PTSD Treatment That Follows the Evidence
Post-traumatic stress disorder is the mind’s alarm system stuck in the on position after trauma. The event ends. The nervous system does not get the message.
PTSD affects survivors of car accidents, assault, sexual violence, disasters, medical emergencies, sudden loss, and combat. Whatever the source, the pattern is recognizable across 4 clusters: re-experiencing (intrusive memories, nightmares, flashbacks), avoidance of reminders, negative shifts in mood and beliefs, and hyperarousal (hypervigilance, exaggerated startle, irritability, broken sleep), persisting for more than a month after the event.
For veterans
Siggy is always free for veterans.
Every visit, every prescription decision, every follow-up, at no cost, with no VA referral required.
See how it works for veteransIn crisis: Veterans Crisis Line, call 988 then press 1, or text 838255. Available 24/7. Siggy is not an emergency service.
The Intrusion and the Withdrawal
Those 4 clusters tend to pull in 2 directions, and treatment addresses both.
It can look like
The intrusive, reactive side is the alarm firing: intrusive memories, nightmares, and flashbacks, along with hypervigilance, exaggerated startle, irritability, and broken sleep. In daily life it is scanning exits in every restaurant, or a smell or a song dropping you back into the worst moment of your life without warning.
The withdrawing, numbing side is the pulling away: avoidance of reminders and negative shifts in mood and belief. In daily life it is sleeping with the TV on because silence is worse, snapping at people over nothing and then avoiding them out of shame, and feeling permanently different from everyone around you.
Treatment
How PTSD Is Treated
The evidence hierarchy for PTSD is unusually well established, and candor about it matters.
The strongest evidence supports trauma-focused psychotherapy: cognitive processing therapy (CPT), prolonged exposure (PE), and EMDR are the first-line treatments in VA/DoD clinical practice guidelines. Medication is an evidence-based option as well, particularly when therapy is inaccessible, declined, or insufficient alone: sertraline and paroxetine are FDA-approved for PTSD, and other SSRIs and venlafaxine have supporting evidence. Prazosin is a non-controlled option some clinicians use off-label for trauma nightmares, with mixed trial results your prescriber will discuss candidly.
Equally important is what the guidelines recommend against: benzodiazepines are specifically not recommended for PTSD. They can interfere with trauma processing and add dependence risk to an already heavy load. Siggy does not prescribe them, which for this condition is not a gap in care. It is the guideline.
What the first weeks look like
With Siggy
How Siggy Treats PTSD
Siggy handles the medication-management side of PTSD care. That starts with a structured evaluation and a video appointment with your provider. From there, a licensed prescriber manages SSRI or SNRI treatment with daily check-ins and clinician follow-ups through the 8-to-12-week response window. Trauma-focused therapy is the first-line standard for PTSD, so medication is not the whole answer. Your prescriber will also connect you to CPT, PE, or EMDR resources. For veterans, that includes VA and Vet Center programs you may already be entitled to use.
Structured intake
Answer clinically structured questions with Siggy, on your own time. Free, private, and reviewed by a clinician.
Video visit in days
Meet a licensed prescriber via video — days from intake, not months. Diagnosis and plan, decided together.
Treatment, same day
If medication is right, it goes to your pharmacy the same day, with follow-ups scheduled inside the adjustment window.
FAQs.
- Can PTSD be treated online?
- The medication side, yes: evaluation, prescribing, and follow-up work well by video, and trauma-focused therapy is increasingly delivered by telehealth too. Your prescriber will help you assemble both pieces.
- I wasn’t in combat. Can I still have PTSD?
- Yes. Most PTSD follows civilian trauma: accidents, assault, disasters, medical events, loss. The diagnosis is about the pattern of symptoms, not the category of the event.
- Why won’t you prescribe Xanax for my symptoms?
- VA/DoD guidelines recommend against benzodiazepines for PTSD because they can impede recovery and create dependence. The medications with actual PTSD evidence, SSRIs and SNRIs, are all within our scope.
- How long until medication helps?
- SSRIs for PTSD typically take 8 to 12 weeks for full effect, with sleep and hyperarousal often improving first. Follow-ups are scheduled inside that window.