Psychiatric Care for Trauma and PTSD

After a frightening or overwhelming experience, some people continue to feel on edge, relive the event, avoid reminders, or feel numb and disconnected. When these reactions last and interfere with life, they may reflect post-traumatic stress disorder or another trauma-related condition. Trauma can also show up as sleep problems, irritability or trouble concentrating.

How our physicians help

Our physicians move at a pace that feels safe, taking time to understand your history without pressing for details before you are ready. Care can combine trauma-focused psychotherapy and medication management from the same physician. We coordinate with trauma therapists and other providers when helpful.

Signs of PTSD and traumatic stress in adults

• Nightmares, or memories that arrive without warning after a smell, a sound or a date on the calendar.
• Changing your route or routines to steer clear of reminders.
• Startling at small noises, scanning every room, or sitting where you can see the door.
• Blaming yourself, or feeling that no person and no place can be trusted.
• Using alcohol or other substances to quiet the memories.

How children and teens show trauma

Young people often show distress through actions more than words.

• Young children acting out parts of the event in play or drawings, over and over.
• Returning to younger habits, like bed-wetting, baby talk or clinging.
• Frightening dreams with no clear story.
• New fears, tantrums or stomachaches with no clear cause.
• Teens taking new risks, using substances, or carrying guilt about what happened.

How a trauma evaluation works

Strong reactions in the first days and weeks after a frightening event are common, and they often ease with time and support. Acute stress disorder describes severe reactions in that first month. PTSD is considered when symptoms last longer than a month and disrupt daily life. Adjustment disorder fits when a painful change, such as a divorce, brings more distress than expected.

We ask about current symptoms, your safety now, and dissociation, which means feeling detached from yourself or losing track of time. Trauma often travels with depression, anxiety or substance use. In children, it can be mistaken for ADHD or defiance. After an accident or assault, we also consider a head injury.

Therapies and medication after trauma

Trauma-focused psychotherapy is the main treatment for PTSD. In cognitive processing therapy (CPT), you examine beliefs that took hold after the event, such as 'it was my fault.' In prolonged exposure (PE), you gradually approach memories and situations you have avoided until they lose some of their power. Eye movement desensitization and reprocessing (EMDR) has you recall the memory while following a therapist's back-and-forth hand movements. Trauma-focused CBT is designed for children and teens, with a caregiver taking part. These therapies are demanding, and symptoms can rise at the start.

For adults, SSRIs and SNRIs are the medication classes used most often. Benefit builds over several weeks, and they can ease intrusive memories, low mood and irritability. A blood pressure medicine from the alpha blocker class is sometimes used for trauma nightmares. Benzodiazepines are generally not advised for PTSD, since they do not treat it and can cause dependence. If you take one now, please do not stop on your own, because sudden withdrawal can be dangerous. For children and teens, therapy comes first, and medication is used more selectively.

Reaching out for yourself or someone you love

Reach out if your reactions have not eased after a few weeks, if they return around an anniversary or a loss, or if a child's behavior has changed and stayed changed.

If someone you love has been through trauma, let them decide when and how much to talk. Listen more than you advise, keep routines steady, and try not to take distance or irritability personally. For a child, calm reassurance and limits on news coverage of the event can help.

Trauma can leave a person feeling alone and convinced that nothing will change. Many people do improve, at their own pace. If suicidal thoughts or urges to hurt yourself come up, or someone is hurting or threatening you now, call or text 988 (the Suicide & Crisis Lifeline) or call 911. We are not an emergency service.

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