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Common Comorbidities in PTSD

Post-traumatic stress disorder (PTSD) is a complex disorder, and there are dozens of potential therapies and treatments that can help people manage the effects. But before you can zero in on the proper treatment options for you, your condition, and your lifestyle, it’s helpful to learn more about PTSD and the complications surrounding it. Read through this quick guide to learn about common comorbidities with PTSD, why you need to know about comorbidities while seeking treatment, and how the team at Summit Ketamine Innovations can help you receive specialized ketamine infusion therapies. 

How Is PTSD Defined in DSM-5?

DSM-5 establishes four areas of criteria for post-traumatic stress disorder: 

  • Intrusion symptoms
  • Avoidance
  • Negative cognitive or mood changes
  • Changes in arousal and reactivity

These four symptoms can manifest in many ways after a distressing event. Common symptoms are severe anxiety, uncontrolled thinking and reflection on the distressing event, nightmares, and flashbacks. These reactions can grow from untreated trauma, and doctors can only diagnose PTSD after the symptoms persist and acutely cause impairment for at least one month. 

However, many other conditions partially mirror PTSD, and people with PTSD commonly suffer other symptoms that aren’t attributable to PTSD directly. That’s why it’s essential to understand whether you have PTSD, which symptoms are due to PTSD, and any other conditions you may be suffering alongside it.  

What Are Comorbidities, and How Are They Defined in Psychiatry?

Comorbidity is a technical term for multiple simultaneous diseases or conditions. Comorbidities are very common in all types of physical, mental, and emotional conditions. In psychiatry, comorbidities are two or more psychiatric conditions or disorders held by one person simultaneously. However, the field is also expanding to consider a co-occurring psychiatric condition and a general medical condition. For example, diabetes and an eating disorder may be regarded as comorbidities. 

Doctors and patients need to identify potential comorbidities because they can make accurate diagnoses far more complex. Comorbidities can also interfere with effective treatments, as medicinal treatments, therapies, and other treatments may not work well together or may accidentally sacrifice recovery in one area in favor of another.

Patterns of Comorbidities in PTSD

PTSD is complex, and comorbidities can make it difficult to get an accurate diagnosis, identify other potential conditions, and find the best treatment for all of your symptoms. There are three main types of comorbidity patterns to consider: 

  1. Existing conditions that lead to, or partially contribute to, the development of PTSD after a traumatic event.
  2. Occurrences that cause or trigger both PTSD and a separate mental, emotional, or physical condition, such as anxiety disorders
  3. Conditions that evolve as a result of untreated PTSD, such as panic disorders

Psychiatrists can ascertain which comorbidities and diagnoses are correct and, through those diagnoses, work with you to create treatment plans with a combination of therapies, pharmaceutical treatments, and other suggestions that work together to treat PTSD in isolation or with comorbidities. 

Why Is It Important to Understand Comorbidity When Seeking Treatment?

Psychiatrists and patients need to uncover potential comorbidities for patients with PTSD because PTSD is frequently paired with co-occurring mental and emotional health conditions like stress disorders, anxiety disorders, and mood disorders. More clearly, understanding specific comorbidities that affect you can help you and your doctors select the right treatment plans, manage symptoms, monitor progress, and help you recover without confusing variables and missed cues. 

We Can Help—Reach Out to Learn More

At Summit Ketamine Innovations, we serve the Denver metropolitan area with specialized ketamine infusions and treatments for PTSD and other mental or emotional conditions. Our mission is to create individualized treatment plans that combine ketamine infusions, psychotherapy, and positive self-care. Contact us today to learn more or to schedule your first appointment.

 

Image Credit: Peopleimages.com – Yuri A / Shutterstock

Effects of Psychological Therapy

There remains in American society a stigma related to psychological therapy and counseling. Perhaps it’s a generational thing, as more millennials and people who identify as Gen Z are more open to using psychotherapy when needed. Like anything else, it offers good and bad.

What is Psychotherapy?

“Psychotherapy, or talk therapy, is a way to help people with a wide variety of mental illnesses and emotional difficulties. Psychotherapy can help eliminate or control troubling symptoms so a person can function better and can increase well-being and healing.”

Going for psychological therapy can help you deal with problems in everyday life; the effect of trauma, medical conditions, or personal loss, like the death of a loved one; and mental disorders, including depression or anxiety.

What Kinds of Psychotherapy are There?

Depending on your condition, a mental health specialist may recommend one or more kinds of therapy. The choice is yours and depends on circumstances, personal preferences, and other factors. Your therapist has the option to mix and match elements from different approaches, including ketamine therapy, to produce the best outcome.

What kinds of psychotherapy can you choose from? There are several.

  • Cognitive-behavioral therapy helps you identify and alter your thinking and behavior patterns that are damaging or ineffective, swapping them with more appropriate thoughts and functional behaviors.
  • Interpersonal therapy is a form of treatment known for its brevity. It helps people comprehend fundamental interpersonal issues and empowers them to learn healthy means to express emotions and strategies to better communicate and relate to others.
  • Dialectical behavior therapy is a particular type of cognitive-behavioral therapy that helps control emotions. It may be most beneficial to someone with long-term suicidal thoughts, eating disorders, or posttraumatic stress disorder.
  • In psychodynamic therapy, you work with a therapist to foster positive self-awareness and alter ingrained patterns to regain control of your life.
  • Supportive therapy utilizes encouragement and guidance to help people grow their resources. It fosters self-esteem, as well as personal and social functioning.

Alternatives to Psychological Therapy

Not everyone is open to the idea of treating personal issues with psychotherapy. Fortunately, many other options exist, among them:

  • Ketamine treatment.
  • Dietary supplements promote health and wellness, in addition to treating pain, depression, and anxiety.
  • Different kinds of mindfulness, meditation, or breathing exercises. Each is easy to do and may give greater insight into your consciousness and the world around you.
  • Chiropractic care.
  • Aromatherapy and massage therapy.
  • Yoga and progressive muscle relaxation.

How Many People Use Psychotherapy?

The National Health Interview Survey noted the following:

  • In 2019, almost 20 percent of adults had gotten various mental health treatment “in the past 12 months, including 15.8% who had taken prescription medication for their mental health and 9.5% who received counseling or therapy from a mental health professional.”
  • Women have less of a problem seeking mental health treatment than men.
  • Non-Hispanic white adults are more open to psychotherapy than other ethnic groups.

Effects of Psychological Therapy

Research indicates that most people receiving psychotherapy enjoy fewer symptoms and can function better in their lives. “About 75 percent of people who enter psychotherapy show some benefit from it. Psychotherapy has been shown to improve emotions and behaviors and be linked with positive changes in the brain and body. According to the American Psychological Association (APA), the benefits also include fewer sick days, less disability, fewer medical problems, and increased work satisfaction.” 

The APA also found that:

  • Psychological therapy is useful in treating numerous mental and behavioral health problems spanning a range of population groups. The average benefits of such treatment are more significant than the outcomes seen with many medical treatments.  
  • Extensive multi-site studies and meta-analyses have shown that psychotherapy lowers morbidity and mortality and decreases in-patient psychiatric care. 
  • Psychotherapy nurtures life skills that have an impact outside the course of treatment. Positive outcomes tend to last longer than those observed in other psychopharmacological treatments and with fewer harmful side effects.

In some cases, psychological therapy is used in combination with other treatments, self-help, certain medicine, and ketamine therapy. It’s also worth pointing out that each person is different and deals with medical and psychological issues accordingly. What works for one person may not work for someone else, and outcomes are often influenced by health, societal pressures, and factors like ethnicity and religion.

There are potential negative side effects of psychotherapy, which may include sleeping problems, stress, anxiety, feelings of helplessness, lower self-esteem, sadness, and other issues. Specific questions should be directed at your healthcare provider.

RLS & Mood Disorders

Physical discomfort in your legs, especially when you don’t know the cause or how to relieve it, is hard enough to deal with. But when you combine that with possible mood disorder symptoms like depression, it’s time to look for help. Ketamine might be just what you need.

What is RLS?

Restless legs syndrome (RLS) is a disorder that triggers an uncontrollable desire to move your legs, generally due to an uncomfortable feeling. It often happens in the nighttime hours or evening while you’re lying or sitting down but moving may bring temporary relief.

Restless legs syndrome can start at any age and normally worsens the older you get. It can disturb sleep and interfere with daily life. However, you can manage your symptoms with proper treatment.

What Causes RLS?

In most cases, it’s hard to determine the cause of this condition. But RLS has a genetic component and is sometimes seen to run in families with a history of the illness, where the symptoms typically begin before the age of 40. Other possible causes include:

  • Hemodialysis and end-stage renal disease.
  • Low iron levels.
  • Certain types of medicine.
  • Use of alcohol, caffeine, and nicotine.
  • Pregnancy, particularly during the last trimester; in most instances, symptoms usually subside within four weeks of giving birth.
  • Nerve damage.
  • Sleep deficiency and other sleep conditions.

Know the Symptoms

People with RLS experience the irresistible call to move, paired with uncomfortable feelings in the lower limbs distinct from normal sensations felt by someone without the disorder. These sensations are often hard to describe but may be characterized as pulling, itching, aching, throbbing, crawling, or creeping. These feelings don’t usually affect your arms and the chest or head less often. They can happen on one or both sides of your body with varying intensity.

RLS & Mood Disorders

Some studies have shown that RLS symptoms occur before those related to depression or anxiety, and some people equate the severity of symptoms to the intensity of mood disorder symptoms. Researchers have documented the links between the sleep disturbance caused by RLS and participants’ mood indications.

Restless legs syndrome and periodic limb movement disorder can disturb the quality and quantity of sleep. Because of these conditions, people with sleep trouble may have problems focusing during the day, and some get depression, experience mood swings, or encounter other health issues. 

Comorbidities of RLS

It’s not uncommon for RLS to be accompanied by various conditions and mood disorders:

  • Insomnia is a common sleep disorder making it hard to fall and stay asleep or causes you to wake up early and keeps you from getting back to sleep.
  • Clinical depression negatively affects your feelings, how you think, and your actions.
  • Bipolar disorder triggers uncommon shifts in mood, energy and activity levels, concentration, and how you complete daily tasks.
  • Schizoaffective disorder is a condition that presents symptoms of psychotic and mood disorders during a single incident or within a few weeks of each other. The word “schizoaffective” has two components: ‘schizo–’ for psychotic symptoms and ‘–affective’ for mood symptoms.
  • Cyclothymia triggers emotional highs and lows, but they’re not as dangerous as what you’d see with bipolar I or II disorder. You may experience cases when your mood markedly shifts up and down from what you’d consider being normal.
  • Persistent depressive disorder means you experience a low mood for at least two years while accompanied by at least two other depression symptoms.
  • Anxiety disorders, like generalized anxiety disorder and separation anxiety disorder.
  • Like arthritis and lower back pain, chronic pain disorders affect nearly three million people a year.

Some medicine or treatment options like ketamine therapy have been known to soothe RLS symptoms and mood disorders, but research is ongoing.

Diagnosis & Treatment

If you think you have RLS or a mood disorder, a medical professional can offer an initial diagnosis. For RLS, you’ll be asked to provide your medical history – both personal and that of your family – and to describe your symptoms. The International Restless Legs Syndrome Study Group provides information on specific criteria. The examination may also uncover a medical problem triggering mood disorder symptoms. Otherwise, you’ll be referred to a mental health specialist for further assessment.

RLS treatment may include medicine, muscle relaxers, and sleep therapy. Mood disorders are typically treated with psychotherapy, but both may benefit from ketamine treatment.

Final Thoughts

If you’re suffering from either RLS or a mood disorder, don’t wait until symptoms either control your daily life or negatively impact how you live. With the proper treatment – psycho or physical therapy, medicine, muscle relaxers, lifestyle changes, or ketamine treatment – you can start living a productive life again.

new-treatment-for-depression-makes-national-news

Ketamine Treatment Makes National News

Here is a collection of stories and articles from the media that highlight ketamine therapy.

Ketamine Isn’t an Opioid and Treats Depression in a Unique Way
Johns Hopkins University School of Medicine, July 31, 2019
Ketamine has gotten a bad rap as an opioid when there’s plenty of evidence suggesting it isn’t one, Johns Hopkins experts say.

Ketamine May Relieve Depression By Repairing Damaged Brain Circuits
NPR, April 11, 2019
The anesthetic ketamine can relieve depression in hours and keep it at bay for a week or more.

Special K: Ketamine, From Party Drug To Depression Medication
NPR, April 22, 2019
Recently, the FDA approved a new drug based on ketamine to treat treatment-resistant depression.

Ketamine offers a lifeline for people with severe depression, suicidal thoughts
CNN, August 4, 2018
Ketamine is a powerful medication used in hospitals primarily as an anesthetic, but recent scientific studies have shown significant promise with treatment-resistant depression and suicidal ideation.

Can We Stop Suicides?
New York Times, November 30, 2018
It’s been way too long since there was a new class of drugs to treat depression. Ketamine might be the solution.

Lasers Highlight Ketamine’s depression-fighting Secrets
WIREDmagazine, April 11, 2019
Researchers implanted prisms in mouse brains to watch how ketamine affects neurons. The findings could lead to more effective antidepressant treatments.

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