June was PTSD Awareness Month
Adding to our awareness – Part II
© Madelyn Griffith-Haynie, CTP, CMC, ACT, MCC, SCAC
Updated Refliections Post
Self-Health Series – Part I HERE
“Emotions are very good at activating thoughts,
but thoughts are not very good at controlling emotions.”
~ Joseph LeDoux
Since my Sleep Awareness post somehow jumped the queue and was posted at the same time as Part-1 of this article, I decided to wait a bit to give readers a shot at catching up. Again, my apologies for seeming to inundate with info – it was not intentional.
This Part may seem long, but much of the first half is review — so those of you who read Part-1 will be able to skim through it quickly.
Identifying PTSD
PTSD can present in a variety of ways, with more than a few symptoms in common with depression, in addition to any or all of those characterizing other anxiety disorders.
As I explained in Part I, PTSD is now believed to be caused by a neuro-chemical alteration in the brain in response to exposure to trauma. It holds us prisoner, responding in the moment to threats from the past.
Unprocessed trauma continues to haunt us, eroding our sense of safety and security. As a result, it can keep us stuck in an amygdala-defensive emotional pattern that may induce a variety of symptoms over which we feel we have no control.
In fact, we cannot control them in the moment. Current therapies are focused on helping us to change our subsequent response to them.
Exposure to trauma physically changes the structure of the brain, upsetting the neurochemical balance needed to respond appropriately, faster than we can over-ride cognitively.
It seems that repeated experience of traumatic events, especially when left to fester unprocessed, can prevent rebalancing, which prevents healing (meaning, allowing the past to remain in the past, confident that you have the strength to handle whatever life throws your way in the future).
In other words, our brains are designed to respond neuro-chemically when our safety is threatened, regardless of what we think about it logically or how we feel about it emotionally.
- Some of us are able to process those perfectly normal and appropriate fearful responses and move forward.
- Others of us, for a great many reasons science is still trying to understand, are not.
- At this point in time, we move forward primarily with statistics.
Statistics explored in Part I
In the previous section of this article we also looked at the prevalence of PTSD compared to the total number of people who ever experienced trauma in their lives. We took a look at the various risk factors for developing PTSD following exposure to trauma.
You saw that the risk was effectively double for women, and that significantly more women are exposed to trauma in their lives than their male friends and relatives – and that recovery times tended to be longer.
Approximately 50% – five out of every ten women – will experience a traumatic event at some point during their lifetime, according to the The National Center for PTSD, a division of the U.S. Department of Veterans Affairs.
One in ten of those women will develop PTSD as a result.
Inadequate understanding & treatment
Science is still looking for many of the pieces of the PTSD puzzle.
Even though a variety of therapies can help relieve PTSD symptoms, at the current time there is no “cure” – or prevention – nor is there an adequate explanation for how exposure to the same trauma can affect different individuals to different degrees of severity.
We also do not have definitive treatment protocols equally effective for everyone who experiences PTSD.
Brain-based research
Right now it looks like the difference between who recovers from trauma and who is more likely to develop PTSD may turn out to have a genetic component.
It may be also be linked to the size of specific areas of the brain, which could be a product of genetics or epigentics (how your internal and external environments change the expression of your genes).
Related Posts:
Making Friends with CHANGE
A Super Brief and Basic Explanation of Epigenetics for Total Beginners (off-site)
While controversial, the most recent research ties the development of PTSD to the size of an area of the brain called the hippocampus, which is primarily known for its role in the formation of non-disordered memories.
Greater size indicates a greater ability to recover from trauma.
A smaller hippocampus may increase the risk of developing PTSD as well as the severity of its symptoms, and/or lengthen the duration and recovery time.
Some studies suggest that repeated exposure to stress may actually damage the hippocampus, through the repeated release of the stress-hormone cortisol.
Related Posts:
Hippocampal volume and resilience in PTSD
Brain region size associated with response to PTSD treatment
So perhaps PTSD is hormonal?
Cortisol is a mobilizing hormone. We need it. We might not even get up off the couch without it. However, it is most widely known for its assistance motivating the body for rapid and effective response to a stressful or life-threatening event – our “fight or flight” reaction.
Problems result because our brains and bodies are not designed
to live in a state of persistent and protracted stress.
Scientists have long suspected the role of cortisol in PTSD. They have been studying it, with inconclusive results, since findings in the 1980s connected abnormal cortisol levels to an increased PTSD risk
A study reported in early 2011 by researchers at Emory University and the University of Vermont found that high blood levels of the hormone PACAP (pituitary adenylate cyclase-activating polypeptide), produced in response to stress, are linked to PTSD in women — but not in men.
PACAP is known to act throughout both body and brain, modulating metabolism, blood pressure, immune function, CNS activity [central nervous system], and pain sensitivity.
Its identification as an indicator of PTSD may lead to new diagnostics and to effective treatments — for anxiety disorders overall, as well as PTSD in particular.
But maybe not cortisol alone
Findings published early this year in the journal Psychoneuroendocrinology point to cortisol’s critical role in the emergence of PTSD only when levels of testosterone are suppressed. [April 2017, Volume 78, Pages 76–84 ]
Testosterone is one of most important of the male sex hormones,
but is is also found in women, albeit in much lower concentrations.
According to UT Austin professor of psychology Robert Josephs, the first author of the study:
“Recent evidence points to testosterone’s suppression of cortisol activity, and vice versa.
It is becoming clear to many researchers that you can’t understand the effects of one without simultaneously monitoring the activity of the other.
Prior attempts to link PTSD to cortisol may have failed because the powerful effect that testosterone has on the hormonal regulation of stress was not taken into account.”
PTSD Risk Can Be Predicted by Hormone Levels Prior to Deployment, Study Says
What we think we know for sure
What science does believe it now knows is that PTSD is a result of both the event that threatens injury to self or others, and the emotional, hormonal response to those events that involve persistent fear or helplessness.
At this time, the goal of PTSD treatment is to reduce, if not eliminate, chronic fear-based emotional and physical symptoms to improve the quality of day-to-day life.
Research is ongoing to see if it is possible to chemically block the development of PTSD by blocking the formation of fear memories.
Blocking human fear memory with the matrix metalloproteinase inhibitor doxycycline
Current treatments are limited to psychotherapy, CBT (cognitive behavioral therapy) or other types of counseling/coaching, and/or medication, along with less well-known and less widely accepted attempts at intervention like EFT (Emotional Freedom Technique: “tapping”) and EMDR (Eye Movement Desensitization and Reprocessing).
The value of information
Before we explore the variety of treatments currently available (in a future article), let’s take a look at some of the symptoms associated with PTSD. It will help you understand your own or those of a loved-one with PTSD.
Understanding, empathy and self-acceptance walk hand in hand – which are healing all by themselves.
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ADD . . . and-so-much-more 