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Comment by antonkar | Hacker News Reader

Fyi, while PTSD is commonly associated with the experiences of war, it can be caused by any trauma, like a car crash or abuse. PTSD is actually a fear of a traumatic memory. A person experiences flashbacks (pieces of the traumatic memory) and fears that the traumatic event will reoccur. The most effective treatment is exposure therapy - in a nutshell, you eventually write down the traumatic memory in full (not just pieces of it) and read it until it becomes boring/you understand that for example it wasn't your fault. Here is a recent meta analysis https://www.sciencedirect.com/science/article/abs/pii/S02727...

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From the abstract: "Exposure therapy showed... a negligible effect relative to other trauma-focused treatments or medication."

Anyway, from my understanding, medications for treating PTSD are less effective than medications for other mental disorders. I'm waiting for the day that PTSD medications catch up, because therapeutic treatment for PTSD is currently centered on reducing discomfort, without much hope for remission, which feels like a dim outlook.

The writing they used in abstract is confusing, the full quote: “Exposure therapy showed large effects relative to waitlist and treatment-as-usual, a small effect relative to non-trauma-focused comparators and a negligible effect relative to other trauma-focused treatments or medication. At follow-up most effects sizes were stable, except for a medium effect favoring exposure over medication.”

They mean exposure is much better than doing nothing, a bit better than “non-trauma-focused comparators“ and on par or negligibly better then the most effective approaches, for example, exposure is often used as a part of a larger therapy like trauma focused CBT

I hesitate to write this, but PTSD is a bit more complex than that.

In some cases there's damage to the hippocampus, which doesn't get better. I've had 40 years to make peace with the crappy accident I was in. But the things like an exaggerated startle reflex, an aversion to chaotic or unplanned sounds and other triggers remain. I always carry a pair of noise-cancelling headphones if I think I might need to be in a noisy environment.

You try propranolol yet? Worked like a slow miracle for me. It completely neutered the negative physical symptoms after some time using it combined with carefully controlled exposure to triggers.

I have never heard of this with regards to PTSD, I will investigate. Thank you!

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