Trauma and stressor related disorders
After trauma, the mind and body can stay on alert: nightmares, flashbacks, avoidance, feeling on edge. These are trauma and stressor related disorders, including PTSD.
PTSD and related conditions develop after experiencing or witnessing threatening events. The nervous system learns to treat the world as dangerous, and reminders can trigger vivid reliving, emotional numbing, or constant vigilance. It is not a character flaw and it is not something you just get over.
Good trauma care is paced to what feels safe for you. Nothing is rushed. PTSD keeps the brain's fear system stuck in the on position, and SSRIs like sertraline and paroxetine help quiet that overactive alarm by stabilizing serotonin signaling, which can reduce nightmares, reactivity, and emotional numbing. Trauma focused therapies work from another angle, helping the brain file the memory as something that happened in the past rather than a present danger. Plans are built collaboratively, with your sense of safety leading the way.
Research and further reading
A few key papers behind how this condition is understood and treated today. Links open the abstract on PubMed, a free public database from the U.S. National Library of Medicine.
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Psychological and Pharmacological Treatments for Adults With Posttraumatic Stress Disorder (PTSD)
Jonas et al. · Agency for Healthcare Research and Quality, Comparative Effectiveness Review No. 92 · 2013
In 92 trials of adults with PTSD, exposure therapy and related trauma focused therapies showed the strongest evidence with large symptom reductions, while several antidepressants (fluoxetine, paroxetine, sertraline, venlafaxine) also showed benefit.
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Schnurr et al. · JAMA · 2007
In a trial of 284 female veterans and active duty personnel, prolonged exposure therapy reduced PTSD symptoms more than supportive therapy and made it more likely that participants no longer met criteria for PTSD.
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Pharmacotherapy for post traumatic stress disorder: systematic review and meta analysis
Hoskins et al. · British Journal of Psychiatry · 2015
Across 51 medication trials, SSRIs beat placebo for PTSD but the average effect was small, with the clearest evidence for fluoxetine, paroxetine, and venlafaxine.
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Brady et al. · JAMA · 2000
In 187 adults with PTSD, sertraline led to a 53 percent response rate compared with 32 percent for placebo.
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Efficacy and safety of paroxetine treatment for chronic PTSD: a fixed-dose, placebo-controlled study
Marshall et al. · American Journal of Psychiatry · 2001
In 551 adults with chronic PTSD, paroxetine at 20 and 40 mg per day improved all three symptom clusters more than placebo.
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