Cobbers on the Brain

Imagine sitting at your desk in your bedroom while trying to hurriedly finish up your homework that is due tomorrow. While focusing intensely on a problem, you begin to hear whispering. Thinking that it is just a result of the silence in your room mixed with exhaustion from studying all evening, you brush it off even though the whispering persists. After you get ready for bed and are lying still trying to fall asleep, the whispering seems to get louder and you cannot help but feel as though someone is there whispering into your ear. You want to speak out to the whispering, but feel confident that there is no one there.

This could be just one symptom of schizophrenia, as auditory hallucinations are the most common type of hallucination occurring for most people with schizophrenia. There are many other symptoms, including:

• delusions
• disorganized thinking or speech
• disorientation
• memory loss
• disorganized behavior
• abnormal motor behaviors
• speech issues
• lack of ability in various areas

The cause of schizophrenia creates a difficult conversation, as there are many different theories. However, most theories conclude that schizophrenia is caused by some type of genetic predisposition combined with environmental factors that allow the affected genes to become expressed. There are also risk factors that can increase the likeliness of developing schizophrenia, including:

• family history of schizophrenia
• increased immune system activation
• being born with older parents
• some pregnancy and birth complications
• taking mind-altering drugs during teens

Some of the risk factors for schizophrenia correlate with the environmental factors that can also increase the development of schizophrenia:

• childhood trauma
• prenatal risks
• migration
• place of birth
• infections

When looking at how schizophrenia occurs in individuals, it is often a misconception that these individuals are in control of their symptoms and actions, causing them to be stereotyped against in society. The true cause of schizophrenia is located in the brain and in many different brain regions. The brain regions that are most affected and involved in schizophrenia are:

• gray matter
• dorsolateral prefrontal cortex
• inferior prefrontal cortex
• medial temporal cortex
• primary auditory cortex
• visual cortex
• auditory language regions such as Wernicke’s area and Broca’s area
• basal ganglia

When seeing the number of brain regions involved in schizophrenia and how they impact the symptoms most generally exhibited, it becomes clear that schizophrenia is a much more genetic based condition and although influenced by environmental factors, is definitely not directly caused without any type of genetic influence.

As previously discussed, the treatment of schizophrenia is a tricky one and there are constant developments in the best and most effective ways to treat individuals with schizophrenia. The most common ways used today are medication and psychosocial treatment, with many people with schizophrenia requiring frequent visits with a psychiatrist. Below is a link to a video of an emerging finding of a schizophrenia “switch” and how it may impact treatment:

https://www.youtube.com/watch?v=m6YE6BJVwtg

The lifestyle of someone living with schizophrenia can be very difficult and often comes with many judgements and obstacles. First, finding the correct combination of medication for individuals with schizophrenia is a very long and difficult journey and can be extremely expensive and tasking on the individual, especially if the medication does not work immediately or is the wrong combination and the symptoms are not controlled. Second, most people in the general population have preconceived stereotypes about those with schizophrenia based on what they have heard, what they have understood from others, or what they have seen in media. Finally, managing symptoms with or without medications for individuals with schizophrenia is very difficult and their symptoms often arise without notice and in unexpected ways.

http://2018neurochem.pbworks.com/w/page/129829617/Wnt%20and%20Schizophrenia

“Stressful events evoke a long-lasting impact on behavior”

In our society today, it is no secret that mental illness is a major topic of discussion. Mental illness disorders affect ourselves, our friends, family members, colleagues, and more. Specifically, anxiety disorders are the most prevalent mental illness in the US. 18.1 percent of adults suffer from this illness. 70 percent of adults in the US have experienced a traumatic event at some point in their lifetime. An estimated 8 percent of adults have PTSD in the US at any given time. These statistics show that there are some underlying factors with these illnesses. Is it all environmental, genetic, only in our brain, or a mix of everything? Below, we will explore parts of the brain that are in overdrive when dealing with illnesses such as PTSD and anxiety.

When a person is under stress, research has found that learning and memory processs can often get messed up. The area of the brain that have shown this happening is the limbic system, which is made up of the thalamus, hypothalamus, hippocampus, amygdala, and the fornix. The area to focus on with anxiety but especially with PTSD is the amygdala. The amygdala is responsible for the preception of, response to, and memory formation of emotions, especially fear. This means that when a person experiences a negative emotion that is associated with a traumatic event, their amygdala will be sure to remember it. Psychologists often call this idea emotional learning. For example, if a child gets bit or attacked by a dog, that is clearly a traumtic childhood event. The amygdala will take the negative stimulus of getting bit by a dog and store that traumatic memory fairly quickly. The negative emotions that were felt during this event are then associated with the dog biting event, which includes dog barks, dog parks, and even simply seeing a dog in public. The amygdala is a major reason for why getting bit by a dog as a child can cause someone to have a phobia of dogs for the rest of their life.

With PTSD and the amygdala, these two words go hand in hand. Several studies have shown that in patients with PTSD, there was hyperactivity, or a large increase in activity, in the amygdala when stimuli were shown that were connected with their traumatic experience. This stimuli can range from pictures from an event, talking through the specific details of the event, noises, etc. This hyperactivity occurs directly after the traumatic event as well as during sessions where triggering stimuli is shown. This all is basically general knowledge. What is not is that in stressful or traumatic events, many parts of the brain are inhibited or weakened, such as the prefrontal cortext. The amygdala is opposite. Because this part of the brain consolidates so many of these traumatic memories, when the memories are triggered, the amygdala springs in to action.

A more recent finding with these PTSD brains and the amygdala is that the same hyperactivity that was found when the patient was shown associated stimuli was also found when shown material unrelated to their event. This included pictures of random people with fearful expressions or event doing oddball, continuous tasks. This finding may suggest that brains with an overactive amygdala may be over-resoinding to inputs that are not deemed dangerous or traumatic to a brain that does not have PTSD. My question is this: In PTSD brains, can there be such a thing as a happy medium of your amygdala detecting what is truly dangerous and what is not? PTSD is a horrible illness that effects far more than those traumatic memories that are stored away.

It is already known there are many factors that contribute to PTSD and anxiety disorders. Traumatic events, memory consolidation, and the amygdala are only a few of them. Sometimes, diving into one part of the big problem makes it seem less daunting. If a researcher can figure out how to keep the amygdala to a normal activity rate, who knows what else could be solved?

https://www.sciencedirect.com/science/article/pii/S2352289514000101

https://pdfs.semanticscholar.org/d3e0/f4c57b4cd63ec0ee1d2a447bef25d960b65c.pdf

During college stress can be a common component of everyday life. There is a certain amount of stress that is healthy, though if the stress consumes you, this can lead to more severe cases such as anxiety and PTSD. Though what are the factors that result in these cases where stress can be debilitating?

Well to start epigenetics is a major factor, this results from changes in the environment resulting in methylation of one’s DNA. This causes changes that can result in certain portions of the DNA being labeled for inducing more activity at those sites. Enough stress can result in the expression and methylation of DNA, causing genetic changes because of the stressor.

The results of the methylation of the DNA creates tags that can be utilized to change the regulation of those genes.

So how do we address the stress? Well as stressful experiences become more regular in our lives, there is no major way to avoid stress. Though effort can be made to reduce the duration of the stress, and find other activities and hobbies as an outlet for mostly stress free activities. Exercise is also a great outlet, as this can relieve stress by distracting you from the stressor, and increasing GABA levels, this results in reducing action potential for neurons, thus decreasing the strength of stressors. However one of the easier solutions for reducing stress is our lifestyle, in the current age of continuous communication via the internet. One can allot time for themselves, by discerning time for when to be stressed, such as at work and separating time after work as being personal time that shouldn’t be affected by work. As with the constant nagging by other employees to reply to work related matter creates unneeded stress, that could be eliminated by limiting the number of work related interactions during vacation, and during one’s personal time.

There is an abundance of anxiety disorders that plague our country and our world today. Anxiety disorders are the most common mental illness in the United States today and they affect 40 million adults every year. There is also a wide spectrum of disorders that are classified as anxiety disorders: Post-Traumatic Stress Disorder, Obsessive-Compulsive Disorder, Major Depressive Disorder, General Anxiety Disorder, and many more.

Environmental Stressors

So what is going on in our world that makes these disorders so prevalent. Nobody really knows what is going on exactly, but some people believe the role of technology in our world as being a good place to start looking. We are constantly around some sort of screen where we can be entertained or connected to the outside world while just lying in bed or (heaven forbid) sitting in class or at work! We are always looking at our social media and many times worry about what other people think about what we posted, how we look, and more. With this constant stimulation and worry about what is going on with our technology, we take less and less time to unwind, relax, and disconnect from the world. This could be one of the biggest environmental stressors in our world today causing anxiety disorders.

Limbic Stress

What is going on in the brain that causes these anxiety disorders? Researchers don’t know exactly what is going wrong in the brain to cause these anxiety disorders, they do know that there is too much activation going on in the limbic system of the brain. In the limbic system are two important parts of the brain that have to do with emotion and memory: the amygdala and the hippocampus. With that over activation, or excitation, going on in the emotional and memory parts of the brain, long-term memories and emotional associations can be made to stressors. This can lead to Post-Traumatic Stress Disorder or Anxiety, two types of anxiety disorders.

Run! Run! As Fast as You Can!

Think about a time when you were very stressed out. This could be from anything: a family matter, school, work, or something else that could cause this. You likely thought, “I wish there was some way for this stress to just go away or some way that I can calm myself down enough to deal with it.” Well there is a way to do this: Exercise! Researchers have found that individuals who work out have a higher concentration of the neurotransmitter GABA in the brain. This buildup of GABA due to exercise is found in the amygdala and hippocampus of the brain. GABA is a neurotransmitter that lowers the action potential of neurons, in other words, it reduces the activity of neurons causing a calming effect. When a stress is felt, GABA is released giving way to a calming feeling, in this case, to the memory and emotional parts of the brain.

Always Listen to Mom

So when somebody tells you that you can’t run away from your problems, that may be true. However, it might help you to relax and better cope with your problems later. So with exercise doing so much good for your body and brain, why wait until something is wrong to make a change. Listen to what your mom always told you, “Go outside and have some fun!”

Image 1: https://www.google.com/url?sa=i&source=images&cd=&ved=2ahUKEwiht9mA2YveAhXl44MKHQM4BcMQjRx6BAgBEAU&url=http%3A%2F%2Fwww.theloquitur.com%2Fwhy-no-one-talks-about-anxiety%2F&psig=AOvVaw3adhBsrqFSYCkPprhDvtC9&ust=1539804521580514

Image 2: https://www.google.com/url?sa=i&source=images&cd=&cad=rja&uact=8&ved=2ahUKEwjx1Jup2oveAhVjrYMKHZciB9AQjRx6BAgBEAU&url=http%3A%2F%2Fwww.ftcollinspersonaltrainer.com%2F2015%2F01%2Fthe-basal-metabolic-rate-explained%2Fexercise-and-anxiety%2F&psig=AOvVaw0yas3okeDsxgmoyRRU5IdZ&ust=1539804863535747

Advancements in technology of today’s age is making it harder and harder to disconnect from the rest of the world. This inability to disconnect seems to be having a negative consequence on our overall health, especially our mental health. Our brains, in essence, are an evolved piece of hardware that was programmed to live in a world where real physical threats, such as lions and tigers and bears (Oh my!) – not a world where the biggest stressor is something someone said on a social media website. Since our brains are programmed to worry about evolutionary pressures that no longer exist, we are now left worrying over petty aspects of our lives’. This constant worry could be changing our genes that alter our memory and lead to memories that impact our everyday lives’.

If you wish to not get muddled by scientific jargon of this stress response and consolidation of memories, I suggest you bypass this next section and go to the basic 8 step mechanism.

Scientific Mechanism

When we encounter stress, our bodies release various molecules related to the stress (hormones called glucocorticoids and neurotransmitters such as glutamate. The glucocorticoids travel throughout the entire body; ultimately, reaching the part of the brain responsible for storing memories – the hippocampus. Within is the hippocampus is an area known as the dentate gyrus (DG), which plays a major role in the formation and storage of new memories¹. Once the glucocorticoids reach the DG, they facilitate signaling of the ERK-MAPK signaling pathway¹. This activation causes a cascade of events that leads to the activation of MSK1 and ELK-1, two nuclear kinases of the DG¹. Activation of these nuclear kinases results in serine10 (S10) phosphorylation and lysine14 (K14) acetylation at histone H3 (H3S10p-K14ac)¹. The phosphorylation and acetylation at this “mark” allows for the DNA, which is in the form of condensed chromatin, to be “opened” for transcription factors to act upon and alter the genes, such as Fos and Egr, for consolidation of memories¹.

8 Simple Steps

Consolidation of memories can be boiled down to as simple as:

1. Stress response releases messengers in the body (glucocorticoids)
2. Messengers travel to the memory part of the brain (hippocampus)
3. Messengers activate a receptor on neurons (glucocorticoid receptor)
4. Receptor activation turns on a pathway (ERK-MAPK pathway)
5. Pathway causes a cascade of events (MSK1 and ELK-1 activation)
6. Ultimately, this cascade causes opening of DNA (H3S10p-K14ac marker)
7. DNA is “read” leading to consolidation of memories (c-Fos and Egr-1 is transcribed)
8. Consolidation of memories

Sometimes this response is so severe that is lasts and is reoccurring, often seen with individuals seen with PTSD.

^{https://www.everydayhealth.com/anxiety/anxiety-and-depression.aspx}

How to reduce stress: Exercise!!!

If you are a college student like me, you are no stranger to stress. During finals, the levels of stress seem to weigh you down. Everyone deals with stress in their lives’. Some people seem to do just fine coping with stressors in their life, while others may struggle a little more. If you are one who tends to struggle with anxiety, try exercising! Studies have exhibited that exercise has a calming effect when someone becomes stressed. Exercise increased levels of GABA, the major inhibitor molecule, in the brain². GABA calms the firing of neurons that causes the feeling of anxiety. A specific study showed that participants who exercised responded better to stress, increasing the levels of GABA as opposed to the participants who did not exercise³. Seek advice from a doctor if anxiety seems too much to bear. However, maybe the only prescription someone needs in order to feel less anxious is to exercise more! GABA levels increase with more exercise, diminishing the activity of neurons that lead to anxiety; thus, calming the hippocampus. Maybe, all you need to do is just sweat out the anxiety.

1. https://moodle.cord.edu/pluginfile.php/708065/mod_resource/content/0/anxiety%20making%20memories%20from%20stressful%20events.pdf
2. https://well.blogs.nytimes.com/2013/07/03/how-exercise-can-calm-anxiety/
3. https://www.sciencedaily.com/releases/2016/02/160225101241.htm

Alzheimer’s Disease:

Alzheimer’s Disease (AD) is the most common type of dementia and is characterized by memory loss and loss of other cognitive abilities that interfere with everyday life. The majority of individuals with Alzheimer’s Disease are greater than 65 years of age, however, some individuals who acquire the disease at a younger age are diagnosed with early-onset Alzheimer’s Disease. AD is a progressive, neurodegenerative disease that worsens over time and is the sixth leading cause of death in the United States. The disease also has a spectrum of severity, where in its mild stage, it will just beginning to affect a person’s functions and in its most severe stage, a person can depend completely on others for aid in their basic activities of daily living. There is no known cause of Alzheimer’s, however there are many aspects that can play into the overall diagnosis and symptoms of Alzheimer’s, including genetic, environmental, and lifestyle. One of these possible causes is that Alzheimer’s is passed through genetics. If a family member has been diagnosed with Alzheimer’s Disease, there is a slightly greater risk that an individual older than 65 will develop Alzheimer’s. However, if an individual is younger than 65, there is a much greater risk of developing AD. Another major aspect of the cause of AD is the role of plaques and tangles in the brain. Plaques are deposits of beta-amyloid protein fragments that build up in spaces between nerve cells and tangles are twisted fibers of tau that build up inside cells. Both of these abnormal structures play a role in the destruction of nerve cells. AD brains show build-ups of these structures, especially in areas of the brain crucial for memory. Plaques and tangles are thought to play a role in blocking nerve cell communication and disrupting cell processes. The death of nerve cells is what causes memory failure and cognitive issues. In the case of genetics, there has been one gene that has been found to be involved in late-onset Alzheimer’s, and that is the apolipoprotein E gene. Typically, if a person carries this gene, they will have a greater risk of developing the disease. Another connection is that the majority of people diagnosed with Down syndrome will develop Alzheimer’s disease. There are many symptoms that may be signs of AD, but the most common include difficulty remembering information, memory loss, confusion, disorientation, mood and behavior changes, losing pleasure in activities, difficulty speaking or swallowing, and muscular difficulties. Since the only way to truly tell if a person has AD is to observe abnormalities in their brain tissue, AD can only be fully diagnosed after death when the brain can be examined in an autopsy. The changes in the brain often begin to occur about a decade before symptoms begin to show. To diagnose Alzheimer’s, doctors will look at health and family records, conduct tests of memory, language, and problem solving, carry out medical tests, and perform brain scans to rule out other causes of symptoms. Since there is no current cure for AD, survival after diagnosis can range from four to twenty years. Current treatments focus on managing the symptoms, which can overall help to slow the progression of the disease. This can include various medications to treat symptoms by managing neurotransmitter release, managing behavior such as agitation or anxiety, and various types of therapies.

Type II Diabetes:

Type II Diabetes is the most common form of diabetes and occurs when the body does not use insulin properly, which is insulin resistance. This can also occur when the body does not produce enough insulin. Insulin comes from the pancreas and is circulated into the bloodstream to allow glucose to enter the cells. Insulin also lowers sugar levels in the bloodstream. In Type II diabetes, the pancreas cannot keep up with the deficient insulin productions and blood glucose levels start to fluctuate. The glucose starts to build up in the blood and causes cells to lose energy and affect your kidneys, nerves, and heart. Some people can control their Type II diabetes, but typically the disease worsens over time. There are many risk factors of Type II diabetes, including weight, inactivity, family history, age, and others. Some symptoms of Type II diabetes include increased thirst and frequent urination, increased hunger, weight loss, fatigue, blurred vision, frequent infections, or areas of darkened skin. Symptoms vary person to person, but any of these symptoms can be a sign to see a doctor. To be diagnosed, doctors will run a blood test to measure your blood glucose levels. There is no cure for this disease, however Type II Diabetes is typically treated with lifestyle changes, oral medications, and insulin injections.

The Connection Between Diabetes and Alzheimer’s:

Insulin Signaling:

Insulin resistance is a characteristic of Type II diabetes and has been proven to be a common mechanism connecting diabetes and AD. This can be caused by oligomers of the ABOs, which causes insulin insensitivity and the removals of insulin receptors. The insulin signaling pathway is impaired in AD brains and as neurons become degraded, there is less insulin in the brain, causing impaired cognitive function. Insulin receptors are distributed in the brain and when insulin reaches the brain, it is synthesized by pancreatic beta-cells. Insulin is supposedly neuroprotective and helps with neuronal survival, however in Alzheimer’s, as neurons are being destroyed, there is not enough insulin to protect the neurons from the plaques and tangles. By boosting insulin signaling with drugs or therapies, this neurodegeneration can be slowed and neurons and pathways can be protected. Both diseases cause insulin resistance.

Inflammation:

In Type II diabetes, insulin resistance often exhibits itself as inflammation, mediated by macrophages. AD also presents with an inflammatory state, mediated by microglia. Activation and secretion of cytokines occur by microglia and cause an inflammatory reaction in AD. By sustained inflammation acting as a trigger, insulin resistance in AD occurs and leads to insulin resistance in diabetes.

Gangliosides:

A ganglioside is a group of lipids present in the gray matter of the brain. In diabetes, ganglioside GM3 is the mediator of insulin resistance. Without GM3, there is enhanced insulin sensitivity. Ganglioside GM1 is involved in the development of insulin receptors. Gangliosides are also known to have a role in the pathogenesis of AD, showing that gangliosides are a factor of causing insulin resistance in both diabetes and AD. The dysregulation of gangliosides causes insulin issues in both diseases. Diabetes causes an increase in the development of plaques and amyloid deposition, both characteristics of AD.

These are just three of the many different ways Alzheimer’s disease is connected to Type II diabetes. By finding the connections between the two diseases, there may be more opportunities for treatments, therapies, and hopefully someday a cure. The impact of both diseases on a individual and an individual’s family can have great impacts on not only their personal life, but also the lives surrounding them. To increase a person’s quality of life, it is important that scientists continue the search for connections of both diseases to the factors that are impacting them.

https://www.alz.org/alzheimers-dementia/what-is-alzheimers

https://www.nia.nih.gov/health/alzheimers-disease-fact-sheet

http://www.diabetes.org/diabetes-basics/type-2/facts-about-type-2.html

https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/symptoms-causes/syc-20351193

https://www.webmd.com/diabetes/type-2-diabetes#2

Everyone experiences stress in their life, whether that being from school, work, or daily life. Imagine never getting to escape those stresses. That’s exactly what individuals who suffer from anxiety and PTSD experience on a daily basis. Strong psychologically stressful events are known to have a long-lasting effect on the behavior of an individual. The consolidation of these stressful events can lead to changes in gene expression and hippocampal function causing stress-related mental disorders such as major depressive disorder, anxiety disorder, and PTSD. Though the understanding of this process is still largely unknown, scientists are making advances in their research quite rapidly giving us a much better idea of the causes behind these illnesses.

What is Anxiety:
Anxiety disorders are a group of mental illness that includes panic disorder, social anxiety disorder, specific phobias, and generalized anxiety disorder. Symptoms include panic, fear, sleeping problems, inability to stay calm or still, shortness of breath, dizziness, tense muscles, and a variety of other symptoms.

What is PTSD:
PTSD is a disorder that develops in some individuals who have experienced a shocking, scary, traumatic or dangerous event. Of course, everyone experiences fear and shock in a traumatic event due to the “fight or flight” response, yet those who never recover from the initial symptoms may be diagnosed with PTSD. These individuals can feel frightened or in danger in normal, everyday situations. To be diagnosed with PTSD, symptoms must last more than a month and be severe enough to interfere with relationships or work to be considered PTSD. The patient must also have at least one re-experiencing symptom, at least one avoidance symptom, at least two arousal and reactivity symptoms, and at least two cognition and mood symptoms.

Memory:
Making memories is vital to our life functioning, obviously. But is there such thing as too much memory? Memories allow us to interact spatially, socially, and with our environment. They are crucial in our ability to adapt as they prepare us cognitively, emotionally, and physiologically for similar situations we may see in the future. However, the memories we make during more traumatic events in our life are much stronger as they have a larger impact on us as individuals. When these memories become too strong in certain individuals, they can develop symptoms associated with anxiety and PTSD. Why these memories become so strong are unknown, but certain social factors can predispose individuals toward the development of PTSD as their adaptation and coping mechanisms can fail. It is estimated that 10-20% of the population will develop a stress-related disorder after experiencing a traumatic event, but why is still largely unknown.

When they body is exposed to a traumatic event, it releases glucocorticoids which bind to receptors. This binding triggers a cascade of events which then activates a protein called EKR. EKR then works to activate ELK-1 and eventually a molecule that modifies histones.

Histones wrap DNA around themselves for consolidation within the cell, controlling which segments of DNA are exposed to be transcribed. When these histones are modified, areas that are not normally able to be expressed can become exposed.

Treatment:

Medication:
Medications used to treat PTSD are almost always used in conjunction with psychotherapy as they can treat symptoms commonly associated with the disorder but cannot relieve a person in terms of flashbacks or feelings associated with the original trauma. These medications only treat symptoms as they mechanism for this strong memory consolidation is sill largely unknown

• The most commonly prescribed class of medication for PTSD (and approved by the FDA) are the serotonin reuptake inhibitor (SSRI) antidepressants. These include drugs such as fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil). This group of medication tend to decrease anxiety, depression, and panic associated with PTSD. These may also help reduce aggression, impulsivity, and suicidal thoughts. These medications usually take 6-8 weeks to work, and many people need to try several types of these antidepressant before they find one that works for them. Relapse of PTSD is less likely when on the medication for longer than one year. These types of medications are especially useful in individuals who have issues with substance abuse or suffer from depression.
• The most common alternative to antidepressants for PTSD are atypical antipsychotics. Atypical antipsychotics include medications such as risperidone (Risperdal), olanzapine (Zyprexa), and quetiapine (Seroquel). Antipsychotic medicines seem to be most useful in the treatment of PTSD in those who suffer from agitation, dissociation, hypervigilance, intense suspiciousness (paranoia), or brief breaks in being in touch with reality (brief psychotic reactions).
• Other medications include mood stabilizers and benzodiazepines ( commonly referred to as minor tranquilizers, sleeping tablets, or anti-anxiety medications)

Psychotherapy:
Trauma-focused psychotherapy, otherwise known as “talk therapy”, is the most effective type of talk therapy for PTSD. There are three most common types of treatments and these have the most research support. In each of these therapies, the patient usually talks with the therapies once a week for 60-90 minutes and last 3-6 months. The therapist teaches the patient specific skills to manage their PTSD symptoms.
• Cognitive Processing Therapy (CPT) Teaches you to reframe negative thoughts about the trauma. It involves talking with your provider about your negative thoughts and doing short writing assignments.
• Prolonged Exposure (PE) Teaches you how to gain control by facing your negative feelings. It involves talking about your trauma with a provider and doing some of the things you have avoided since the trauma.
• Eye-Movement Desensitization and Reprocessing (EMDR) Helps you process and make sense of your trauma. It involves calling the trauma to mind while paying attention to a back-and-forth movement or sound (like a finger waving side to side, a light, or a tone).

Bibliography:

https://psychcentral.com/disorders/ptsd/posttraumatic-stress-disorder-ptsd-treatment/

https://www.ptsd.va.gov/understand_tx/tx_basics.asp

https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml

https://www.webmd.com/anxiety-panic/guide/anxiety-disorders#1