Post-Traumatic Stress Disorder in Wittman, MD
PTSD, more formally known as post-traumatic stress disorder, is most commonly associated with combat veterans. However, anyone who experiences a traumatic event can develop PTSD. New research has shed some light on the physical, neurobiological effect PTSD has on the brain and what this may mean for sufferers and treatment of this debilitating condition.
What is PTSD?
Post-traumatic stress disorder is a condition that originates from the involvement or exposure to a traumatic event. Even witnessing a traumatic event can incite PTSD. Things like a car crash, seeing a murder, rape, terrorist attacks, and so on, can trigger PTSD. The event usually triggers our primal fight-or-flight response, enveloping us with intense fear, helplessness and profound feelings of a certain demise.
Typically our response to intense, life-threatening fear is transient, which is to say fleeting. The sensation(s) usually dissipate after a while. However, in PTSD, the experience continues, even reoccurs after the traumatic event. PTSD presents in three main categories of symptoms, reminders of the inciting event, activation and deactivation.
Reminders of the traumatic event: These reminders typically present in the form of nightmares, flashbacks, disruptive thoughts and daydreams. Try as you might these thoughts are uncontrollable and inescapable in the midst of PTSD. They become so prevalent that day-to-day life is severely affected.
Activation: This group of symptoms can be classified as mood and temperament change. Sleep disturbances like insomnia are common. Irritability, impulsiveness, hyperarousal, and extreme anger and hostility are also hallmarks of activation.
Deactivation: This occurs when the mind tries to remove itself from the negative stimuli, even though they are only perceived at this point. Dissociation may be experienced in severe instances. However, the most common symptoms of PTSD under deactivation are withdrawal, depression , avoidance, confusion, and an overall sensation of mental “numbness” may be reported and observed. Given these very real symptoms, researchers believe that underlying brain structure may lead to an increased susceptibility to developing PTSD.
How Does PTSD Affect the Brain and Vice Versa?
It’s believed within the neurological community that pre-existing biological markers may lay dormant in the brain until exposed to extreme stress, at which time they “activate,” causing PTSD. Similarities have also been found in those with PTSD and traumatic brain injuries (TBIs), including withdrawal and irritability.
An area of the brain known as the hypothalamic-pituitary-adrenal axis (HPA axis) is the brains “airport control tower” in guiding the body’s physiological reaction to stress . The HPA axis itself is limited by the hippocampus and prefrontal cortex. In those with PTSD, a smaller hippocampus is observable. What this means is that the HPA—the part of the brain responsible for starting and managing our reactions to stress and trauma—can run wild.
The HPA axis also has a hand in the presence of the hormone cortisol , the body’s anti-stress hormone. Dysregulation of the HPA axis then can result in a hormonal imbalance of cortisol (a low cortisol level is known as hypocortisolism). Low cortisone levels mean that a person is ill-equipped to handle large stressors or trauma. Thus, a pre-existing hypocortisolism in people exposed to traumatic events may be the reason many develop PTSD. A hydrocortisone shot—if given shortly after a traumatic event—has been shown to be effective in preventing PTSD, further emphasizing the role cortisol and the HPA axis plays in PTSD.
Neurochemicals including noradrenaline, serotonin, amino acids, peptides and opioids have been observed as having a role in the development of PTSD. Noradrenaline has been connected with the storing of traumatic/emotional events in our memories as well as the activation of our autonomic nervous system (automatic response to stress). In PTSD, these take the form of flashbacks and physical panic attacks. In those with PTSD not only have greater amounts of noradrenaline been reported but greater sensitivity to them as well, magnifying their effect.
Serotonin has been linked to many of the symptoms present in the activation stage of PTSD. Two versions of serotonin particularly may contribute to PTSD and related symptoms in a round-about way. One version of serotonin fosters the connection between events and memories while the other version has an effect on the hippocampus (the part of the brain responsible for governing the HPA axis). On paper, these finding may not sound like much, but they open doors for treatment options.
By studying the brain along with its structure and chemistry, researchers are unlocking keys to PTSD treatment never before realized. If you—or a loved one—has PTSD, there may be alternative treatment options available.
Request more information about post-traumatic stress disorder today. Call (410) 266-3613 or contact Annapolis Integrative Medicine online.
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