Understanding PTSD: The Impact of Trauma

Post-traumatic stress disorder (PTSD) develops after exposure to a traumatic event—an experience that involves actual or threatened death, serious injury, or sexual violence. However, PTSD isn't simply "remembering" a traumatic event. It's a complex neurobiological condition affecting the autonomic nervous system, memory processing, emotional regulation, and the body's stress response.

When I evaluate patients with PTSD, I'm assessing multiple systems: autonomic nervous system dysregulation (hyperarousal, hypervigilance), memory processing disruptions (intrusive memories, flashbacks), sleep architecture changes (nightmares, fragmented sleep), stress hormone patterns (cortisol dysregulation), and alterations in threat detection circuits. Research indicates that PTSD involves changes in the amygdala, hippocampus, and prefrontal cortex—brain regions critical for fear processing, memory consolidation, and emotional regulation.

PTSD symptoms typically fall into four clusters: re-experiencing (flashbacks, nightmares, intrusive memories), avoidance (avoiding reminders of the trauma), negative alterations in cognition and mood (negative beliefs, emotional numbness, memory problems), and hyperarousal (hypervigilance, startle response, sleep disruption, irritability). These symptoms persist beyond a month and significantly impact functioning. PTSD often co-occurs with depression, anxiety, and substance use disorders, which may require integrated treatment approaches.

Complex PTSD (C-PTSD) can develop after repeated or prolonged trauma, often in childhood, and may include additional symptoms such as difficulties with emotional regulation, relationship problems, and a distorted sense of self. The National Institute of Mental Health estimates that approximately 3.6% of U.S. adults had PTSD in the past year.

An Integrative Approach to PTSD Treatment

Effective PTSD treatment requires addressing both the psychological and neurobiological impacts of trauma. Research indicates that trauma affects multiple systems: the autonomic nervous system (fight-flight-freeze responses), memory processing (traumatic memories stored differently than normal memories), sleep architecture (nightmares disrupting REM sleep), and stress hormone regulation (cortisol patterns altered). Medication can help manage symptoms, but trauma-informed psychotherapy is essential for processing traumatic memories and restoring a sense of safety. Learn more about how psychiatrists safely combine psychotherapy and medication.

When I work with patients with PTSD, I'm addressing these systems comprehensively. My approach includes:

Trauma-Informed Evaluation: Comprehensive assessment that recognizes the impact of trauma on multiple systems, conducted in a safe, non-retraumatizing manner
Medication Management: When indicated, medications such as SSRIs, SNRIs, or prazosin (for nightmares) may help manage symptoms, allowing patients to engage more effectively in psychotherapy
Trauma-Focused Psychotherapy: Evidence-based approaches including trauma-focused cognitive behavioral therapy (TF-CBT), eye movement desensitization and reprocessing (EMDR), and other trauma-processing modalities
Nervous System Regulation: Techniques to help regulate the autonomic nervous system, including grounding techniques, breathing exercises, and body-based approaches
Sleep Optimization: Trauma often disrupts sleep architecture, particularly REM sleep where nightmares occur. Addressing sleep disruption is crucial for recovery, as adequate sleep supports memory consolidation, emotional regulation, and nervous system restoration
Lifestyle Support: Attention to nutrition, physical activity, stress management, and mind-body practices that support nervous system regulation and recovery

Treatment proceeds at a pace that feels safe for the patient. Processing trauma too quickly can be retraumatizing, while avoiding processing can maintain symptoms. The therapeutic relationship provides a foundation of safety from which healing can occur.

Complex Trauma and C-PTSD

When trauma occurs repeatedly or over an extended period, particularly in childhood, it can lead to complex PTSD. This may involve:

Difficulties with emotional regulation and self-soothing
Challenges in relationships, including difficulty trusting others or maintaining boundaries
Distorted sense of self, including feelings of worthlessness or shame
Dissociation as a coping mechanism
Somatic symptoms related to trauma stored in the body

Treatment for complex trauma often requires a longer-term approach, focusing first on stabilization and safety, then gradually addressing trauma processing. The therapeutic relationship itself becomes a vehicle for healing, providing a corrective experience of safety and trust.

What to Expect in Treatment

Your initial evaluation is comprehensive and trauma-informed—typically 90 minutes—allowing time to understand your history, symptoms, and goals in a safe, non-retraumatizing manner. We discuss treatment options and develop a collaborative plan that prioritizes your sense of safety and agency.

Treatment typically involves both medication management (when indicated) and trauma-focused psychotherapy. The pace of trauma processing is determined collaboratively, with your sense of safety as the primary guide. Some patients benefit from short-term treatment focused on a specific trauma. Others benefit from longer-term treatment addressing complex trauma and its ongoing impacts.

The goal is not just symptom reduction—it's restoring a sense of safety, processing traumatic memories, improving emotional regulation, and rebuilding a life that feels meaningful and connected. Recovery from PTSD is possible, and many patients experience significant improvement with appropriate, trauma-informed care.

Serving Los Angeles Area

I provide adult PTSD treatment to patients throughout Los Angeles County, including Hollywood, Beverly Hills, Santa Monica, West Hollywood, Burbank, Glendale, Pasadena, and surrounding areas. The practice is located in Hollywood and offers both in-person and telepsychiatry visits for adults throughout California.

If you're experiencing symptoms of PTSD, know that effective, trauma-informed treatment is available. PTSD is a treatable condition, and recovery is possible with appropriate care.

References & Resources

For additional information about PTSD, I recommend these authoritative sources:

For more information about PTSD and trauma, see our article on trauma and PTSD. PTSD often co-occurs with depression—if you're experiencing both, learn more about our approach to treating depression.

Contact us to schedule a consultation or learn more about our approach to PTSD treatment.