People have always used drugs to deal with traumatic stressed. Each culture and each generation has its preferences—gin, vodka, beer, or whiskey; hashish, marijuana, cannabis, or ganja; cocaine; molly, lean; opioids like oxycontin; tranquilizers such as Valium Xanax, and Klonopin. When people are desperate, they will do just about anything to feel calmer and in more control. However, drinking and drugs are not the answer. Mainstream psychiatry follows this tradition. Over the past decade, the Department of Defense and Veterans Affairs combined have spent over $4.5 billion on antidepressants, antipsychotics, and antianxiety drugs. A June 2010 internal report from the Defense Department’s Pharamaceconomic Center at Fort Sam Houston in San Antonio, Texas USA showed the 213,972, or 20 percent of the 1.1 million active-duty troops surveyed, were taking some form of psychotropic drug: antidepressants, antipsychotics, sedative hypnotics, or other controlled substances. 

However, drugs cannot “cure trauma; they can only dampen the expressions of a disturbed physiology. And they do not teach the lasting lessons of self-regulation. They can help to control feelings and behavior, but always at a price—because they work by blocking the chemical systems that regulate engagement, motivation, pain, and pleasure. Some of my colleagues remain optimistic: I keep attending meetings where serious scientists discuss their quest for the elusive magic bullet that will miraculously reset the fear circuits of the brain (as if traumatic stress involved only one simple brain circuit). I also regularly prescribe medication. Just about every group of psychotropic agents has been used to treat some aspect of posttraumatic stress disorder (PTSD). The serotonin reuptake inhibitors (SSRIs) such as Prozac, Zoloft, Effexor, and Paxil have been most thoroughly studied, and they can make feelings less intense and life more manageable.  

Patients on SSIRs often feel calmer and more in control; feeling less overwhelmed often makes it easier to engage in therapy. Other patients feel blunted by SSRIs—they feel they are losing their edge. I approach it as an empirical question: Let us see what works, and only the patient can be the judge of that. On the other hand, if one SSRI does not work, it is worth trying another, because they all have slightly different effects. It is interesting that the SSRIs are widely used to treat depression, but in a study in which we compared Prozac with eye movement desensitization and reprocessing (EMDR) for patients with posttraumatic stress disorder (PTSD), many of whom were also depressed, EMDR proved to be a more effective antidepressant than Prozac. Keep in mind, however, that selfishness and preoccupation with deficiencies keep some from growing beyond their existing internal achievements to become greater people.  

Medicines that target the autonomic nervous system, like propranolol or clonidine, can help to decrease hyperarousal and reactivity to stress. This family of drugs works by blocking the physical effects of adrenaline, the fuel or arousal, and thus reduces nightmares, insomnia, and reactivity to trauma triggers. Blocking adrenaline can help to keep the rational brain online and makes choices possible: Is this really what I want to do? Since I have started to integrate mindfulness and yoga into my practice, I used these medications less often, except occasionally to help patient sleep more restfully. Self-actualizers have an unbiased view of reality, acceptance of themselves and others, simplicity, social interest, self-reliance for their own requirements, focus on problems outside of themselves, profound personal relations, creativity, and great tolerance. When they try to inspire others, they do so for the sake of those others, not for their own aggrandizement.  

Traumatized patients tend to like tranquilizing drugs, benzodiazepines like Klonopin, Valium, Xanax, and Ativan. In many ways, they work like alcohol, in that they make people feel calm and keep them from worrying. (Casino owners love customers on benzodiazepines; they do not get upset when they lose and keep gambling. Many journalists are also on these drugs because the traumatic nature of the job.) However, also like alcohol, benzos weaken inhibitions against saying hurtful things to people we love. Most civilian doctors are reluctant to prescribe these drugs, because they have a high addiction potential and they may also interfere with trauma processing. Patients who stop taking them after prolonged use usually have withdrawal reactions that make them agitated and increase posttraumatic symptoms. Some of my patients have told me they know a guy who is kind of like a benzo, he makes them feel comfortable, but they have withdrawal from not seeing him. 

I sometimes give my patients low doses of benzodiazepines to use as required, but not enough to take on the daily basis. They have to choose when to use up their precious supply, and I ask them to keep a diary of what was going on when they decided to take a pill. That gives us a chance to discuss the specific incidents that trigger them. Openness involves an appreciation of things others might consider impractical and a readiness for new and unusual experiences. The traits that make up this factor tend to be more esoteric than those in the other factors, less based on overt behavior (observable actions) and more on covert behavior (the things we do that others cannot directly observe—thoughts, feelings, attitudes, beliefs). The highly open individual has a greater appreciation for subjective or abstract reality.