What is PTSD?
Post-Traumatic Stress Disorder (PTSD) is a mental health condition that can develop after experiencing or witnessing a traumatic event. It’s normal to feel afraid during and shortly after trauma, but PTSD occurs when these reactions don’t fade and instead intensify or persist long after the danger has passed.
PTSD affects about 6% of people in the U.S. at some point in their lives, and around 12 million adults in any given year. It can develop at any age and affects people from all walks of life.
Important to know: Having PTSD is not a sign of weakness. It’s a legitimate medical condition involving biological, psychological, and social factors—and it responds well to proper treatment.
Types of Traumatic Events
PTSD can develop after many types of trauma.
Direct Trauma Exposure
- Combat exposure
- Physical assault or abuse
- Sexual assault or abuse
- Serious accidents (car crashes, workplace injuries, natural disasters)
- Life-threatening illness or medical events
Witnessed Trauma
- Seeing violence happen to others
- Witnessing death or serious injury
- First responder or medical work involving traumatic cases
Learning About Trauma
- Learning about the violent death of a loved one
- Discovering that a close family member experienced trauma
- Repeated exposure to traumatic details (first responders, investigators, journalists)
Complex PTSD
Complex PTSD can develop from prolonged, repeated trauma, especially in childhood, such as:
- Chronic childhood abuse or neglect
- Long-term domestic violence
- Being a prisoner of war
- Long-term captivity or trafficking
PTSD Symptoms: The Four Clusters
The DSM-5 organizes PTSD symptoms into four categories.
1. Intrusive Memories (Re-Experiencing)
- Flashbacks (feeling like you’re reliving the trauma)
- Nightmares about the event
- Unwanted, distressing memories
- Strong physical reactions (sweating, rapid heartbeat, panic) when reminded of trauma
- Intense emotional distress when triggered
Example: A combat veteran hears a car backfire and feels instantly transported back to a battlefield, with the same terror as during the original event.
2. Avoidance
- Avoiding places, people, or activities that remind you of the trauma
- Avoiding thoughts, feelings, or conversations about what happened
- Emotional numbness or detachment
- Gaps in memory for parts of the traumatic event
Example: A sexual assault survivor avoids the neighborhood where the assault occurred and refuses to talk about the event, even in therapy.
3. Negative Changes in Thinking and Mood
- Persistent negative beliefs (“The world is completely dangerous,” “I can’t trust anyone”)
- Ongoing blame of self or others
- Strong feelings of fear, anger, guilt, or shame
- Loss of interest in activities you used to enjoy
- Feeling detached from family and friends
- Difficulty feeling positive emotions
- Hopelessness about the future
4. Alterations in Arousal and Reactivity (Hyperarousal)
- Feeling constantly on guard (hypervigilance)
- Being easily startled
- Irritability or angry outbursts
- Reckless or self-destructive behavior
- Difficulty concentrating
- Trouble falling or staying asleep
Example: A trauma survivor sits with their back to the wall in restaurants, constantly checks locks at home, and struggles to relax even in safe environments.
Understanding Trauma Triggers
Triggers are reminders of the traumatic event that cause PTSD symptoms to flare up.
Common Triggers
- Sensory: Smells, sounds, sights, tastes, or physical sensations
- Environmental: Locations, weather, time of day or year
- Interpersonal: Certain people, relationship dynamics, conflicts
- Internal: Emotions, body sensations, or thoughts
- Media: News stories, TV shows, movies, or social media content
- Anniversaries: Dates related to the trauma
Trigger Responses
When triggered, you might experience:
- Sudden panic or intense anxiety
- Flashbacks or feeling “out of body”
- Physical symptoms (sweating, nausea, racing heart)
- Emotional overwhelm (fear, anger, crying)
- Strong urge to flee, isolate, or shut down
Evidence-Based Treatment for PTSD
PTSD is highly treatable, and most people experience meaningful improvement with proper care.
Psychotherapy (Primary Treatment)
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)
- Gradually processes trauma memories in a safe environment
- Often 12–16 weekly sessions
- Includes exposure to memories, cognitive restructuring, and coping skills
- 60–80% of patients show significant improvement
Eye Movement Desensitization and Reprocessing (EMDR)
- Processes traumatic memories while following bilateral eye movements or tapping
- Often 6–12 sessions (varies)
- Especially effective for single-incident trauma
- Does not require you to describe every detail of the trauma out loud
Prolonged Exposure (PE) Therapy
- Involves repeated, detailed recounting of the traumatic memory
- Typically 8–15 weekly sessions
- One of the most researched and effective treatments
- Helps reduce avoidance and fear around trauma reminders
Cognitive Processing Therapy (CPT)
- Focuses on examining and challenging unhelpful beliefs about the trauma
- Often 12 sessions
- Particularly helpful for trauma-related guilt and shame
Medication Management
As a Psychiatric Mental Health Nurse Practitioner, I prescribe and manage medications that can support PTSD recovery.
FDA-Approved Medications for PTSD
Sertraline (Zoloft)
- SSRI antidepressant
- Reduces all major PTSD symptom clusters
- Typical dose: 50–200 mg daily
Paroxetine (Paxil)
- SSRI antidepressant
- Helpful for intrusive thoughts and hyperarousal
- Typical dose: 20–60 mg daily
Off-Label but Evidence-Based Options
Prazosin
- Originally a blood pressure medication
- Very effective for trauma-related nightmares
- Typical dose: 1–20 mg at bedtime
Venlafaxine (Effexor XR)
- SNRI antidepressant
- Effective for PTSD and co-occurring depression
- Typical dose: 75–300 mg daily
Medications for Specific Symptoms
- Sleep disturbances: Trazodone, mirtazapine
- Severe hyperarousal: Short-term use of clonidine or guanfacine
- Acute distress: Benzodiazepines may rarely be used short-term, with caution
Important: Medication is usually most effective when combined with trauma-focused therapy.
Integrated Treatment Approach
The most effective PTSD treatment usually includes:
- Trauma-focused psychotherapy
- Medication management (when appropriate)
- Self-care strategies and coping skills
- Supportive relationships and community resources
Co-Occurring Conditions
PTSD often appears alongside other conditions, such as:
- Depression
- Anxiety disorders (panic disorder, GAD, social anxiety)
- Substance use disorders
- Chronic pain
- Sleep disorders
As part of PTSD treatment, I also assess and address co-occurring conditions so your care is truly comprehensive.
The Recovery Process: What to Expect
Early Treatment (Weeks 1–4)
- Comprehensive assessment and diagnosis
- Education about PTSD and how treatment works
- Safety planning, including crisis resources if needed
- Starting trauma-focused therapy and/or medication
Active Treatment (Months 2–6)
- Gradual reduction in PTSD symptoms
- Building coping and emotion regulation skills
- Processing traumatic memories in therapy
- Adjusting medications based on response
- Reconnecting with activities and relationships
Maintenance and Relapse Prevention (6+ Months)
- Continued symptom improvement
- Stronger ability to manage triggers
- Possible gradual medication taper (when appropriate)
- Transitioning out of intensive therapy
- Long-term strategies to maintain progress
Recovery is rarely a straight line. Ups and downs are normal and do not mean treatment is failing.
Self-Care Strategies for PTSD
Professional treatment is essential, but self-care supports recovery.
Grounding Techniques
5–4–3–2–1 Technique
- 5 things you can see
- 4 things you can touch
- 3 things you can hear
- 2 things you can smell
- 1 thing you can taste
Physical Grounding
- Hold something cold (like an ice cube)
- Splash cool water on your face
- Stomp your feet or press them into the floor
- Hold or focus on a textured object
Managing Hyperarousal
- Progressive muscle relaxation
- Slow, diaphragmatic breathing
- Box breathing (4–4–4–4) or 4–7–8 breathing
- Mindfulness meditation (even 5–10 minutes daily)
Lifestyle Supports
- Regular physical activity (yoga is especially helpful for PTSD)
- Consistent sleep schedule and calming pre-bed routine
- Limiting caffeine, nicotine, and alcohol
- Staying connected to supportive people
- Joining a trauma or PTSD support group if helpful
When to Seek Professional Help
Reach out for professional help if:
- Symptoms last more than a month after trauma
- Symptoms are getting worse instead of better
- You’re experiencing flashbacks or frequent nightmares
- You avoid important places, people, or activities
- You’re using alcohol or drugs to cope
- PTSD symptoms interfere with work, relationships, or daily life
- You’re having thoughts of self-harm or suicide
Early treatment can prevent symptoms from becoming more severe or long-lasting.
PTSD Treatment via Telehealth
At Aegis Behavioral Health Group, I provide comprehensive PTSD care through secure telehealth appointments.
Benefits of Telehealth for PTSD
- Talk about trauma from the comfort of your own space
- No travel, parking, or waiting rooms
- Easier to maintain consistent sessions
- Private and discreet
- Research shows telehealth is effective for PTSD treatment
What I Offer
- Comprehensive PTSD assessments and diagnosis
- Medication management tailored to your symptoms
- Coordination with trauma therapists
- Treatment of co-occurring conditions (depression, anxiety, substance use)
- Clear crisis plan and follow-up schedule
I strongly encourage pairing medication management with trauma-focused therapy, and I can help connect you with therapists in Delaware and Hawaii.
Insurance and Access
I accept many major insurance plans, including:
Delaware
- Highmark Blue Cross Blue Shield
- Aetna
- UnitedHealthcare
- Medicare
- Medicaid
Hawaii
- HMSA
- UHA
- UnitedHealthcare
- Medicare
- QUEST (Medicaid)
We can review coverage and options during your initial consultation.
Take the First Step Toward Healing
Trauma does not have to define your future. With the right support and treatment, most people with PTSD experience substantial relief and reclaim their lives.
Contact Aegis Behavioral Health Group:
Evening and weekend appointments are available.
Final Thoughts
PTSD is a normal response to extraordinary stress. You didn’t choose what happened to you—but you can choose to seek help.
You survived the trauma. You can survive the healing process too, and you don’t have to do it alone.
About the Author
Jason Eala, DNP, APRN, PMHNP-BC is a board-certified Psychiatric Mental Health Nurse Practitioner with specialized training in trauma and PTSD. He provides compassionate, evidence-based psychiatric care via telehealth for patients in Delaware and Hawaii.
Crisis Resources
- 988 Suicide & Crisis Lifeline: Call or text 988
- Crisis Text Line: Text “HELLO” to 741741
- Veterans Crisis Line: Call 988 and press 1
- RAINN (Sexual Assault): 1-800-656-4673
- National Domestic Violence Hotline: 1-800-799-7233
Disclaimer: This article is for educational purposes only and does not replace medical advice. Always consult a qualified healthcare provider for diagnosis and treatment of PTSD or any mental health condition.
