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     Post-Traumatic Stress Disorder is a life-altering, if not life-threatening problem. The truth is, life will never be the same as it was, but it could be better than it ever was. It’s going to cost you time, money, and energy, however, to beat it. You have undoubtedly been concerned that you are thinking about the problem all the time. This is because your instincts (e.g. things you "know" without having to learn) are telling you to pay more, not less attention to the problem. In fact, with the exception of basic survival activity (feeding yourself, working, etc,) all of your available time for at least 3 to 6 months should be devoted to neutralizing the anxiety produced by this trauma. It is critical that you rebuild a base of physical and emotional strength from which you can work during the next two to three years (sometimes more).

     Remember the early lessons in this book? I proved to you that it is impossible to control your thoughts. If you find your mind continually drifting to the trauma. If demands on your time that were previously normal are now upsetting. If you find yourself wishing for "time to think" - listen to the advice you are receiving. Your mind knows what you need, you must trust it. If you do decide to further pursue a course of action to heal the effects of your trauma, you may find some useful guidelines in the following recommendations.

     Whether or not your physical health has been the same pre-trauma as post-trauma, there is a good chance that this distress has taken a heavy toll on you, Consult your physician for a complete physical exam. Be honest with him about the reasons for the exam. Bring with you a list of physical problems and bad health habits have (e.g. too much smoking, drinking, eating problems etc.). This will help him know where to look for problems. 

     After the consultation and physical exam, your doctor will make treatment recommendations. Begin a journal, and make these recommendation your first entries. This begins your overall treatment regime.

General Health Habits

     There are some post – trauma activities you must do regardless of how you feel. It is important to have a daily schedule. This can be difficult if you feel chaotic inside. Your best chance at a schedule is to plan realistic events around exercise, rest and eating periods. If you must work, then a certain number of hours per week is already scheduled for you. You still have weekends and evenings with which to cope, however. Let’s look at the most important elements of your daily schedule.

         Implementation of a realistic set of exercise goals is critical. Optimum is 3-4 times per week for the first 6 months. The emphasis here is on the word "realistic". If you have exercised little in your life, your goals will not be the same as an athlete. You should begin with mild aerobic activity for about 30 minutes. Try to sweat "a little" - not a lot. If you feel slightly energized when done you have reached the correct level of exertion. As your physical stamina improves, you will notice that you are exerting yourself a little more in each workout. You may then increase the length of the exercise session or include one "double session" each week. Starting with too ambitious a project will most certainly produce burnout. Think of exercise as something you will continue to do for the rest of your life. Form the habit first, then move to higher levels.

Rest

 A frequently neglected fact of exercise is that the activity results in muscle tissue being "torn down" rather than "built up". The "building up" period comes when the body is at rest. For this reason it is a good idea to rest immediately after exercise, for a period of time equal to the exercise time. During this time your body can most easily begin to restore muscle tissue to higher functional levels – maximizing the benefits of the exercise.

     The other form of rest that is so critical is a regular (6 to 8 hours) night’s sleep. Since sleep disturbance is often a problem in PTSD, achieving 6 to 8 hours of sleep in a 24 hour period can be quite challenging. If the problem is a serious one, professional intervention will help. You should try to succeed in this area without the use of prescription sleeping pills. If you must use them, doe so sparingly because long term use tends to exacerbate the problem in addition to risking an addiction. You do not need to add more problems to an already difficult situation.

     We have better information available on the development of good nutritional habits than ever before. If you have any doubts whatsoever about the manner in which you nourish yourself, ask your physician to recommend a nutritionist for you to consult. Such a professional will provide the most simple and effective nutritional program for your individual situation. Combined with adequate rest and exercise, you are providing your body with the most potent defenses possible in your battle against the problem of Post-Traumatic Disorder.

Psychotherapy

    The chances of overcoming Post- Traumatic Stress Disorder without psychotherapeutic help are virtually nil. Since the problem is so widespread, there should be a specialist in your area with whom you can consult. This person should be able to provide evidence that he or she is well trained in the science and application of both verbal psychotherapy and systematic desensitization. Make sure that the practitioner's expertise extends to the science and application of long term (more than one year) psychotherapy for two reasons. First, chances are good that you will remain in treatment for more than one year. Don’t let this scare you, you’re not crazy. Mother Nature heals slowly, even under the most optimum conditions. Secondly, there are many practitioners in the mental health industry who don’t know any more about long term therapy than they do about flying airplanes. If you get one of these people, the only option he or she has to offer is "brief" psychotherapy. I have seen many individuals in my practice who have been the victims of "brief" therapy. The therapist declares them "cured", and they leave feeling like nothing more can be done. If you are among the few who complete treatment in three months or less, a therapist specializing in both therapies will not try and keep you just to run up a bill. Therapist have lots of work to do – especially the good ones! Finally, let me add that psychotherapy, properly conducted, can be a rewarding and life-giving experience. While it may be somewhat painful at times, it is not nearly as painful as untreated PTSD.

Medications

     Medications fall into two categories: self-prescribed and physician-prescribed. The self-prescribed medications include over-the-counter drugs (e.g. aspirin, sleep aids, digestive tract medications), alcohol, and illegal mind altering drugs such as marijuana, cocaine, etc. It is frankly self destructive to self-prescribe any medications for symptoms of PTSD. Attempts at self therapy here echo the truth that "such an individual has an incompetent doctor who has a fool for a patient". So if your self prescribed medication consumption has significantly increased since the trauma, you need to consult your physician immediately. Any action short of this alternative is guaranteed to make things worse.

     The legal, physician prescribed medications deserve some attention in the early phases of PTSD. Frequently, these medications provide a helpful protective shield for the body in the face of enormous anxiety, pain and anguish. I do recommend, however, that such medications only be used after natural methods (psychotherapy, rest, etc.) have fallen short after a month or so. This is, of course, not true under exceptional medical circumstances. Prescription medications can help to quiet the emotional overload in the early stages, allowing the victim to return to normal rest, activity and nutritional cycles.

     If your symptoms have disrupted your rest, activity and nutritional cycles for a year or more, you are nearing the stage of exhaustion in the stress-response cycle. It is very important that you interrupt this cycle as quickly as possible. An experienced physician can prescribe medication to help your body gain some needed relief from this constant emotion and physical agony. Psychotherapy will then be more effective for long-term healing.