Most Commonly Asked Questions about Stellate Ganglion Block (SGB)

Most Commonly Asked Questions about Stellate Ganglion Block (SGB)
By stella
12th Dec 2022

If you’ve experienced symptoms of emotional trauma and mental health challenges, you’ve most likely researched the different types of treatments available for relief, like talk therapy and medication – two of the most common types of treatment. So naturally, we gravitate toward these treatments as they are currently the most well-known and covered by most insurance companies. 

We may be skeptical at first when we encounter new types of innovative treatments. While a whole network of innovative and minimally invasive procedures can offer relief sometimes in an instant, they aren’t the first line of defense for treatment recommendations.

Innovative treatments like the Stellate Ganglion Block (SGB) have been around for decades, even centuries, but many are just finding out about it now. 

Stella’s Stellate Ganglion Block (SGB), known as the Dual Sympathetic Reset, has made waves in mental health care and has challenged the traditional care path model as a safe and efficient way to relieve symptoms like depression, anxiety, and PTSD. It can help relieve years, and even decades, of debilitating symptoms. As this life-saving treatment gains awareness, education is a crucial step in addressing the questions and concerns of those looking for the right care. 

This article covers the 15 most commonly asked questions about the Stellate Ganglion Block (SGB):

Is SGB proven to work?

At Stella, we believe in the transparency of treatment outcomes. While no medical procedure is guaranteed to work for everyone, the Stellate Ganglion Block (SGB) by Stella has helped thousands of patients find lasting relief from their trauma-related symptoms. 

The PTSD Checklist (PCL) is a self-report survey used to measure PTSD symptoms. According to the National Center for PTSD Guidance, a 10-point decrease in PCL score is a clinically significant improvement. In a study of 327 Stella patients who received SGB between December 2016 and February 2020, on average, over 83% reported a 28.9-point decrease in their PCL score. These Stella patients experienced a result that’s almost three times better than that of other treatments. 

How long do the positive effects of SGB last?

Over 83% of Stella patients experience lasting relief from their trauma symptoms after one dual injection.

The duration of the Stellate Ganglion Block’s (SGB’s) positive effects varies from patient to patient, lasting months or years. 

While the longevity of SGB’s effectiveness is still being researched, in a 2014 study, 70% of participants were clinical successes at a follow-up administered between 3 and 6 months after treatment.

Will SGB erase my memory or impair my survival instinct?

The Stellate Ganglion Block (SGB) does not erase your memory, but after treatment, you may find that your memory is clearer. 

SGB does not compromise your survival instinct because it does not “turn off” your fight-or-flight response. When your fight-or-flight response is stuck in an overactive state, your body is constantly experiencing a high level of stress which can be due to an imaginary threat. For example, it can feel like you’re being chased by an imaginary bear, for example. SGB does not take your ability to run away from the bear. Instead, it removes the imaginary bear. Should a real bear appear, you will still instinctually run away from it. 

How is SGB by Stella different from SGB from other providers?

Widely considered the pioneer of the Stellate Ganglion Block (SGB) for PTSD, Dr. Eugene Lipov, Stella’s Chief Medical Officer, is a Board Certified anesthesiologist and pain management physician. More than fifteen years ago, he initialed his SGB protocol that has the ability to “reset” the fight-or-flight response, returning it to its pre-trauma state.

SGB was originally developed as a single injection. 

After researching and testing many ways of administering SGB for PTSD treatment, Dr. Lipov found that two injections – known as the “Dual Sympathetic Reset” – yield the best results. The injections are given back to back. 

Each Stella doctor is Board Certified and is personally trained by Dr. Lipov in Stella’s proprietary SGB methodology. We also require that our doctors use image guidance for correct needle placement. 

 SGB by Stella 

The “Dual Sympathetic Reset”

Traditional SGB
ProviderBoard Certified medical doctor Naturopathic practitioner, CRNA, Board Certified medical doctor
Trained by Dr. Eugene Lipov?YesNo
Side of NeckRight. Left for right-sided non-responders. Right
Injection Site(s)C6 and C4 (or C3)C6
Sedation Local and Twilight Sedation (optional)Varies
Accessibility40+ Treatment Centers nationwideSingle clinic
Financing PlansProvided to those who qualify Typically unavailable

Has SGB been clinically studied?

Yes, there are numerous clinical studies about Stellate Ganglion Block (SGB).

This study explores the effectiveness of single and dual injection SGB. While both methods are effective, the study proposes that dual injection SGB – the same approach Stella uses – may be more effective than a single injection SGB in the treatment of PTSD. 

Mulvaney S. W., Curtis K. E., Ibrahim T. S. (2020) Comparison C6 Stellate Ganglion versus C6 and C4 Cervical Sympathetic Chain Blocks for Treatment of Posttraumatic Stress Disorder (PTSD): Analysis of 147 Patients. J Neurol Disord Stroke 7(3): 1163.

This multisite, randomized clinical trial of SGB outcomes on PTSD symptoms, reports an improvement in the PTSD symptoms of active-duty service members after two SGB procedures. On average, the group treated with SGB experienced a 12.6-point decrease in their Clinician-Administered PTSD Scale (CAPS-5) score, and the control group experienced a 6.1-point decrease in their CAPS-5 score. 

Olmsted, K. L. R., Bartoszek, M., Mulvaney, S., McLean, B., Turabi, A., Young, R., … & Walters, B. B. (2020). Effect of stellate ganglion block treatment on posttraumatic stress disorder symptoms: a randomized clinical trial. JAMA psychiatry, 77(2), 130-138.

This review of recent and historical SGB literature finds evidence of substantial beneficial psychiatric effects that supports the use of SGB as a PTSD treatment that may provide positive results and reduce barriers to therapy, particularly among military populations.

Summers, M. R., & Nevin, R. L. (2017). Stellate ganglion block in the treatment of post‐traumatic stress disorder: A review of historical and recent literature. Pain Practice, 17(4), 546-553.

Co-authored by Dr. Eugene Lipov, Stella’s Chief Medical Officer, this study reviews the clinical evidence and neurobiology of SGB for PTSD treatment. 

Lipov, E., & Kelzenberg, B. (2012). Sympathetic system modulation to treat post-traumatic stress disorder (PTSD): a review of clinical evidence and neurobiology. Journal of affective disorders, 142(1-3), 1-5.

How does SGB work with other types of treatments (like talk therapy)?

The Stellate Ganglion Block (SGB) can work well in combination with other treatments. After SGB, many Stella patients feel a new sense of calm that can accelerate the positive impact of existing therapies (e.g., talk therapy, EMDR, CBT, DBT, etc.). For example, patients may find that they can recall their past and discuss it with their mental health provider without feeling as though they’re reliving it. 

If you already have a mental health provider, we suggest that you continue working with them after SGB to further your healing. If you do not have a mental health care provider, Stella may be able to refer you to one.

What’s included with Treatment by Stella?

Treatment by Stella is a commitment to your recovery, from first contact to the moment you feel like yourself again. The Stella Standard of Care was created to meet your needs before, during, and after treatment. This is the new model of trauma treatment. 

Getting To Know You:

The first step is to speak with a licensed Psychiatric Mental Health Nurse Practitioner (PMHNP). The PMHNP will conduct a bio-psycho-social assessment, including a review of your symptoms and health history. The PMHNP will create a custom treatment recommendation for you using this information.

Our PMHPs use validated measures to gauge your symptoms. These measures include the Post-traumatic Stress Disorder Checklist (PCL-5) for symptoms of PTSD/ emotional trauma, the Generalized Anxiety Disorder-7 (GAD-7) for anxiety, the Patient Health Questionnaire-9 (PHQ-9) for depression, and the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) for traumatic brain injury.

Curated Care:

Throughout the journey, you will work with a dedicated Patient Care Coordinator who will coordinate your care and help answer any questions along the way.

If receiving the Stellate Ganglion Block (SGB), the entire procedure takes less than 20 minutes, but please plan on being at the facility for one to two hours. The positive effects of SGB are often immediate.

If receiving ketamine, each treatment typically takes 45 minutes. Please plan on being at the facility for one to two hours. Most have relief from symptoms within hours of treatment.

Those on Care Plans will work with Stella’s PMHNPs over six months and receive an individualized treatment plan that combines biological and psychological interventions to provide the best outcomes possible.

Ongoing Support:

Following treatment, your PMHNP will call to review the procedure’s effectiveness and ask about any symptoms you may be experiencing. Each patient will also have a 30-minute follow-up to continue that review and discuss how to maximize the positive effects of treatment. PMHNPs are there to physically, mentally, and emotionally support a patient, as uniquely required, during this session.

Those on Care Plans will have additional follow-up sessions with Stella’s PMHNPs which include completing standard mental health assessments, determining whether additional treatment is warranted, and discussing trauma-informed, healing-related topics such as getting better sleep, approaching grief, or mindfulness techniques.

Stella is here for you

Fast and effective care for symptoms of emotional trauma and mental health challenges is at our front door, and we have already helped thousands of people in need. The more questions asked and the more information given can help lead innovative treatments like SGB and mental health companies like Stella into the lives of people in need. We’re dedicated to you and innovative treatments because the possibilities are endless. 

If you are interested in learning more, please contact our Care Advocate team directly by calling 1-412-455-8813.

what is sgb
post-traumatic stress disorder

Preventing, Understanding and Discussing Death by Suicide

Preventing, Understanding and Discussing Death by Suicide
By stella
06th Sep 2022

Over the pasts few decades, awareness of suicide prevention in the United States has expanded. Independent volunteer prevention programs like the American Foundation for Suicide Prevention, various counseling programs, and government programs on the local, state, and federal levels like the new 988 Suicide and Crisis Lifeline have all taken shape to help those in need. While these programs have saved countless lives, it is hard to know someone that hasn’t been affected by suicide whether it be family, friends or coworkers. A recent Stella employee survey revealed that just over 51 percent of it’s employees have lost a loved one to suicide. 

Though awareness surrounding suicide has become more prevalent, it is still a leading cause of death in the US. According to the Centers for Disease Control, “Suicide is a leading cause of death in the United States with 45,979 deaths in 2020.” Suicide rates saw an increase of 30 percent between the years 2000–2018. The rate decreased in the years 2019–2020 but still remains on the list of highest mortality rates in the country. 

Who is affected the most by suicide and suicide attempts?

While all different types of people are affected by suicide and suicide attempts, some groups are more at risk than others. According to the Substance Abuse and Mental Health Services Administration, or SAMHSA, the groups most affected by suicide are: 

Middle-Aged People and Older Men

Upwards of 80 percent of all suicides in the U.S. are among middle-aged men and women, 45-54. Men 85 and older have the highest suicide rate in the country due to possible isolation, a history of violence, and more. 

American Indians

Young American Indian men face a greater risk of suicide and suicidal ideations due to isolation, historical trauma, poverty caused by systemic issues, cultural stress, and more. American Indian men in the Northern Plains seem to face the greatest risk. 

Alaskan Natives

Alaska currently holds one of the highest suicide rates in all fifty states. Young Alaskan men are especially at risk due to substance abuse and isolation. 

Two other very important groups affected by higher percentages of suicide listed by SAMHSA are veterans and members of the LGBTQ+ communities. 


According to the 2021 National Veteran Suicide Prevention Annual Report, over 6,000 veterans took their own lives in 2019. That’s around 14 percent of the 45,000 plus people that committed suicide that year. “Veterans ages 55-74 were the largest population subgroup,” the VA reported. “They accounted for 38.6% of Veteran suicide deaths in 2019.” Many veterans suffer from post-traumatic stress injury that can further lead to debilitating mental health conditions. 


The LGBTQ plus community faces an insurmountable challenge with homophobia, hatred, and acceptance from outside parties. This can lead to suicidal ideations and suicide attempts for those receiving the hatred. The CDC says, “Gay, bisexual, and other men who have sex with men are at even greater risk for suicide attempts, especially before the age of 25.” LGBTQ plus youth have an even higher risk of suicidal ideations and attempts due to their unsafe environments. 

Suicide and trauma

Symptoms of trauma and post-traumatic stress injury can often run hand in hand with suicidal ideations or attempts. There is evidence that trauma, particularly brought on by sexual abuse in childhood and veterans that have seen combat, does “increase the risk of suicidal thoughts,” according to the U.S. Department of Veterans Affair. “In this research, combat trauma survivors who were wounded more than once or put in the hospital for a wound had the highest suicide risk.” Veterans can carry the weight of combat long after they’ve returned home from war. The guilt often leads to suicidal ideations. More studies continue to explain that those with PTSI, or PTSD, have higher suicide ideations or attempts – Partly, due to the lack of preventions or ability to express emotions in a safe environment. 

Treatment of suicidal ideations and attempts

Around five people die by suicide in one hour in the United States, that’s one person every 11 minutes, and the number of those that thought about suicide is even higher, 12.1 million people seriously considered taking their life, and just over three million planned an attempt, and 1.2 million attempted taking their life. The emotional and physical impact of suicide or suicide attempt is astronomical on their loved ones. It can lead to post-traumatic stress injury, depression, anxiety, and other mental health conditions. Suicide and suicide attempts can also make a large impact financially. “In 2019, suicide and nonfatal self-harm cost the nation nearly $490 billion in medical costs, work loss costs, the value of statistical life, and quality of life costs,” the CDC reported last year.  

There are various modalities used to combat suicidal ideations. And though, there is no one size fits all approach to solving suicidal ideations, some of the most popular avenues are cognative behavioral therapies that reduce the ideations through patients actively working on coping mechanisms, Antidepressants, antipsychotic medications, anti-anxiety medications that can help reduce symptoms, and support from loved ones. 

New innovations

Over the last couple of decades, new treatments like the stellate ganglion block (SGB) and ketamine have given hope to many with suicidal ideations. SGB is an injection of local anesthetic into the stellate ganglion that helps restore normal biological function. Some evidence has shown that it can efficiently reduce symptoms of trauma, like hypervigilance, trouble sleeping, and anxiety, that can lead to suicidal ideations. 

One person that received SGB treatment by Stella said, “None of the memories have disappeared but I no longer feel them or relive them every second of every day. I was at a point where I couldn’t stop feeling suicidal, it was absolute torture to even imagine having to live another day stuck in my own head. I no longer feel suicidal.”

According to a study byThe BMJ, ketamine has a rapid relief effect on those suffering from depression and severe suicidal ideations. More patients involved in the study reached a full remission of suicidal thoughts within three days time compared to those with a placebo. Like SGB, ketamine is not a cure, but a big step forward on the path to recovery. 

How is Stella handling suicide prevention?

Stella’s number one priority is to help those in need suffering from certain mental heatlh conditions – Conditions that can often lead to symptoms like suicidal ideations or even attempts. The tireless advocates, care coordinators, and medical professionals work daily to ensure opportunities for healing like the stellate ganglion block and ketamine treatments are available to those in need. 

Like a lot of mental health companies, Stella has actively opened up a conversation about mental health, combating the stigmas surrounding those suffering. The more open people are, the more resources become available to those that may not know where to search. The Stella blog has opened up a dialogue about the signs and symptoms of trauma, depression, anxiety, and more. The Story of Our Trauma podcast offers insight from those experiencing similar situations, like Ron Self, a veteran affected by a suicide attempt. And our testimonial page has shared personal stories of successful solutions to those combating symptoms. 

What else is being done to prevent suicide and suicide attempts?

More than 90 percent of people who survive an attempted suicide never go on to die by suicide, according to the CDC. But 90 percent is still far too many people. Recent large-scale programs from the federal government have been initiated, like the 988 Suicide and Crisis Lifeline, to help with suicidal ideations that can lead to suicide attempts. 

The 988 Lifeline

The 988 Suicide and Crisis Lifeline provides 24/7 suicide prevention counselors from over 160 centers in the United States. The Biden Administration increased federal funding from $24 million to $432 million to include resources for select groups of people like the ones mentioned in the previous section. It is available and open to anyone that is in emotional distress or facing suicidal ideations. 

American Foundation for Suicide Prevention

The American Foundation for Suicide Prevention is a volunteer organization that has been around since 1987 and has remained a valuable resource for those looking for help with suicidal ideations. The organization actively funds research and education surrounding suicide, advocates for policies at a federal level, and supports those that have been impacted by the suicide of a loved one. 

Suicide remains a leading cause of death in this country, but with awareness and active dialogue, we can lower the number of those with ideations, plans and those that take their own life. The resources are available, and if you or a loved one is suffering from suicidal ideations, please connect with the 988 Lifeline.


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Addressing the mental health needs of Black, Indigenous, and People of Color

Addressing the mental health needs of Black, Indigenous, and People of Color
By stella
28th Jul 2022

Each July, National Minority Mental Health Awareness Month brings awareness to the unique struggles that racial and ethnic minority groups face regarding mental illness in the US. Unfortunately, members of the BIPOC (Black, Indigenous, and People of Color) communities and other minority groups often face disproportionate inequities in care, support, or mental health services in this country.

As a result, they are significantly more likely to develop mental health conditions. One of the significant barriers to mental health treatment is access and the need for understanding mental health support.

Traumas can impact communities as a collective and the individuals themselves and a major barrier to treatment around mental health is the lack of access and understanding of mental health support. 

This BIPOC Mental Health Awareness Month, we sat down with three mental health care advocates to discuss the struggles of their communities, the stigmas they still face and the changes they hope to see.

Ryan Mundy, the founder and CEO of Alkeme Health, founded the company after noticing that there weren’t any health platforms that focused on the trajectory of Black health.

“They were never given permission to talk about it so it’s kind of like a self-fulfilling prophecy. It becomes a stigma because nobody has the language or the education or the space to talk about it.”

Alkeme is a streaming platform that provides therapists, wellbeing courses, guided meditations, and livestream sessions centered around the Black experience. 

“We’re Black today, Black tomorrow. Black forever. And underneath that, there’s a lot of different ways in which people show up as Black. I’m not here to segment or to say you are too Black or not Black enough. If you identify as Black, our aim is to have a space for you within the platform.”

Artist Leo “Lowhi”, mental health advocate from Asian Mental Health Project, discussed how he felt shame and guilt around feeling emotions from an early age. 

“The fear of reaching out and having someone judge me for that, in my mind state at the time, that’s worse than whatever pain that I’m going through.”

Leo educates, empowers and advocates for mental health with the Asian Mental Health Project which provides resources to make mental healthcare more accessible. Join a community wellness group or sign up for Asian Men’s Wellness Check-in today.

And Kathleen, who associates herself with both the Latinx and Middle Eastern Community, discusses how admitting that you need help and that you are not okay is actually the strongest decision you could ever make for yourself. 

“It can be an uphill battle if you’re surrounded by people who don’t believe in mental health and they believe that whatever you’re going through is just made up, that it’s ‘all in your head.’ “ 

mental health
BIPOC Mental Health Awareness Month

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What's All The Talk About Trauma Response?

What's All The Talk About Trauma Response?
By stella
24th Mar 2022

If you are a trauma survivor, a mental healthcare worker, or know someone who has experienced trauma, you have noticed the rise in trauma awareness, especially during the pandemic. 

Data from finds that nearly a quarter (23%) of 18-to 24-year-olds say they’ve sought mental health counseling during the pandemic. This is a noticeable increase from April 2020, when 13% of adults under 25 reported that they had turned to a mental health professional during the COVID-19 crisis. 

The last 2 years have brought critical paradigm shifts in our views on trauma. There has been increasing acknowledgment of trauma, post-traumatic stress, and the solutions that need to be taken to support those that have experienced it. Awareness has been influenced by musicians, actors, and popular personalities.

Lady Gaga created and expanded her Mental Health First Aid for teenagers in high schools across the country. Prince Harry joined BetterUp, which provides coaching and mental health services to businesses and individuals. And, in his memoir Over the Top, Van Ness describes his experiences with addiction, depression, trauma, and being HIV-positive.

Over the past 18 years, Google searches for “trauma” have steadily risen, peaking in 2021, according to’s article How trauma became the word of the decade. These spotlights are important to the growing awareness of mental health and trauma but we must continue to educate ourselves, and others, as we push forward on destigmatization.

What Happens if We Don’t Know We Have Trauma or Leave Our Trauma Untreated?

When trauma remains untreated, signs, symptoms and responses may begin to appear.

Some recognizable symptoms following trauma are agitation, nervousness, anxiety, trouble concentrating, depression and headaches. There are many more, which you can explore on our previous blog, Signs and Symptoms.

Outside of the gaining an understanding of the signs of trauma symptoms, there has been a growing movement happening right now on TikTok where users are having tough conversations around trauma and information sharing with one another. With over 110.8M views on the hashtag #traumaresponse, more and more people who have unknowingly experienced trauma are recognizing their own personal symptoms and responses for the first time.

What most don’t know is that there can be a difference between a trauma symptom and a trauma response.

What is Trauma Response?

Trauma Response is the unconscious response style we can develop in the wake of untreated trauma that shifts our previous way of relating to others or our situations. 

Trauma can change our personality. It’s response patterns reflect what trauma has taught us and how we apply these lessons to increase our feeling of being safe. However, trauma also changes our sense of identity and our relationships over time, and may themselves cause additional loss and further trauma in our lives. 

What Can Trauma Responses Look Like?

Hyper Independence 

Trauma can make us feel that our safest path is to work and live alone. We may feel like the only person we know we can rely on is ourselves and it can make us feel undeserving of connection with others. We can feel ashamed of who we have become and avoid social contact and interdependence for this reason as well. 


Overworking ourselves can be an attempt to outrun our trauma. It is a distraction from our trauma symptoms. When we are not working, symptoms increase because we longer have the focus of work to distract our intrusive memories. 

Lack of Memory

Cognitive changes are part of the trauma response, including memory and concentration loss. Think of unaddressed trauma as a “file” on your mental computer that slows the whole system down. While it is unaddressed, it is always running in the background. Then all of a sudden, it sends a “pop up” into your mental space – which impedes the ability to focus and remember things with clarity. 

There may also be a conscious or unconscious suppression of disturbing memories. When we suppress one thing,  we often suppress other memories as well since our memories often interlock in our memory network. 

Apologizing Constantly

Apologizing constantly can be a behavior designed to “keep the peace” and “socially appease” someone else. If our trauma is interpersonal, this behavior can develop in response to an attempt to avoid dangerous interactions. The same can happen with People Pleasing (Fawning) and Over Explaining (Fawning) trauma responses. 


Many trauma survivors have said for years that trauma shrinks their world. We may feel overwhelmed or unsafe in groups, quick to anger, misunderstood, or just uninterested in being around people. 


Oversharing can be part of lacking boundaries when we have been violated in traumatic ways and can also be part of the anxious-ambivalent attachment style 

Body Dysmorphia 

Body dysmorphia and past trauma are only just beginning to be understood. Nevertheless, a growing body of research suggests that trauma is strongly associated with the development of BDD.

Approaching Trauma Treatment

Though many people have experienced or are now recognizing exposure to trauma, awareness surrounding trauma is growing, and that’s a good thing. Signs, symptoms and responses to trauma can come in many different forms. The more access we have to care, the better the chance of us finding relief when needed. 

There are many highly recommended treatments for trauma. In recent years, the Stellate Ganglion Block (SGB) has emerged as a promising treatment option for symptoms of trauma. Stella founders Dr. Eugene Lipov and Dr. Shauna Springer recently published a study with other trauma experts that you can read more about here or learn more about SGB on our “How It Works” page.

Post-Traumatic Stress

What Is PTSD?

What Is PTSD?
By stella
14th Feb 2022

If you’re asking yourself, “Do I have PTSD?” (which Stella refers to as PSTI) and think that you may be experiencing symptoms, take this PTSD test online. Or, contact our Patient Care Team directly by calling 1-866-497-9248 or emailing [email protected].

Everything You Need To Know About PTSD

What does PTSD stand for? PTSD is an abbreviation for Post-Traumatic Stress Disorder.

And what is PTSD? In the field of psychology, PTSD is thought to occur in response to experiencing a traumatic or stressful event that creates feelings of horror or helplessness. What most don’t know is that PTSD isn’t always caused by one big traumatic event. Years of cumulative trauma can cause PTSD as well. PTSD can last for months or years, and we can experience a range of physical and psychological symptoms – we’ll explore this a little later.

When we experience trauma, our body’s fight-or-flight response turns on, and sometimes it stays on long after the traumatic event. Many researchers agree that the amygdala (also known as the brain’s “fear center”) becomes overactivated after trauma, causing nerve growth.1 This nerve growth may prevent the fight-or-flight response from returning to a normal level. Brain imagery data suggests that trauma symptoms cause changes that are visible in the brain.2

How Common Is PTSD?

Before the COVID-19 pandemic, it was estimated that 6% of the U.S. adult population would struggle with trauma symptoms at some point in their lives.3 The additional burden of psychological trauma beginning in 2020 is hard to calculate. Not only has COVID-19 impacted physical and mental health, but it’s also had serious repercussions on jobs, access to basic resources, relationships, and more.

Post-Traumatic Stress Disorder vs. Post-Traumatic Stress Injury

A growing number of trauma experts have advocated to “drop the D” in PTSD. And as of 2015, the Pentagon, government officials, organizations, and advocates have stopped using “disorder” to describe Post-Traumatic Stress (PTS).4

Dropping the D in PTSD highlights the fact that PTS may be an injury rather than a disorder.5

There are two key reasons why dropping “disorder” is essential:

  1. “Disorder” connotes a sense of permanence which is misleading because PTS is treatable.
  2. “Disorder” has a stigma that can prevent those who need help from asking for it.

The language we use to describe human experiences matters. Words have the power to make us feel isolated and stuck or understood and empowered. That’s why, at Stella, we replaced “Disorder” with “Injury.” We encourage you to adopt the term Post-Traumatic Stress Injury (PTSI), too.

What Causes Post-Traumatic Stress Injury?

Traditionally, PTSI has been linked to events such as war, sexual assault, or natural disasters. But when we consider the definition of trauma – a deeply distressing or disturbing experience – it becomes clear that many events can be categorized as trauma. Think workplace abuse, reproductive challenges, divorce, loss of a loved one, or a sports injury.

We also know that LGBTQ+ community members and/or ethnic minorities are often mistreated and/or oppressed. As a result, may experience traumas like bullying, physical violence or threat, and homelessness. These are the most common – but certainly not all – causes of PTSI today:

  • Adoption
  • Bullying or hazing
  • Childhood trauma or abuse
  • Childhood neglect
  • COVID-related trauma (e.g., hospitalization for COVID, post-COVID health challenges)
  • Combat and/or warfare
  • Death or injury of a loved one
  • Divorce
  • Domestic abuse
  • First responder trauma (for healthcare workers, EMTs, and LEOs)
  • Homelessness
  • LGBTQ+ trauma (e.g., harassment, rejection, identity crisis)
  • Loss of pregnancy
  • Natural disaster
  • Non-physical interpersonal abuse (e.g., emotional abuse by a narcissistic individual)
  • Personal health issues
  • Physical violence or threat
  • Political/ national refugee-related trauma
  • Racial trauma
  • Reproductive challenges/ infertility
  • Secondary PTSD
  • Sexual assault
  • Sports injury
  • Victim of crime by a stranger (e.g., mugging, break-in, robbery)
  • Witnessing a traumatic event
  • Workplace injury or job-related accident
  • Workplace abuse, loss, harassment, or other related workplace trauma

What Does Post-Traumatic Stress Injury Feel Like?

Anxiety is one of the most common symptoms following trauma exposures. While it’s normal to feel anxious from time to time, when we experience PTSI, anxiety often persists. We feel our worries and fears intensely. In addition to thinking about what could go wrong, we also experience a faster heart rate, heavy breathing, sweating, and feeling tired.

Intrusive thoughts, hypervigilance (or feeling constantly unsafe and on-edge), nightmares, flashbacks, and guilt can add to the sense of uneasiness we feel when experiencing trauma symptoms.

Depression is also common and is frequently identified through changes in mood. When we have PTSI and are depressed, we may withdraw from the activities we used to take pleasure in. Sometimes this is because we struggle to enjoy ourselves and other times it may be to avoid a trigger.

While the symptoms often develop immediately after the trauma or stressful event, they must persist for more than 30 days to receive a diagnosis of PTSI. Before 30 days, the symptoms are classified as “Acute Stress Disorder.” While many mental healthcare resources highlight the 17 most common symptoms of trauma, there are actually more:

  • Agitation
  • Anxiety
  • Crying spells
  • Depression
  • Dizzy spells
  • Flashbacks
  • Headaches
  • Hypervigilance
  • Nervousness
  • Nightmares
  • Obsessive-compulsive tendencies
  • Panic episodes
  • Paranoia
  • Problems with concentration or thinking
  • Problems with memory
  • Shakiness
  • Sleep disturbances
  • Substance abuse
  • Suicidal thoughts or attempts

At Stella, we work with those who have experienced a wide range of traumas. With the right insights and the right support, healing is possible.

Post-Traumatic Stress Injury Treatments

Contrary to popular belief, symptoms of trauma is treatable. Pharmaceutical drugs and talk therapy are two of the most popular treatment options. Stella is ushering in breakthrough treatments for PTSI that can rapidly relieve the worst PTSI symptoms and lay the foundation for game-changing outcomes and long-lasting healing from trauma.

You can learn more about Treatment by Stella by calling our Care Team at 908-928-4086.

  1. Eugene G.LipovaJaydeep R.JoshiaSarahSandersaKonstantin V.Slavinb A unifying theory linking the prolonged efficacy of the stellate ganglion block for the treatment of chronic regional pain syndrome (CRPS), hot flashes, and posttraumatic stress disorder (PTSD)
  2. Alkire, M.T., Hollifield, M., Khoshsar, R., Nguyen, L., Alley, S. R., and Reist, C. (2015). Neuroimaging suggests that stellate ganglion block improves post-traumatic stress disorder (PTSD) through an amygdala mediated mechanism. Presented at the Anesthesiology Annual Meeting, October 24, 2015.
  3. U.S. Department of Veterans Affairs. (2018, September 13). How Common is PTSD in Adults? U.S. Department of Veterans Affairs. Retrieved February 2, 2022, from
  4. Itkowitz, C. (2021, October 28). Dropping the ‘D’ in PTSD is becoming the norm in Washington. The Washington Post. Retrieved February 2, 2022, from
  5. Ochberg, F. (2012). An injury, not a disorder. Dart Center for Journalism and Trauma. Retrieved 8/25/21 from:


Do I Have PTSD?

Do I Have PTSD?
By stella
14th Feb 2022

*The following article refers to PTSD (Post-Traumatic Stress Disorder), whereas at Stella, we use the term PTSI (Post-Traumatic Stress Injury). We encourage you to adopt this language to break the stigma against Post-Traumatic Stress.  Read more about the shift from PTSD to PSTI here.

If you’re asking yourself, “Do I have PTSD?”, this is a great place to start. In this article, we answer the following questions: 

  1. How does trauma affect the brain? 
  2. What is PTSD? 
  3. How common is PTSD? 

We also share a free PTSD quiz and explain how to interpret the results to help evaluate each individual’s situation. 

While only mental healthcare professionals can provide a diagnosis, we can help explain the symptoms we may be experiencing in response to a traumatic event or ongoing stressors.

How Does Trauma Affect the Brain?

Did you know that the body’s fight-or-flight response turns on after traumatic or high-stress experiences? Whether it’s once or many times, these experiences can cause a biological brain injury where the fight-or-flight response gets stuck in overdrive. And this overactivation can cause debilitating physical and psychological symptoms. 

What Is PTSD? 

PTSD is a term mental healthcare professionals use to describe the trouble we have recovering after a traumatic or stressful experience. PTSD has been referred to as a disorder, yet many claim it’s an injury. Stella and others have suggested a new term – Post Traumatic Stress Injury (PSTI) – in place of Post Traumatic Stress Disorder (PTSD)1.

Most say there are 17 different symptoms following trauma exposure; however, there are more. Some of the most common symptoms include anxiety, problems with memory, depression, and headaches.

How Common Is PTSD? 

Trauma is a universal human truth. It may surprise you that 60% of men and 50% of women experience trauma at least once in their lives.2 Research suggests that only 2-11% of people experiencing trauma symptoms are actually diagnosed.3 

Despite how pervasive trauma is, we may not know how to identify symptoms following a traumatic event or ongoing stressors.

We only learn that we have trauma symptoms after researching the issues being had since the traumatic or stressful experience, confiding in a friend, or seeking a professional’s help.

It’s estimated that 50% of people experiencing trauma symptoms do not seek treatment.4 Stella exists to change that. We’re ushering in breakthrough treatments that are fast, effective, and research-backed.  

How Do I Know If I Have PTSD?

If you believe you’re experiencing symptoms, take Stella’s symptom quiz to assess their severity.

Stella uses a broad symptom assessment tool that gauges post-traumatic stress symptoms and depression symptoms while collecting relevant health and demographic information. 

Stella’s symptom quiz includes questions regarding mental health challenges and their symptoms like depression and anxiety. For example, “Do you have little interest or pleasure in doing things?” and “Are you super alert, watchful, or on guard?” After carefully reading the first six questions, you’ll indicate how much you’ve been bothered in the last two weeks to a month on a scale of “Not at all” to “All Days.” Then, the following three questions for you to answer will help us understand what type of dysregulation you may be experiencing, followed by questions about relevant diagnoses and demographic information. We know that answering these questions can be difficult, but you are not alone.

The answers to these questions produce results that can vary from modest to severe. These results help inform Stella’s individual curated care plan recommendations. tell us if our treatments can effectively address your symptoms.

After completing the symptom quiz, your results will be presented on screen and emailed to the address previously provided.  In addition, the results page will ask if you would like to speak with a Care Advocate to determine if Treatment by Stella is right for you. After answering “Yes, I’d like to book a call,” you will be prompted to find a date and time on the calendar presented. Within the email, we provide you with a telephone number if you want to discuss treatment options with our care team later. 

Please know that the results from the symptom quiz is not a diagnosis and that we encourage you to seek a professional assessment. 

If you already took the symptom quiz and want to learn more about treatment options, please get in touch with a Care Advocate today: 908-928-4086

  1. Itkowitz, C. (2021, October 28). Dropping the ‘D’ in PTSD is becoming the norm in Washington. The Washington Post. Retrieved February 2, 2022, from
  2. U.S. Department of Veterans Affairs. (2018, September 13). How Common is PTSD in Adults? U.S. Department of Veterans Affairs. Retrieved February 2, 2022, from 
  3. Ellen C. Meltzer, MD MSc,1 Tali Averbuch, MPP,1 Jeffrey H. Samet, MD MA MPH,1,5 Richard Saitz, MD MPH,1,3,4 Khelda Jabbar, MD,6 Christine Lloyd-Travaglini, MPH,7 and Jane M. Liebschutz, MD MPH1,5 Discrepancy in diagnosis and treatment of post-traumatic stress disorder (PTSD): Treatment for the wrong reason
  4. Spoont, M, Arbisi, P., Fu, S., Greer, N., Kehle-Forbes, S., Meis, L., Rutks, R., & Wilt, T.J. (2013). Screening for Post-Traumatic Stress Disorder (PTSD) in Primary Care: A Systematic Review [Internet]. Washington (DC): Department of Veterans Affairs (US). Available from: https://www.ncbi. Spoont, et al., 2013.

Post-Traumatic Stress

PTSD Signs and Symptoms

PTSD Signs and Symptoms
By stella
14th Feb 2022

If you’re asking yourself, “Do I have PTSD?”(which Stella refers to as PSTI) and think that you may be experiencing symptoms, take this PTSD test online. Or, contact our Patient Care Team directly by calling 1-866-497-9248 or emailing [email protected].

Spotting the signs and symptoms of PTSD can be difficult. Research suggests that only 2-11% of people experiencing trauma symptoms are actually diagnosed.1 This is one of the many reasons Stella is dedicated to the education of the impact of emotional trauma and the available treatment options. We strongly believe that demystifying the impact and treatment of trauma reduces stigmas associated with PTSD.

While PTSD has been referred to as a disorder, many claim it’s an injury. Stella and others have suggested a new term – Post Traumatic Stress Injury (PSTI) – in place of Post Traumatic Stress Disorder (PTSD)2.

What Are the 17 Symptoms of PTSD?

Trauma can cause symptoms that diminish our capacity to experience warm and loving feelings from others (i.e., emotional numbness), which can lead to profound negative changes to our self-image and identity and spark fears that often limit our enjoyment of pleasurable activities. When we have symptoms following trauma exposure, we may have recurring feelings of helplessness and horror. We also commonly experience panic attacks, feelings of self-blame and shame, chronically disrupted sleep, and relationship conflicts with loved ones.

Read on to learn more about the 17 most common symptoms. 


Agitation is a feeling of anxiety or nervous excitement. Like many symptoms experienced after trauma, agitation is understood on a spectrum. Words like restless, uneasy, and tense generally describe mild agitation. When we’re agitated, we may be fidgety or find it hard to sit still. Agitation can build to the point that we’ve become short-tempered or continually irritable. Untreated trauma can contribute to aggressive or harmful behavior toward ourselves or others.

Nervousness and anxiety

It’s normal to worry about stressful situations (like a job interview or putting an offer in on a house) before they happen. But when we experience symptoms following trauma exposure, these nervous feelings are persistent and all-consuming to the point that they disrupt everyday life. Tense, worried thoughts often manifest physically. For example, when we’re exposed to trauma and experience anxiety, we might have an increased heart rate, breathe rapidly, sweat, or feel tired. 

Problems with concentration or thinking

The body’s fight-or-flight response turns on when we experience trauma or a very stressful event. And sometimes it stays on long after the traumatic event, which can make us feel like we need to be on constant high alert. This, in turn, makes it challenging to concentrate or think clearly. 

Problems with memory

After experiencing trauma, the fight-or-flight response may become “stuck” in an over-activated state that causes nerve growth around the amygdala (also known as the brain’s “fear center”).3 The amygdala – along with the hippocampus and prefrontal cortex – plays a role in the brain’s ability to process stress and memory. Memory loss can also occur as a defense mechanism. 


When the fight-or-flight response is triggered, the body releases cortisol and adrenaline – two hormones that help it respond to a threat. When we experience symptoms of trauma, our fight-or-flight response can become locked into a continually activated state, and, in this state, our bodies produce hormones which can impact the body’s nervous system, sometimes resulting in headaches4

Depression and crying spells

Depression negatively impacts how we think and feel about ourselves. It can also influence the way we behave. When we are exposed to trauma and experience depression, we may feel sad, lose interest in activities we enjoyed before their trauma, feel guilty and worthless or notice changes in our appetite. Depression can also cause increased fatigue and disrupted sleep – we might have trouble sleeping while others sleep too much. And at its worst, depression can lead to suicidal ideation.

Suicidal thoughts or attempts

We can be so overwhelmed by our symptoms that we sometimes consider harming ourselves or suicide. When we’re experiencing trauma symptoms, we can also experience depression, panic attacks, anxiety, and substance abuse and are at higher risk for suicide. In fact, people diagnosed with trauma symptoms are 9.8 times more likely to die by suicide.5 

If you are thinking about suicide or need emotional support, please text “HOME” to 741741 for free, 24/7 crisis counseling from Crisis Text Line. We want you to know that you are not alone and that there is hope. 

Mood swings

Trauma triggers and other common experiences like panic attacks and bursts of irritability can cause sudden mood changes following trauma exposure. While bipolar disorder is a different condition, the mood swings that come with trauma exposure may sometimes be mistaken for bi-polar disorder, and in some cases, we may have both conditions. Working with a licensed clinician is the key to figuring out the right diagnosis.

Obsessive-compulsive tendencies

While being diagnosed with trauma symptoms and Obsessive-Compulsive Disorder (OCD) are different conditions, after we’re exposed to trauma, we may behave in ways that look similar to OCD. For example, we may check the locks on their doors several times before leaving the house in response to the hypervigilance that can come after a trauma. 

OCD and those diagnosed with trauma symptoms can both suffer from intrusive, disturbing thoughts. When we experience both conditions, we often feel a constant impending sense of doom or dread. 

Panic episodes

Feeling afraid is common when we’re exposed to trauma. When we are suddenly overwhelmed with intense fear, it could mean that we are experiencing a panic attack. Sometimes these episodes seem to come without warning or reason. Other times, they happen in response to a reminder of our trauma.  

During a panic attack, we may feel like we’re not in control of ourselves or afraid of dying. Chest pain, trembling, hot flashes or chills, a choking sensation, and other physical symptoms are commonly associated with panic attacks.


In reaction to traumatic or highly stressful events, we can become paranoid. Our belief that we are unsafe causes us to act highly guarded and suspicious of others. We adopt this way of thinking to protect ourselves from being harmed or harassed. 


Shakiness is related to many common trauma symptoms like agitation, nervousness, anxiety, panic episodes, and substance abuse. 

Substance abuse 

When experiencing symptoms following trauma, we may use drugs and alcohol to cope as taking substances can temporarily reduce or numb the upsetting feelings we’re experiencing. 

Are There Other PTSD Symptoms?

Yes. Experiencing symptoms of trauma can also commonly include flashbacks, hypervigilance, nightmares, and sleep disturbances. 

Trauma affects us all differently.

Treating Symptoms of PTSD with Stella

In recent years, the Stellate Ganglion Block (SGB) has emerged as a promising treatment option for symptoms of trauma. Stella founders Dr. Eugene Lipov and Dr. Shauna Springer recently published a study with other trauma experts that indicates that the SGB is an effective treatment for trauma symptoms regardless of gender, trauma type, PTSD-related medication use, history of suicide attempt, or age.6 

SGB by Stella has the potential to help millions of people with emotional trauma experience lasting relief. To learn more, please visit our “How It Works” page.

  1. Ellen C. Meltzer, MD MSc,1 Tali Averbuch, MPP,1 Jeffrey H. Samet, MD MA MPH,1,5 Richard Saitz, MD MPH,1,3,4 Khelda Jabbar, MD,6 Christine Lloyd-Travaglini, MPH,7 and Jane M. Liebschutz, MD MPH1,5 Discrepancy in diagnosis and treatment of post-traumatic stress Itkowitz, C. (2021, October 28). Dropping the ‘D’ in PTSD is becoming the norm in Washington. The Washington Post. Retrieved February 2, 2022, from
  2. disorder (PTSD): Treatment for the wrong reason
  3. Eugene G.LipovaJaydeep R.JoshiaSarahSandersaKonstantin V.Slavinb A unifying theory linking the prolonged efficacy of the stellate ganglion block for the treatment of chronic regional pain syndrome (CRPS), hot flashes, and posttraumatic stress disorder (PTSD)
  4. B. Lee Peterlin DO,Gretchen E. Tietjen MD,Jan L. Brandes MD,Susan M. Rubin MD,Ellen Drexler MD,Jeffrey R. Lidicker MSc,Sarah Meng DO Posttraumatic Stress Disorder in Migraine
  5. National Center for PTSD. PTSD and Death from Suicide. Retrieved 9/28/21 from 
  6. Lipov, E. G., Jacobs, R., Springer, S., Candido, K. D., & Knezevic, N. N. (2022). Utility of Cervical Sympathetic Block in Treating Post-Traumatic Stress Disorder in Multiple Cohorts: A Retrospective Analysis. Pain Physician, 25(1), 77-85. Available from: