Post-Traumatic Stress Disorder (PTSD)

Q I've struggled with PTSD for over three years—can Korean medicine treatment still help now? I wonder if it's too late.

A. It's not too late. Recovery is possible even in chronic PTSD when appropriate treatment begins, and Korean medicine treatment helps create a bodily state—by calming hyperarousal and insomnia—in which you can focus better on psychotherapy.

Q I've been diagnosed with PTSD but I also have depression and panic symptoms. Can all of these be treated at once?

A. It is very common for PTSD to be accompanied by depression and anxiety disorders. In Korean medicine treatment, we address all three at once with formulas that treat the disharmony of heart and kidney and heart-and-gallbladder deficiency together, stabilizing whichever symptom is most severe first.

Q Since my PTSD started, I've developed unexplained headaches and pain all over my body. Can a psychological problem show up as physical symptoms?

A. Yes. The chronic stress response of PTSD appears as somatic symptoms, commonly including tension headaches, musculoskeletal pain, and digestive problems. Psychogenic pain is still real pain, so receiving psychotherapy and Korean medicine treatment together is effective.

Q Is there a way to come back to reality when a flashback hits? In that moment it feels like nothing works.

A. Grounding techniques can help. Naming five things you can see and four things you can hear in turn, or focusing on the sensation of your feet touching the floor, brings your awareness back to the present time and place.

Q I don't want to lie down because I'm afraid to fall asleep. I feel like a nightmare will start the moment I drift off. Is there a way to improve my sleep?

A. Creating a safe environment and establishing a regular bedtime routine before sleep are important. Cognitive Behavioral Therapy (CBT-I) methods such as sleep restriction therapy and stimulus control techniques are effective, and utilizing relaxation breathing and acupressure on the Baihui and Neiguan points before bed can also be helpful.

Q I keep having thoughts that I want to die. I'm not sure if it's because of PTSD, but it's just too hard.

A. Please contact the Mental Health Crisis Counseling line at 1577-0199 (24 hours) right now, or visit a nearby emergency room. Suicidal thoughts are a serious complication of PTSD and require immediate professional intervention.

Q Is it safe to take Gyeobitang or Ondamtang for a long period? I am being extra cautious because I am already taking psychiatric medication.

A. Gyeobitang and Ondamtang are highly safe prescriptions with a long history of clinical use. When used in conjunction with psychiatric medication, we maintain a dosage interval and monitor the treatment with regular blood tests.

Q I am currently taking SSRIs prescribed by a psychiatrist. Is it okay to take herbal medicine at the same time? Won't it cause serotonin issues?

A. It is possible to take herbal medicine concurrently with SSRIs, but certain ingredients that can affect serotonin levels should be avoided. If you provide the detailed names and dosages of the medications you are currently taking, we can formulate a prescription using ingredients that do not pose a risk of interaction.

Q Can PTSD be cured completely? It's been years and I'm still struggling. How long do I have to be in treatment?

A. With early, appropriate treatment, a substantial proportion of people improve. Even chronic PTSD that has lasted for years can recover when combined with evidence-based psychotherapy such as prolonged exposure therapy or EMDR, and Korean medicine treatment plays a role in boosting outcomes by calming the autonomic nervous system and improving sleep.

Q Every night I have nightmares and flashbacks come during the day too—will these ever lessen? I don't know how to tell whether I'm getting better.

A. A decrease in the frequency of nightmares and a weakening in the intensity of flashbacks are the first signs of recovery. In many cases sleep quality improves first, followed by a reduction in re-experiencing responses and the recovery of daily functioning.

Q Why does Post-Traumatic Stress Disorder (PTSD) develop? The accident is over, but my body still reacts as if it's happening right now.

A. An extreme traumatic event disrupts the brain's memory processing circuits, leaving the threat response continuously activated even after the event has ended. The amygdala becomes overactivated while the prefrontal cortex loses its regulatory function, causing the same fear and arousal responses to occur even with minor stimuli.

Q Besides traffic accidents, what kinds of experiences can trigger PTSD? I wasn't directly hurt—I only witnessed the accident—so is it normal to be struggling this much?

A. Yes, you don't have to be directly harmed. Witnessing a life-threatening event, learning of the sudden death or serious injury of someone close to you, or being repeatedly exposed to trauma through rescue or emergency work all meet the formal diagnostic criteria for PTSD.

Q Suddenly, the events of that time come back vividly to mind, or even just hearing a similar sound makes my heart sink. How can I reduce these triggers?

A. A trigger is when sensory information (sounds, smells, scenes, weather, etc.) associated with an event activates the amygdala to trigger a re-experience response. Combining psychotherapy that identifies triggers and exposes the patient to them in stages with traditional Korean medicine treatments that lower autonomic hyperarousal can help reduce the intensity of the response.

Q When I drink coffee my heart seems to race and my anxiety gets worse. Are there foods that are good or that I should avoid with PTSD?

A. Caffeine and alcohol stimulate the autonomic nervous system and worsen hyperarousal, so cutting back is recommended. Foods rich in tryptophan (nuts, tofu, eggs), omega-3 fatty acids, and magnesium help calm the nervous system.

Q I'm looking for a Korean medicine clinic for PTSD in the Dongincheon area of Dong-gu, Incheon. Can I see a Korean medicine clinic while also attending psychiatry?

A. Attending both is possible, and combining them is in fact recommended. At your first visit, we take a history of the circumstances of the trauma, your current symptoms, and your medications, then perform pattern differentiation and build a treatment plan that prioritizes calming the autonomic nervous system and improving sleep.

Q Specifically, what is the sequence of steps involved in treating PTSD with Korean traditional medicine?

A. The process begins by stabilizing autonomic nervous system hyperarousal and sleep problems (Stage 1). This is followed by nourishing the heart energy and improving blood circulation to enhance psychological resilience (Stage 2). Finally, the treatment proceeds to a maintenance stage (Stage 3) to prevent recurrence and aid in returning to daily life.

Q What should I prepare before my first appointment? It's my first time visiting a Korean medicine clinic for PTSD and I feel lost.

A. If you note down the timing and type of the traumatic event, which symptom is hardest right now (whether nightmares, flashbacks, avoidance, or hyperarousal is the most severe), and the name and dose of any psychiatric medication you are taking, your first visit will go quickly and accurately.

Q Do herbal medicine or acupuncture actually work for PTSD? Trauma is a problem of the mind, so I'm not sure how Korean medicine could change anything.

A. Problems of the mind also show up as physiological responses in the brain and autonomic nervous system. Acupuncture (HT7 Shenmen, PC6 Neiguan, GV20 Baihui) and herbal formulas in the Guibi-tang and Ondam-tang families have been clinically reported to have meaningful effects in calming an over-aroused autonomic nervous system and supporting sleep and psychological stability.