Depression symptoms and emotional support impact PTSD treatment progress

January 23, 2014

Many individuals with posttraumatic stress disorder (PTSD) also experience depression. Researchers at Case Western Reserve University found that during PTSD treatments, rapid improvements in depression symptoms are associated with better outcomes.

Often while undergoing treatment, those suffering PTSD typically count on family and friends to help them through it. But advising individuals with PTSD to "toughen up" or "just get over it" can actually negatively impact these individuals and lead to a transient increase in , according to a new Case Western Reserve University psychology study.

The findings are reported in the Journal of Consulting and Clinical Psychology online article, "Depression Sudden Gains and Transient Depression Spikes During Treatment for PTSD." This is one of the first studies to shed light on how depression symptoms impact progress during PTSD treatment.

Funded by the National Institute of Mental Health, the study examined 84 PTSD patients treated only with medication, and another 116 involved in 10 therapy sessions designed to help them revisit their trauma and better cope with their fears.

Participants received either an evidence-based psychotherapy (Prolonged Exposure therapy) or an antidepressant (Zoloft), which is approved by the Food and Drug Administration to treat PTSD.

Specifically, this study tracked sudden depression spikes or reductions in depression symptoms during PTSD treatment. Also examined were how social support from family and friends impacted sudden depression changes and how those changes affected the overall treatment outcome.

Negative social support from family or friends (for example, blaming the victim) was associated with experiencing a worsening in depression symptoms for individuals receiving medication or therapy for PTSD, explained Stephanie Keller, a Case Western Reserve doctoral student and the study's lead author.

Participants rated their depression symptoms (such as sadness, loss of interest in daily activities or hobbies, concentration problems, sleep or appetite issues, and suicidal thoughts) before starting each of the 10 treatment sessions, and finally at the end of treatment.

These survey scores allowed researchers to systematically track and analyze any changes in the depression levels.

Researchers found that patients experience ups and downs in depression whether treated only with medication or only therapy. Individuals who had rapid decreases in actually improved more during PTSD treatment than those who had gradual change, Keller said.

However, as transient depression symptom worsened, it did not negatively impact treatment outcome.

Overall, this study suggests that therapists should help PTSD patients to improve the quality of their social relationships, Keller said.

She also said for those patients who do have a temporary increase or worsening in their symptoms, clinicians may want to provide encouragement to stick with therapy and remind patients that a temporary spike in depression does not necessarily mean that they will benefit less from treatment.

Norah Feeny from Case Western Reserve's Department of Psychological Sciences and Lori Zoellner from the University of Washington's Department of Psychology are principal investigators on the NIMH-funded study and co-authors of this paper. The William T. Dahms, M.D. Clinical Research Unit, through funding from the Cleveland Clinical and Translational Science Award, provided additional research support.

Explore further: Researchers find half of those diagnosed with PTSD also suffer from depression

Related Stories

Researchers find half of those diagnosed with PTSD also suffer from depression

June 4, 2013
About one of every two people diagnosed with posttraumatic stress disorder (PTSD) also suffer symptoms of depression, according to new research by Case Western Reserve University's Department of Psychological Sciences.

Maternal posttraumatic stress disorder associated with increased risk for child maltreatment

September 2, 2013
Posttraumatic stress disorder (PTSD) in mothers appears to be associated with an increased risk for child maltreatment beyond that associated with maternal depression, according to a study published by JAMA Pediatrics.

Prolonged exposure therapy found beneficial in treating adolescent girls with PTSD

December 24, 2013
Researchers at Penn Medicine report in the December 25 issue of JAMA that a modified form of prolonged exposure therapy – in which patients revisit and recount aloud their trauma-related thoughts, feelings and situations ...

Study finds mending ruptures in client-therapist relationship has positive benefits

November 6, 2013
In order for prolonged exposure therapy, an evidence-based psychotherapy for post traumatic stress disorder (PTSD), to reach its full potential, any misperceptions or ruptures in trust and communication between therapist ...

PTSD psychotherapy is enhanced with D-cycloserine

June 4, 2012
Posttraumatic stress disorder (PTSD) is among the most common, distressing, and disabling medical consequences of combat or other extremely stressful life events. The first-line treatment for PTSD is exposure therapy, a type ...

Increased risk for cardiac ischemia in patients with PTSD

December 2, 2013
There is growing concern that long-term untreated posttraumatic stress disorder (PTSD) symptoms may increase the risk of developing a number of medical problems, particularly compromised cardiovascular health.

Recommended for you

Researchers crack the smile, describing three types by muscle movement

July 27, 2017
The smile may be the most common and flexible expression, used to reveal some emotions, cover others and manage social interactions that have kept communities secure and organized for millennia.

Ketamine for depression encouraging, but questions remain around long-term use

July 27, 2017
A world-first systematic review into the safety of ketamine as a treatment for depression, published in the prestigious Lancet Psychiatry, shows the risks of long-term ketamine treatment remain unclear.

Even babies can tell who's the boss, UW research says

July 27, 2017
The charismatic colleague, the natural leader, the life of the party - all are personal qualities that adults recognize instinctively. These socially dominant types, according to repeated studies, also tend to accomplish ...

DREAMers at greater risk for mental health distress

July 27, 2017
Immigrants who came to the United States illegally as small children and who meet the requirements of the Development Relief and Education for Alien Minors Act, more commonly known as DREAMers, are at risk for mental health ...

Negativity, be gone—new online tool can retrain your brain

July 27, 2017
Anxiety and depression can have devastating effects on people's lives. In some cases, the mental disorders lead to isolation, poverty and poor physical health, things that often cascade to future generations.

Research aims to shape more precise treatments for depression in women

July 27, 2017
Among women in the United States, depression is at epidemic levels: Approximately 12 million women in the U.S. experience clinical depression each year, and more than 12 percent of women can expect to experience depression ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.