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The Golden Hours

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Melissa Arendt

Shaili Jain, M.D., a top expert on trauma, writes about cutting edge medical interventions that hold the promise of preventing PTSD.

Primary prevention of trauma is not always possible, and PTSD researchers have ventured into the realm of secondary prevention as a result. Secondary prevention intervenes in the window of time after trauma exposure but before the onset of PTSD, an opportunity to strike before it’s too late. This window of time has come to be referred to as the golden hours, a time during which medical intervention could set a pathway toward recovery.  The PTSD literature is flush with enticing leads about the way medications and psychological therapies can be harnessed to prevent the onset of PTSD in those who have survived trauma. Dr. Gustav Schelling, a German physician caring for very sick patients in an intensive care unit (ICU), was used to reports of patients developing PTSD related to their near-death experiences. He observed that patients who were given hydrocortisone as part of the care for their critical illness experienced fewer signs and symptoms of PTSD after they recovered.  Cortisol is known to impair the retrieval of long-term memory, and scientists have hypothesized that hydrocortisone, del …

Adapted excerpt from The Unspeakable Mind: Stories of Trauma and Healing from the Frontlines of PTSD Science by Shaili Jain, M.D. © 2019. Printed with permission from HarperCollins publisher

Shaili Jain, M.D. serves as a PTSD specialist at one of America’s top VA hospitals and is a trauma scientist at the National Center for PTSD. She is a professor at Stanford University.

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