If you’re dealing with post-traumatic stress disorder (PTSD), you’ve already done something brave by looking for help. PTSD can make ordinary days feel heavy—sleep gets weird, attention drifts, nerves are on edge, and memories barge in uninvited. The good news: PTSD is treatable, and there are multiple evidence-based paths to feeling better. This guide breaks down what works, what Lighthouse Psychiatry in Arizona offers, and how a step-by-step plan can move you from “white-knuckling it” to real relief.
What is PTSD?
PTSD is a stress-response system that’s stuck on “protect.” After trauma—combat, accidents, assault, natural disaster, medical emergencies, cumulative childhood adversity—your brain keeps scanning for danger even when you’re safe. That shows up as intrusive memories, nightmares, flashbacks, avoidance, hyper-vigilance, irritability, trouble concentrating, and feeling detached or on guard.
Healing usually involves:
- Processing the memory safely (so the past feels like the past)
- Updating unhelpful beliefs (e.g., “I’m not safe anywhere” → “I can reduce risk and cope”)
- Calming the over-firing alarm system (sleep, nervous system regulation)
- Re-engaging with life—relationships, work, school, joy
What actually works for PTSD (the short list)
Across large, independent reviews, trauma-focused talk therapies are the first-line treatments for adults with PTSD. In a nutshell, the best-supported psychotherapies are:
- Cognitive Processing Therapy (CPT) – updates trauma-related beliefs (guilt, blame, danger, trust).
- Prolonged Exposure (PE) – helps you gradually face memories/situations you’ve been avoiding, so they lose their power.
- Eye Movement Desensitization and Reprocessing (EMDR) – reprocesses memories while you do sets of guided bilateral stimulation (e.g., eye movements), helping the brain store the memory in a less distressing way.
Authoritative clinical guidelines recommend these individual, trauma-focused psychotherapies over medications for primary PTSD treatment because they generally create larger, more durable gains.
Where medications fit
Medications can help, especially when psychotherapy isn’t available yet, you prefer meds, or symptoms (like depression or anxiety) are blocking therapy work. The strongest medication evidence for PTSD symptoms is for:
- Sertraline (SSRI)
- Paroxetine (SSRI)
- Venlafaxine (SNRI)
These have the most consistent data for reducing overall PTSD symptoms. A practical add-on many people ask about, prazosin, can help with PTSD-related nightmares (but not overall PTSD symptoms). On the flip side, benzodiazepines (like alprazolam, clonazepam) are not recommended for PTSD—they don’t help and can make outcomes worse.
Interventional & device-based options (and how they relate to PTSD)
Transcranial Magnetic Stimulation (TMS)
TMS uses focused magnetic pulses to modulate brain circuits involved in mood and anxiety. In the U.S., TMS has FDA clearance for depression and for OCD; clinics may also use it off-label for other conditions, including PTSD, based on clinical judgment and individual response. Practically, that means insurance coverage is typically tied to depression indications.
At Lighthouse Psychiatry, you’ll see two flavors:
- NeuroStar TMS (for MDD; also used clinically alongside care for anxiety/OCD)
- EEG-guided TMS (MeRT), which customizes stimulation based on your brain’s electrical patterns. As of now, standard TMS is FDA-cleared for depression (and OCD with specific systems), while use for PTSD is an off-label, shared-decision scenario you’d discuss with your clinician.
Esketamine (SPRAVATO®) & Ketamine
- Esketamine (Spravato) is an FDA-approved nasal spray for treatment-resistant depression (TRD) and for MDD with acute suicidal ideation or behavior—not PTSD specifically. It’s administered in-clinic with monitoring and is often covered by insurance when criteria are met.
- IV ketamine infusions are used off-label in psychiatry (including for depression and sometimes for PTSD symptoms). Current major guidelines recommend against ketamine as a PTSD treatment due to limited and mixed evidence; however, some individuals with comorbid depression may still benefit symptomatically under specialist care. Coverage is uncommon.
What about MDMA-assisted therapy? As of August 2024, the FDA declined to approve the first MDMA-assisted therapy application for PTSD, citing trial-quality concerns and asking for more research. It’s not available as an approved treatment in routine care.
Photobiomodulation (tPBM)
Lighthouse also offers transcranial photobiomodulation, a non-invasive light-based approach being explored for brain health. It’s an emerging modality—promising mechanisms are being studied, but it’s not a guideline-endorsed first-line PTSD treatment. Think of it as a potential adjunct you’d consider after an evidence-based core plan is in motion.
How Lighthouse Psychiatry personalizes PTSD care
Lighthouse Psychiatry blends evidence-based psychotherapies, medication management, and advanced interventional options under one roof, with in-person and virtual care across Gilbert and Scottsdale. What that looks like for PTSD:
- Trauma-focused counseling
- EMDR – structured 8-phase model for reprocessing trauma memories.
- ART (Accelerated Resolution Therapy) – uses image rescripting techniques to help the emotional charge drop quickly.
- CMI (Critical Memory Integration) – an experiential, memory-reconsolidation approach.
- Trauma-focused CBT, mindfulness/ACT, DBT skills, individual, couples/family, and group therapy options.
- Ketamine-Assisted Psychotherapy (KAP) is available as an adjunct in specific treatment plans.
- Psychiatric medication management
- Care follows robust guidelines for PTSD and co-occurring conditions (depression, anxiety, sleep issues), with shared decision-making around SSRIs/SNRI, prazosin for nightmares, and avoidance of meds that don’t help PTSD. Genetic testing can support complex cases.
- Interventional treatments
- NeuroStar TMS and EEG-guided TMS (MeRT) (FDA-cleared for depression and OCD; off-label discussion for PTSD).
- Spravato (esketamine) for treatment-resistant depression or MDD with acute suicidal ideation/behavior (helpful when PTSD and MDD overlap).
- IV ketamine (off-label; typically self-pay).
- Photobiomodulation (tPBM) for brain-health optimization alongside therapy/meds.
A practical, 90-day roadmap (what many patients experience)
Everyone’s plan is unique, but a lot of successful PTSD care follows a cadence like this:
Weeks 1–2: Assessment & stabilization
- Full intake, safety planning, sleep/energy baseline, and goal setting.
- Start prazosin for nightmares (if appropriate) and/or begin SSRI/SNRI, or hold meds if starting trauma-focused therapy immediately and symptoms are manageable.
- Psychoeducation: How PTSD works, what each therapy does, what to expect.
Weeks 3–8: Core therapy begins
- CPT, PE, or EMDR—weekly sessions, with simple between-session practices.
- If depression is also significant, consider parallel steps: measurement-based medication adjustment, or interventional options like TMS (for depression indication) to speed functional gains so therapy “sticks.”
Weeks 9–12: Consolidation & relapse-prevention
- Taper therapy frequency as symptoms drop.
- Build a personalized “maintenance plan”: sleep routine, grounding scripts, trigger map, early-warning signs, booster session schedule.
Beyond 12 weeks
- Many people keep short booster check-ins (monthly or quarterly).
- If residual depression persists, discuss adding (or continuing) TMS/Spravato for the depression component; if trauma symptoms linger, your therapist may pivot among CPT/PE/EMDR or add ART/CMI elements.
Your between-session coping toolkit
Therapy does the heavy lifting, but daily micro-habits speed recovery:
- Grounding (5-4-3-2-1 sensory reset) and paced breathing (inhale 4, exhale 6) to dial down hyperarousal.
- Sleep scaffolding: fixed wake time, light exposure within an hour of waking, caffeine curfew, bedroom cool/dark/quiet.
- Body inventory: quick scans to notice jaw/shoulder tension; unclench + lengthen exhale.
- Trigger map: list “red-flag” contexts and “green-light” supports; plan a graded re-entry with your therapist (PE-style).
- Connection: pick one safe person/activity each day—even a 10-minute walk call.
- Compassionate self-talk: swap “What’s wrong with me?” for “My nervous system is trying to protect me—and I can retrain it.”
Common questions (straight answers)
Will I have to relive the worst moment of my life?
Not endlessly. PE and EMDR revisit memories in a structured, titrated way with your therapist tracking distress and stopping when you’ve hit your limit. The goal is to transform the memory from a live wire to a historical file—so it loses its charge.
How long does treatment take?
A standard course is roughly 8–12+ sessions for CPT/PE/EMDR, often weekly. Many feel meaningfully better by week 4–6; some need longer, especially with complex trauma.
Are meds required?
No. Psychotherapies are first-line. Medications can help with global symptoms, depression, sleep, and anxiety—especially while therapy ramps up. SSRIs/SNRI have the best evidence; prazosin can target nightmares. Benzodiazepines are discouraged.
Is TMS approved for PTSD?
Not specifically. TMS is FDA-cleared for major depressive disorder and OCD; use for PTSD is off-label and considered case-by-case. Insurance coverage generally tracks the approved indications.
Is MDMA-assisted therapy available?
No—not approved as of 2024. The FDA requested more data before considering it.
Spravato is approved for treatment-resistant depression and MDD with suicidal ideation/behavior. IV ketamine is off-label; major PTSD guidelines recommend against ketamine for PTSD itself, though it may help comorbid depression for some. You and your clinician would weigh benefits, risks, and coverage.
Why Lighthouse Psychiatry can be a smart home base
PTSD care works best when you don’t have to ping-pong across town for every piece of your plan. At Lighthouse Psychiatry, you can combine trauma-focused therapy, medication management, TMS/MeRT, Spravato, ketamine, photobiomodulation, KAP, and group/family support under one roof—and adjust as your symptoms change. That flexibility matters when recovery is non-linear.
How to get started (low-friction version)
- Book an intake – Share your story, goals, and non-negotiables (e.g., “nightmares first,” “I prefer therapy over meds”).
- Pick your first-line therapy – CPT, PE, or EMDR (your clinician will explain pros/cons based on your symptoms and preferences).
- Decide on supports – Sleep plan, prazosin for nightmares (if indicated), SSRI/SNRI if symptoms are severe or therapy access is delayed.
- Layer tools as needed – For co-occurring depression: consider TMS (depression indication), Spravato (eligible depression indications), or ketamine (off-label) after a risk-benefit chat.
- Measure and tweak – Short questionnaires, sleep logs, and session-by-session check-ins keep the plan honest and effective.
Services at Lighthouse Psychiatry (Arizona)
Here’s a concise list of Lighthouse Psychiatry offerings you can discuss with the team:
- Trauma-Focused Counseling
- EMDR (Eye Movement Desensitization & Reprocessing)
- ART (Accelerated Resolution Therapy)
- CMI (Critical Memory Integration)
- Trauma-Focused CBT, Mindfulness/ACT, DBT skills
- Individual, Couples/Marriage, Family, and Group Therapy (in-person & virtual)
- Advanced Psychiatry & Interventional Care
- Psychiatric Medication Management (for PTSD and co-occurring conditions)
- EEG-Guided TMS (MeRT)
- SPRAVATO® (esketamine) nasal spray for treatment-resistant depression & MDD with suicidal ideation/behavior
- IV Ketamine (off-label; typically not covered by insurance)
- Photobiomodulation (tPBM) brain-health therapy
- Genetic (Pharmacogenetic) Testing
- ADHD Care & Cognitive Testing (Creyos)
- On-site pharmacy; insurance accepted
If PTSD is crowding out your life, you don’t have to manage it solo. With an evidence-first plan and a flexible toolkit, relief is realistic—often in weeks, not years. When you’re ready, Lighthouse Psychiatry can help you map the path that fits your symptoms, your preferences, and your life.
