often recommend using the second foundation, mindfulness of sensations, as the primary focus. The second foundation not only provides a solid, real-time anchor for attention, but also serves as an exposure or desensitization exercise that short-circuits habituated stimulus-response patterns.

After finding an anchor, the next mindfulness step is physically based – the following breathing exercise will help you attain the body’s natural relaxation response.

3. Come into your body where your emotions reside.

Find a comfortable and relaxed position, whether seated or lying down. Try to keep your spine straight and stay physically relaxed as much as you can. Begin by taking ten natural, gentle breaths, focusing your mental attention on your nostrils as you inhale, pause, and then exhale. At the tail end of your exhale, count a number aloud or to yourself, designating the completion of a cycle. Then, repeat that number during the next inhalation until you’ve completed ten full breath cycles.

If you get distracted by external sounds, passing thoughts, or physical discomfort, that’s totally normal. Don’t give up, get frustrated, or treat the breathing exercise like a race. Simply recognize your distraction as part of the exercise and calmly choose to return your focus to the breath, beginning again at the number one. After ten continuous breaths, expand your awareness to include your entire body.

Drop down into the body and feel the sensations arising, fully devoting your attention in the same manner that you were attending to the breath passing in and out of your nostrils. Yes, this body is where you always live, and yet, perhaps, you hardly notice it. If your entire body is too broad or vast a terrain to attend to, break it up into parts or regions in your mind, and go through a complete body scan, segment by segment, from the crown of your head to the tips of your toes and back again.

Do not judge what you notice about your body, desire something different, secretly hope for something to change, or expect a continuous, pleasant ride. Meet every physical sensation with utter acceptance. The goal of this practice is to ground yourself in the present moment of lived experience, here and now, rather than dwelling on the mental abstractions of past and future. This practice also helps you reconnect with the body, close to where the emotions truly reside, rather than occupying yourself with the stories or perceptions of emotions. Once you’ve completed a body scan, continue on the next step…

4. Befriend one emotion to undercut the reactivity circuit.

Imagining your body is a terrain and your awareness like a radar scanner, tracking the most intense or pervasive signal. Gravitate towards that signal, wherever it is, and make it the new object or anchor of attention. Every emotion has two parts: the sensation signal in the body, and the story fabricated in the mind. You are only interested in the first. Perhaps your sadness is like a hollow sensation in the gut. Your anxiety might be a constriction in the chest. Your anger may present as a burning sensation in the jaw. As you experience pain, tension, tightness, gripping, bluntness or dullness in any particular region, let those physical sensations become your signal and resist the urge to push them away.

Explore the signal like a child exploring a new territory, or a scientist using a microscope. You are observing energy patterns at play in the present moment. Meanwhile, avoid indulging the story line about what the signal seems to mean – allow those thoughts to pass on their own in the background of your awareness. If, at the time of your practice, your signal is pleasant, relaxing, and enjoyable, follow the same instructions of attending moment by moment with acceptance and without attaching to the story. If there is no pervasive sensation or signal, keep your attention openly scanning the body from head to toe and back, resist the urge to become disinterested, and stay attuned until something prominent emerges. Once you’re locked into a pervasive emotional signal, continue to the next phase of the exercise.

5. Go deeper by inquiring into the qualities of the sensation.

During this phase of the meditation practice, I often encourage my clients to inquire about the specific nuances of their signal by prompting them with the following questions: Where is the signal located in the body? What is its shape? What is its texture? Does it have a color? Is it dense or dispersed? Static or moving? This inquiry helps bring one’s attention closer to the signal, thereby deconditioning the habituated stimulus-avoidance-response circuit. When focusing on the sensation without the story line, my clients are often amazed to find that they are able to sit with and accept their distressing emotions for longer periods of time. However, one session of mindfulness meditation is not enough to escape the cycle of negative thoughts and emotional reactivity. You’ll need to continue to practice accordingly as follows.

6. Work your edge, systematically staying present for longer periods of time.

Just like physical strength, endurance and flexibility, emotional tolerance and resilience are skills that can by systematically developed. Treat meditation like a mental workout – you wouldn’t expect physical results in one session, but you would expect slight to moderate discomfort as you stretch and tone new muscles. Befriending distressing emotions through mindfulness requires a systematic increase in the intensity and duration of exposure to the signal. When you lift weights, run on the treadmill or do yoga postures, you are often asked to “work your edge” in a safe, responsible and consistent manner. You go right up to the threshold of your perceived capacity, breathe, and stay a little longer than you think you can. If you back off and avoid the edge of your comfort zone, you won’t grow new neural pathways and your emotional flexibility atrophies.

Conversely, if you go through the process of exposure in meditation too deeply, too quickly, or too recklessly, you risk getting overwhelmed or experiencing re-traumatization, the mental equivalent of physical injury, and can actually strengthen the negative avoidance response. Finding the right balance is key, and I often use a rating scale to help orient clients to the optimal ranges for new learning: the numbers 1-4 mean you’re not in the ball game, while 8-10 mean you’re risking injury. A number within the range of 5-7 is considered the sweet spot for change.

By mindfully attending to emotions with care, patience, and diligence, and by following these instructions over time, you’ll find that it is possible to turn an enemy into an ally, befriend anxiety, and reclaim your life. Though it can be very beneficial to find a mentor, therapist, or group that can help you understand and practice mindfulness meditation, by following these steps you can begin to experience the benefits of mindfulness through day-to-day efforts.

Date of original publication: July 20, 2015
Updated on: March 23, 2016
Posted in MindFulness | Leave a comment

Understanding Traumatic Stress

Posted on August 27, 2016 by JmaC

Stress is something we all face. It comes in many forms and differs across contexts, from work-related or financial stress, to social problems, to new life changes, to internal experiences. Some stressors are minor or short term, while others may be chronic. Because stress varies in intensity, length, and type across individuals, it can be difficult to pinpoint what “stress” is without looking to the body for answers.

The three I’s for traumatic stress on the body are:

    • Impact
    • Intensity
    • Intervention

What occurs in the body during times of stress?

Although what causes stress is different for each person, the “stress response” – theimpact – is universal. In the face of a major stressor (internal or external), the body goes into a “fight or flight” mode. During this “fight or flight” mode, the sympathetic nervous system and a specialized stress-response system called the hypothalamic pituitary adrenal (HPA) axis are activated. This activation results in the release of stress hormones and changes in the body to deal with the threat. When the threat is resolved, another system, called the parasympathetic nervous system, is activated to help the body return to homeostasis, a healthy balance of both systems. Although this stress response system works very well for acute stressors, activating this stress response over and over or being unable to return to homeostasis due to chronic stress can be very harmful to one’s physical and mental health, with research showing links between stress and many conditions, including depression and cardiovascular disease1.

What is traumatic stress?

Trauma is a specific type of stress that reflects exposure to terrible events generally outside the range of daily human experience that are emotionally painful, intense, and distressing. According to the Diagnostic and Statistical Manual of Mental Disorders, 5thedition2, there are specific criteria for what qualifies as a traumatic event:

“Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:

• Directly experiencing the traumatic event

• Witnessing, in person, the traumatic event

• Learning that the traumatic event occurred to a close family member or close friend. In cases of actual or threatened death of a family member or friend, the event must have been violent or accidental

• Experiencing repeated or extreme exposure to aversive details of the traumatic event (e.g., first responders collecting human remains; police officers repeatedly exposed to details of child abuse)” (pg. 271)2.

The reason for this narrow definition of trauma, and its distinction from stress more generally, is in part because traumatic events can result in particularly problematic trauma responses that are unique from general stress responses. In addition to that initial stress response in the body discussed earlier, long term psychological consequences are seen in many individuals that are exposed to traumas. A psychiatric condition commonly associated with trauma exposure is posttraumatic stress disorder (PTSD) which includes a variety of symptoms:

• Re-experiencing the trauma in distressing ways

• Avoidance of trauma-related cues

• Negative beliefs about oneself or others as a result of trauma

• Mood alterations following the trauma

• Hypervigilance

Many of the symptoms of PTSD are normal reactions in the first few weeks after the trauma but can become PTSD if they persist past the first month and cause problems with family, friends, work, or other important areas of one’s life.

Keep in mind that trauma responses are different across people and many will see no lasting negative effects of trauma. For example, rates of PTSD in the general population are approximately 8%, despite 50-60% of individuals reporting exposure to a traumatic event3. For those that do have negative psychological outcomes as a result of trauma, the development of PTSD is not the only potential response. Depression, substance use problems, and other anxiety disorders are also common trauma-related conditions that can emerge as a result of trauma exposure.

How will trauma affect you?

It is hard to know exactly how trauma will affect you. We know that there are many things that can influence the likelihood of developing PTSD or other psychological problems after exposure to trauma:

  • Type of trauma
  • Age that the trauma occurred
  • Severity of traumatic event or exposure to multiple traumas
  • Presence of other risk factors such as negative family environment or co-occurring psychological problems
  • Biological factors

Biological and environmental factors interact to create greater risk for or resilience against negative outcomes following trauma4. But, there is still so much we do not know about why some develop PTSD and some do not. The best thing to do if you are exposed to a traumatic event is to reach out to a professional for intervention and help. Exciting new research suggests that early intervention in emergency departmentsfollowing trauma might prevent PTSD and depression symptoms from developing5, so reaching out sooner rather than later may be particularly important. One example of this in action is how schools now respond to traumatic events, like shootings, by bringing in counselors and making mental health services readily available. If these professionals were trained in trauma-focused treatment, it might be particularly effective at reducing risk for developing PTSD following such traumas.

And for people who have struggled for a long time with PTSD or other trauma-related problems, it is never too late to get help. Common treatments, which can include counseling and/or medication, help people at all ages and stages of recovery. For PTSD in particular, research supports the use of exposure therapy and cognitive processing therapy, as well as selective serotonin-reuptake inhibitors (SSRIs) either alone or in combination with therapy6-8. It is important to find a clinician that is licensed and trained in working with people who have PTSD. For the therapy to work best, you want to find someone with expertise in what you are going through. Don’t be afraid to ask the clinician if they have been trained in cognitive behavioral therapy and have worked with traumatized people before. Remember, this is not something that you have to survive or face alone!

Date of original publication: October 22, 2015
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