where to get help with about posttraumatic stress disorder

The psychotherapy that is most widely accepted as useful for PTSD is cognitive-behavioural psychotherapy (CBT). CBT is a relatively structured kind of psychotherapy; it involves the use of specific techniques which are taught to the patient, there are a limited number of sessions (with "homework exercises" between sessions), and the goals of the therapy are explicitly agreed upon by the therapist and patient.

An important aspect of psychotherapy of PTSD, whether it is cognitive-behaviourally oriented or not, is that the therapeutic environment provides a safe place for people to go and discuss the traumatic event, their fears and reactions to the event, and their symptoms. This feeling of safety is a way for people with PTSD to begin to re-establish a sense of trust with others. This is true for individual therapy (between one person and a therapist) and group therapy (where people who have experienced similar events come together to discuss their symptoms, learn more about PTSD, and provide support for each other).

Several antidepressants have been shown useful in the medication treatment of PTSD. These agents work even when there is no co-existing depression, and they are of course particularly useful when such symptoms also exist and require treatment. There is increasing evidence for the value of the selective serotonin reuptake inhibitors (SSRIs) in PTSD. Sertraline (Zoloft) and paroxetine (Aropax) are licensed for the treatment of PTSD in some countries. A number of other classes of medication may also be useful in some patients. Benzodiazepines (also known as ‘tranquilizers) should be avoided or used with great acre as they are probably not helpful and they might create dependency. A psychiatrist should carefully monitor medication. Medication can take a few weeks  to take effect and must not be stopped suddenly.

A combination of medication and cognitive-behavioural psychotherapy will likely be helpful for many people. Medication may act to decrease symptoms fairly early on, and so help the person to carry out the CBT techniques. Conversely, the use of CBT may be crucial in helping the person to return to a normal life, and ultimately perhaps allow them to discontinue medication without return of symptoms.

For more information about PTSD or any other mental health issue contact the Mental Health Information Centre of South Africa Tel +27 21 938-9229. You can also ask your GP for a copy of the PTSD chapter in the False Alarm! How to conquer the Anxiety Disorders patient guide.

Further resources / references
Bathuthuzele Youth Stress Clinic, PO Box 19063, Tygerberg 7505
Tel: 021 938 9229

MRC Unit on Anxiety Disorders, PO Box 19063
Tygerberg, 7505 / Tel: (021) 938 9161

National Center for PTSD
VA Medical Center (116D), White River Junction, VT 05009, USA
Tel: 1 800 827-1000 / Internet: http://www.ncptsd.org

Books about PTSD
Copshock: Surviving PTSD. Allen R. Kates. Holbrook Street Press, 1999.
Crisis and Chaos: Life With the Combat Veteran. Colleen McCarty-Gould. Kroshka Books, 1998.
Stress Response Syndromes: PTSD, Grief and Adjustment Disorders. Mardi Jon Horowitz. Jason Aronson, 1997.
Trauma and Recovery: The aftermath of violence -- from domestic abuse to political terror. Judith Lewis Herman. Basic Books, 1992.
Treating the Trauma of Rape: Cognitive-Behavioral Therapy for PTSD. Edna B Foa, Barbara O. Rothbaum. Guilford Press, 1998.