What is Post-Traumatic Stress Disorder
Post-traumatic stress disorder (PTSD), or “shell shock” as it was known in the early twentieth century, is most often associated with military veterans. This is because the vast majority of diagnoses are made post-combat resulting from the highly stressful, frightening, and distressing events experienced during the war. However, this psychological disorder impacts people of all ages, professions, and walks of life, with nearly 3.5% of the adult population being affected by PTSD.
The onset of this condition is spurred by trauma that can take many forms. Whether it manifests in proximity to a traumatic event, or years later, PTSD severely impacts and interferes with an individual’s ability to live their daily life.
PTSD is caused by experiencing or witnessing one or more traumatic events that are often rooted in violence or life-threatening events, however, it can also develop as a result of persistent and continuous emotional, psychological and physical abuse.
Not everyone who goes through a traumatic event develops PTSD, but certain people are considered at higher risk than others. These potential risk factors include:
- Working as a first-responder, military professional, or other high-stress position
- Having other psychological conditions that could amplify trauma
- Experiencing prolonged trauma
- Being exposed to trauma in childhood
- Possessing a family history of mental health problems
- Lacking a support system
- Serious road accidents
- Violent personal assaults, such as sexual assault, mugging, or robbery
- Serious and/or life-threatening health conditions like cancer and multiple sclerosis
The medical community recognizes five primary types of PTSD, including:
Normal stress response:
This type of response takes place in adults following a singular traumatic event. The recovery time is quick (generally less than one month) and involves building self-awareness and understanding of the trauma.
Acute stress disorder:
Acute stress disorder also occurs after a singular traumatic event and involves ongoing panic attacks, paranoia, detachment, and more that interfere with daily life.
Uncomplicated PTSD stems from a singular traumatic event and symptoms are milder than in other forms. It is characterized by either reliving the trauma of attempting to repress the trauma, along with feelings of dissociation.
This type of PTSD accompanies other disorders like depression, anxiety, substance abuse, and/or panic disorder. Extra care is taken throughout treatment to manage symptoms of the accompanying disorder(s).
Complex PTSD results from a series of or ongoing traumatic events (combat or childhood trauma, for example). Individuals with this type of condition frequently have trouble adjusting to a normal daily routine or returning to work. Symptoms occur at a higher intensity and are more difficult to treat, and the trauma can last for years or a lifetime.
Symptoms of Post-Traumatic Stress Disorder
PTSD symptoms vary widely – after all, no two people experience trauma the same. Generally, the disorder is diagnosed after the persistence of the trauma (in memory or dreams), emotional avoidance, and reactive behavior. Specific symptoms include:
- Intrusive memories including vivid, distressing memories, flashbacks, and recurring nightmares can all be signs of PTSD.
- Difficulties with falling asleep and staying asleep
- Cognitive difficulties and difficulty concentrating and focusing
- Panic, paranoia, emotional numbness, and dissociating from relationships with friends and family signify the presence of PTSD
- Avoidance of social situations, crowds, busy places, and other types of stressful events
- Repression, either voluntary or involuntary of the traumatic and associated events
- Mental blockages or gaps in memory
- Negative thoughts and feelings especially overwhelming negative feelings including, surrounding and stemming from the trauma.
- Emotional reactions and arousal can range from uncontrollable outbursts of anger to being easily startled, to experiencing feelings of guilt and shame.
Post-Traumatic Stress Disorder Medications & Treatments
Usually, a combination of medications and psychotherapies are used to treat PTSD, with the aim to help the individual cope with their symptoms and reduce psychological, emotional, and physical responses to the traumatic event. The type and success of any treatment or a combination of therapies also depend on the severity of the symptoms and how soon they occur after the traumatic event.
Antidepressants: Individuals who experience intense sadness, negative emotions, or numbness may be prescribed an antidepressant to help with these feelings.
Symptom-specific medications: To minimize specific symptoms someone has or any co-morbidities that are present—like a severe panic disorder or trouble sleeping at night for months on end—a physician might prescribe additional medications.
Psychotherapy: Therapies that involve understanding the trauma and being able to vocalize what has happened are a common way to help those affected overcome PTSD. Therapy may be done individually or in a group setting.
Psychological therapies: These include protocols such as trauma-focused cognitive behavioral therapy (CBT) or eye movement desensitization and reprocessing (EMDR)
Cognitive restructuring: This type of treatment helps individuals recognize their symptoms, identify why they might feel a certain way, and overcome feelings that the trauma will recur.
Exposure therapy: Exposure therapy is a powerful way for individuals to face painful memories and learn to accept or work through them. This might employ simulations or describing the event over and over again.
Self-care practices: Maintaining a healthy lifestyle through diet, exercise, medication, and more can ease symptoms and reduce stress over time. Support groups: A network of people to talk to, share experiences with, and lean on during particularly tough stretches of time is the best medicine for some. Loneliness can intensify negative emotions, but many people benefit from trauma-specific support groups that provide a safe environment to heal.
CBD for Post-Traumatic Stress Disorder
Research and Scientific Evidence for using CBD for PTSD
The body of research relating to PTSD and using cannabidiol (CBD) to treat it is growing, and showing that this cannabinoid has the potential for being an effective, safe, and side-effect free treatment option.
In a 2015 review paper published in Neurotherapeutics, researchers wanted to determine CBD’s potential as a treatment for anxiety-related disorders, including PTSD, by assessing evidence from preclinical, human experimental, clinical, and epidemiological studies.
They found that the existing preclinical evidence strongly supports CBD as a treatment for anxiety disorders such as post-traumatic stress disorder although few studies have investigated chronic CBD dosing. Likewise, evidence from human studies supports an anxiolytic role of CBD, especially in relation to the treatment of multiple PTSD symptom domains.
In the context of PTSD treatment with CBD, the data showed that it effectively reduces arousal and avoidance behaviors, prevents the long-term adverse effects of stress, as well as enhances the extinction and blocking of the reconsolidation of persistent fear memories.
In another, more recent 2018 review of the literature concerning the therapeutic potential of CBD in the treatment of PTSD published in Frontiers in Neuroscience, the researchers looked at evidence obtained from animal studies (“bench research”) as well as knowledge gathered from human trials (“confirmation in human trials”).
They concluded that, although the mechanisms of CBD action in behavioral responses related to trauma are still unclear, these probably related to CBD activating CB1 receptors indirectly, by potentiating the endocannabinoid system. Similarly, CBD inhibits both the uptake and hydrolysis (by FAAH) of anandamide, the endocannabinoid is known for its acute anxiolytic effects and responsible for the regulation of learned fear by dampening its expression, enhancing its extinction, and disrupting its consolidation.
From the data on human and animal studies, the researchers concluded that CBD offers therapeutic benefits for disorders related to inappropriate responses to traumatic memories. Likewise, the effects of CBD on the different stages of aversive memory processing, making it a potentially effective pharmacological adjunct to psychological therapies for PTSD.
Published in 2019 in the Journal of Alternative and Complementary Medicine, researchers examined the clinical benefit of CBD for patients with PTSD using a retrospective case series of 11 adult patients at an outpatient psychiatric clinic.
They administered CBD in an open-label, flexible dosing regimen for 8 weeks to patients diagnosed with PTSD by a mental health professional. In addition, patients received routine psychiatric care, which included concurrent treatment with psychiatric medications and psychotherapy. PTSD symptom severity was assessed every 4 weeks by patient-completed PTSD Checklist for the DSM-5 (PCL-5) questionnaires.
The analysis showed that from the total sample of 11 patients, 91% (n = 10) experienced a decrease in PTSD symptom severity at 8 weeks with the mean total PCL-5 score decreasing 28%, from a mean baseline score of 51.82 down to 37.14. The researchers concluded that the administration of oral CBD in addition to routine psychiatric care reduced PTSD symptoms, also appearing to provide relief in a subset of patients who reported frequent nightmares as a symptom of their PTSD. They also reported that CBD was generally well-tolerated, and no patients discontinued treatment due to side effects.
Anecdotal Evidence about using CBD for PTSD
According to the Veterans Association, reported that CBD is effective for helping with many of the difficulties our veterans are currently facing, including the relief symptoms of PTSD and anxiety. Similarly, there are several media pieces and stories about people, including this veteran, that take CBD for their PTSD, indicating that it is a popular, effective, and side-effect free choice for many.
CBD as a Complementary Treatment for PTSD
Anxiety disorders like PTSD are also often characterized by sleeping difficulties which can interrupt REM sleep. This is thought to contribute to anxiety and depression. Therefore, in addition to reducing anxiety and improving overall mood, CBD can further support people suffering from PTSD by helping promote REM sleep.
The calming and relaxing properties of CBD can also be beneficial when used in conjunction with psychotherapeutic interventions like CBT, EMDR, and mindfulness practices. However, CBD should not be taken in conjunction with other medications without consulting the treating physician first as CBD may negatively interact with these.
From the research currently available, the data is highly suggestive of CBD have powerful anxiolytic effects in both animals and humans. Although more research needs to be done, scientists hypothesize that CBD’s efficacy in treating PTSD stems from its ability to affect different stages of aversive memory processing that regulates learned fear responses by dampening its expression, enhancing its extinction, and disrupting its reconsolidation. When considering using CBD for PTSD, always consult a medical practitioner before as they can monitor dosage, symptom severity, and other clinical parameters. In addition, CBD is contraindicated with use with certain medications, so they can ensure that your CBD treatment is both safe and effective.