Post-Traumatic Stress Disorder (PTSD) is what happens to some people after having experienced a life-threatening event, or series of events, such as combat, natural disaster, terrorism, serious accidents, or violent personal assaults. Rescuers and witnesses can get PTSD too. After experiencing a traumatic event, the brain is reset to a perpetually more active state and biological changes have been created. PTSD sufferers tend to relive the events through flashbacks, intrusive thoughts, and nightmares, with resulting behaviors such as avoidance of activities or places associated with the trauma, emotional numbness, chronic insomnia, sleep disorders, panic attacks, feeling that the future is shortened, are easily startled, have constant anxiety or fear of future bad events, and violent outbursts. PTSD can be acute or chronic and can occur right after a terrible event or even appear years after the fact. It can also be chronic after years of abuse or growing up in an unpredictable and stressful home, such as with an alcoholic or drug abusing parent. A key to treatment of PTSD is early identification of these symptoms.Brain Activity
PTSD sufferers also evidence atypical brain wave activity, reduction in the size of the hippocampus, overactivation of the amygdala, excessive arousal of the sympathetic nervous system (the stress response), production of higher than average levels of bodily opiates (endorphins), increased limbic, basal ganglia, and anterior cingulate gyrus activity. They may be likely to suffer from other disorders such as depression, alcohol or drug use, phobias or conduct disorders.Chemicals
Those at higher risk include people with childhood abuse, family dysfunction and preexisting psychological disorders. PTSD sufferers may have lower base levels of cortisol than normal thus allowing adrenaline to roam free during the trauma. Adrenaline serves to help imprint strong emotional events. Cortisol levels tend to keep adrenaline levels in check. Therefore, a person with lower cortisol levels would be that much more likely to form a strong memory of the trauma.Brain Scans
Brain scans of people who have suffered from severe trauma or abuse have shown some developed PTSD and some have not. Studies showed, people with PTSD recalled their experience visually while those without PTSD recalled similar experiences verbally. The conclusion was that verbal memory is protective and visual memory is raw and non-protective. The type of memories a patient has may help indicate the appropriate course of treatment. PTSD sufferers who underwent brain scans, prior and post treatment with EMDR, showed significant improvement and a calming of the hyperactive areas in the brain.Treatments
Psychotherapies with the strongest evidence of improvement in PTSD symptoms include Trauma Focused Psychotherapies such as Prolonged Exposure (PE), Cognitive Processing Therapy (CPT) and Eye Movement Desensitization and Reprocessing (EMDR). Medications may also be helpful as an integrated part of a patient’s treatment. Other goals of treatment may include: A patient becoming involved in things that may help to pursue a purpose in life; Believing in one’s personal control and power and believing that one can grow and learn from negative events; Seeing one-self, in essence, in a more positive light than others might; Having a social support network in order to express optimism and to engage in laughter.
If you need help managing PTSD or have further questions feel free to contact me.
Julie Cunningham, PMHNP, MBA