Medication for post traumatic stress disorder Post traumatic stress disorder (PTSD) occurs after exposure to significant trauma and results in enormous personal and societal costs. Although traditionally treated with psychotherapy, there is increasing recognition of a theoretical basis for medication treatments. This was a systematic review of 35 short‐term randomised controlled trials of pharmacotherapy for PTSD (4597 participants). A significantly larger proportion of patients responded to medication (59.1%) than to placebo (38.5%) (13 trials, 1272 participants). Symptom severity was significantly reduced in 17 trials (2507 participants). The largest trials showing efficacy were of the selective serotonin reuptake inhibitors, with long‐term efficacy also observed for these medications.

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Upside: The New Science of Post-Traumatic Growth

“I’m reading a book about post-traumatic growth,” I told a friend who had suffered significant health-related trauma.

“Is that when post-traumatic stress grows worse over time?” she asked, worried.

Not at all, I told her, though I understood where she was coming from. It’s not easy to wrap one’s mind around the concept of an upside to trauma. But post-traumatic growth, a fledgling field of research, refers to positive changes that many people experience in the aftermath of traumatic events.

The term post-traumatic growth was coined by Richard Tedeschi and Lawrence Calhoun of the University of North Carolina, Charlotte. In 1996, Tedeschi and Calhoun published a psychological measurement tool called the Posttraumatic Growth Inventory, but the concept has been around for all of recorded history. In Upside: The New Science of Post-Traumatic Growth, journalist Jim Rendon points out that a traumatic incident, a passage through darkness, and ultimate growth are all part of mythology’s archetypal story. He cites Man’s Search for Meaning, published in 1946, in which Viktor Frankl explains what he came to understand about trauma and suffering while in a Nazi concentration camp. He reminds us of a 1936 story about a young boy who saw his parents murdered and vowed to spend his life fighting crime. That boy, of course, was Bruce Wayne, and his crime-fighting alter-ego was Batman.

So post-traumatic growth, by any name, is nothing new, and psychologists are finally taking a good, hard look at it. And while nobody suggests that trauma is a good thing, that it’s easily moved through, or that we would all be better off with some trauma in our lives (not that we have a choice), Rendon looks at what psychologists have learned about how people grow and even thrive in the aftermath of traumatic experiences.

Post-traumatic growth, Rendon writes, can manifest in many different ways. It can be a person feeling that life has more meaning and that they are closer to their loved ones, or it can be a life-altering change that sends them, as Rendon puts it, “on career and life paths they never would have considered before.” The book offers stories of people suffering all manner of almost incomprehensible traumas — a parachute that doesn’t open, a child killed by a stray bullet, a grenade explosion, a fall in front of an oncoming train — to illustrate what researchers have learned about post-traumatic growth.

Perhaps surprisingly, Rendon finds that people who experience post-traumatic growth are not outliers, either.

“In study after study, research shows that about half or more of trauma survivors report positive change as a result of their experience,” Rendon writes. “…Every time I talk to one of these people in my reporting — someone who has totally altered his life, his sense of self, someone who says he is thankful for what most of us would consider a terrible tragedy — I am thrilled and amazed,” he continues. “What an exceptional person, I think. And then I remember all of the others who have told me similar stories. This kind of miraculous transformation, it turns out, is hardly unusual. The potential for such inspiring change lives inside most people.”

In each chapter, Rendon uses stories and research to explore things like the importance of deliberate rumination, the role of social support, the power of talking or writing about your experience, where optimism fits in, how faith helps, and creativity.

Still, the people in the book don’t spring from their hospital beds full of hope and optimism. They move through anger, despair, depression — everything you would expect under the circumstances. But ultimately, they find their way to new careers that will help others, new communities, better relationships, deeper faith, creative breakthroughs. (The story of the Tutu Project, which you may have seen online, is in here. The series of photographs of Bob Carey in a pink tutu is now a successful fundraiser to help women with breast cancer, but it started as a way for Carey to deal with trauma when his wife, Linda, was diagnosed.) Each horrendous tale concludes not with pie-in-the-sky happily ever after, but with solid, sustainable, realistic transformation.

Before she fell in front of an oncoming train as the result of an overenthusiastic hug (the unfortunate hugger was killed), Mariam Davies lived a life of partying and dead-end jobs. After the accident — and a predictable period of anger and depression — Davies went on to become a therapist, providing low-cost counseling in her South London neighborhood. Although she can walk, she’ll never run again, and she has to wear a colostomy bag.

“I still get down about things,” she says. “I still get upset that I have to wear crap knickers that aren’t sexy because they have to hold my bag in. This is horrible, I hate it. But it’s not the end of the world.” In fact, Davies says that before the accident she knew something had to change. And after the accident she remembers waking up in her hospital bed, “having a really powerful sense that this is what I’ve been waiting for.”

Davies’s is only one of many moving, inspiring, and enlightening stories in the book, and each person changes and grows in individual ways, although helping others is a recurring theme. Upside is a well-researched, well organized, informative, and eminently readable introduction to the science behind something we’ve all been aware of on some level, but haven’t before put a name to.

Sophia Dembling is author of Introverts in Love: The Quiet Way to Happily Ever After.

Upside: The New Science of Post-Traumatic Growth
Touchstone, August 2015
Hardcover, 288 pages
$26