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Post-traumatic stress disorder

Perturbatio posttraumatica · Posttraumatická stresová porucha

What it is

Trauma memory stays live — the body keeps reacting as if it is happening now.

Symptoms & signs

  • Flashbacks
  • nightmares
  • avoidance
  • hypervigilance
  • numbness
  • startle

🚩 Get help if…

  • call 112 / 911 now Thoughts or plans of suicide
  • call 112 / 911 now Urge to hurt yourself or someone else
  • see a doctor soon Flashbacks or nightmares most nights for over a month
  • see a doctor soon Heavy drinking or drug use to cope

Where it strikes

Medical treatment

  • Trauma-focused CBT — the best-supported treatment here trials support
  • EMDR — it works, though the eye movements add nothing to the exposure trials support
  • Prolonged exposure trials support
  • SSRIs — a smaller effect here than in depression mixed evidence
  • Prazosin for nightmares — the largest trial was negative mixed evidence

Natural & lifestyle

  • Exercise
  • yoga and body-based therapy
  • sleep repair
  • peer support
  • no alcohol self-medication

Emerging & experimental

  • MDMA-assisted psychotherapy (FDA declined approval in 2024)
  • propranolol reconsolidation blockade
  • stellate ganglion block

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Acupuncture — trials disagree mixed evidence
  • Cannabis — trials disagree mixed evidence
  • Service dogs — small studies show fewer symptoms early / small studies
  • Ayahuasca and ibogaine retreats — reports of relief; unregulated, with real risks anecdotal / traditional

ICD codes