Medication can't cure PTSD
Medication won’t cure Post-Traumatic Stress Disorder (PTSD) or Complex Post-Traumatic Stress Disorder (C-PTSD.)
If you’re a holistic practitioner or healer, you’ve probably worked with clients with post-traumatic stress symptoms. Some clients arrive at my clinic having diagnosed themselves with PTSD or C-PTSD and a few ask me if medication is an answer to their distress.
Medication can help the symptoms of PTSD and C-PTSD, but over time, new symptoms tend to pop up. You can usually only suppress symptoms for a limited time. That’s because the PTSD wants to be addressed, and it uses symptoms to get attention to heal the root cause of the traumatic stress.
Of course, that’s not an easy thing to accept when you're highly symptomatic and your life is being torn apart...but help your clients address the underlying dysregulation causing the PTSD, and they’ll do better than survive…they will thrive as the amazing human being they already are.
I’ve a number of clients who asked their GP to prescribe anti-depressants to help manage their symptoms and then have asked my opinion on whether they should take them. Clients sometimes feel disappointed in themselves and the therapeutic process, and those who are philosophically opposed to medication often criticise themselves for not being able to climb out of the hole they’re in without a prescription.
As a psychotherapist, it’s my professional duty to support my clients’ autonomous decisions, and without going beyond my scope of practice, I can reassure them that pharmaceuticals can work in their best interests. I find it’s usually best to be neutral and supportive if a client is considering taking anti-depressants.
When a client asks for your opinion, they don't want to hear about your scope of practice. Of course you can't say anything that is beyond your scope, but back-pedalling out of the conversation altogether won't help your relationship with your client at all. I usually begin by telling them that before starting on anti-depressants, it can be useful to think about how they will come off them. The longer they stay on them, the more carefully they will have to do that.
The type of antidepressant can be a factor when making a withdrawal plan. I encourage them to find out what category of drug they have been prescribed. It's better to come off SSRIs in the summer months because the body chemistry doesn't feel so deprived of melanin when there are more hours of sunshine to make it. Advise them to make a plan to get safe sun exposure during the withdrawal period (just 15 minutes a day with shoulders bare). I also suggest they time their withdrawal for when they are out of their familiar environment and normal routine – a holiday is ideal.
For many people, it takes approximately two-months to come off anti-depressants if they’ve taken them for twelve months or less. They should expect a longer withdrawal process if they’ve been taking medication for longer. It’s important to normalise all possible scenarios – you have no way of knowing how long your client will need to keep taking them.
Then I give my client the freedom to choose to not take them by letting them know about the scientific research. Studies have found that the outcomes from taking antidepressants are no better (or worse) than the outcomes from therapy. If they’re not sure they want to take medication, I will ask them if they have considered getting a mental health plan referral to supplement our work. I strongly encourage them to see a mental health practitioner as often as they can – at least every two weeks. Then I let them know that the research also supports the outcomes of medication and therapy combined. I tell them that pharmaceuticals can help regular, targeted psychotherapy be even more effective.
Although there is a large volume of published research investigating treatment options for veterans with PTSD, to date, there are no studies of people with C-PTSD. That’s because the official psychological manual of mental disorders (the DSM, 5th edition) does not recognise C-PTSD as a mental health condition. The reasons why there aren't more effective ways of treating C-PTSD is rooted in red-tape, bureaucracy and research funding that is limited to disorders listed in the DSM. Fortunately, the European equivalent to the DSM has paved the way for change by admitting C-PTSD into the International Classification of Diseases (ICD, 11th edition) so there’s hope for a change in the next edition of the DSM.
In my small-group program, the topics of boundaries, scope and ethics are part of the training curriculum. They're introduced in a way that is non-confronting, interesting and engaging - not the usual end of course mandatory tick boxes learning activity. The training program is delivered live over 10-weeks, in an intimate group online setting.