In the 1950’s, Post Traumatic Stress Disorder was often stigmatized in popular culture after the Vietnam conflict, and this stigma was portrayed in many popular films and shows. The misunderstanding of PTSD slowly began to change in 1980, when it was recognized as a specific condition with identifiable symptoms. Since then, PTSD is listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders.
In 2010, the US Senate officially designated June 27th as National PTSD (Post Traumatic Stress Disorder) Awareness Day. Staff Sergeant Joe Biel died in 2007 after suffering from PTSD; Biel committed suicide after his return from duty to his home state. SSgt. Biel’s birthday, June 27, was selected as the official PTSD Awareness Day, which is now observed every year.
Organizations that work with anyone at risk for this condition use this day to get information about symptoms and treatments out to the public. Our hope is that the more people that know about this disorder, the more people will recognize the symptoms and get treatment. PTSD is not exclusive to veterans or currently serving members of the United States military, but a portion of those who serve are definitely at risk for PTSD.
PTSD can affect anyone
Dr. Capote, Medical Director of the Division of Neuropsychiatry at DENT, speaks about who statistically is most likely to have PTSD. “When people typically hear PTSD, they think of violence or sexual assault. They are surprised to hear that automobile accidents are statistically the most likely event to cause PTSD.”
According to the American Psychological Association, car accidents are the leading cause of PTSD among the civilian (non-military) population. Not everyone experiences the same PTSD symptoms.
“There are varying degrees of PTSD,” says Dr. Capote, “People [who were in car accidents] may experience resistance getting into a car, might feel very uneasy, or might experience flashbacks when crossing the area of the accident. For others, the traumatic event can unleash an ongoing process of symptoms.”
For those who were in a car accident, avoidance symptoms can display themselves in three ways: driving phobias, limitations on driving, and anxious behaviors as passengers.
Can we predict PTSD?
“Genetically, we can predict PTSD,” explains Dr. Capote. “People with serotonin transport problems are more likely to be affected.”
There is increasing evidence that those with PTSD show abnormalities in serotonin function. It is documented that different types of acute stress result in an increase in 5-HT (serotonin receptors) turnover in the medial prefrontal cortex, nucleus accumbens, amygdala and lateral hypothalamus in experimental animals. This can lead to a higher chance of PTSD symptoms, such as anxiety. Furthermore, patients with PTSD had decreased platelet paroxetine binding, which suggests alterations in the serotonin receptors.
Recently, several studies suggest close interactions between serotonergic and γ-aminobutyric acid (GABA)-ergic systems. Mice lacking the 5-HT1A receptor display marked anxiety, and animals exposed to stress exhibit down-regulation of 5-HT1A receptors. Moreover, this suggests a pathological pathway originating from 5-HT1A receptor deficit leading towards dysfunctions within GABAergic systems, resulting in increased levels of anxiety.
Research has found that 90% of US citizens are exposed to at least one traumatic event in their life, while others are exposed to more than one. “What is interesting is that if your serotonin is in tact, you can have massive amounts of trauma and not get PTSD,” says Dr. Capote.
Any person can get PTSD at any age. Not everyone with PTSD has been through an extreme event. Someone can start showing symptoms of PTSD after a family member or friend experiences danger or harm, or when a loved one unexpectedly dies.
“Really, the criteria is trauma in which the individual has a loss of life or limb, or an expectation of loss of life or limb. There is no objective measure of the trauma it takes to cause PTSD. It is in the context of each individuals experience and expectations,” says Dr. Capote.
Symptoms to look out for
Being exposed to a traumatic event is scary. It is very common to experience any number of symptoms associated with PTSD, including:
- Feelings of anxiety and increased heart rate when you are faced with reminders of the event
- Frightened thoughts
- Staying away from places, objects or events that are reminders of that experience
- Feeling emotionally numb
- Feeling strong guilt, depression or worry
- Losing interest in activities that were once enjoyable
- Having trouble remembering the event
- Being easily startled
- Feeling tense or “on edge”
- Having difficulty sleeping
- Angry outbursts
It’s natural to have some of these symptoms after a dangerous event. Sometimes people have very serious symptoms that go away after a few weeks. This is called acute stress disorder, or ASD. When the symptoms last more than a few weeks and become an ongoing problem, it might be PTSD. Some people with PTSD don’t show any symptoms for weeks or months.
Why does it happen?
These symptoms may occur as your body’s natural response to a traumatic event. Above all, these symptoms are designed to keep you aware of potential dangers and prevent you from experiencing that event again.
“Essentially, we are talking about the triggering of the evolutionary mechanisms and developments in the brain,” explains Dr. Capote. “Not wanting the repetition of [a traumatic] event could be useful for preservation in the future. There is the belief that evolution has favored anxiety problems because it does help the species to continue to propagate.”
How is PTSD diagnosed and treated?
A doctor who has experience helping people with mental illnesses, such as a psychiatrist or psychologist, can diagnose PTSD. The diagnosis is made after the doctor talks with the person who has symptoms of PTSD.
“While there are some medications for PTSD and new ones being studied, there is very strong evidence for cognitive behavior therapy as EMDR,” Dr. Capote explains.
EMDR is a unique, nontraditional form of psychotherapy designed to diminish negative feelings associated with memories of traumatic events. Unlike most forms of talk therapy, EMDR focuses less on the traumatic event itself and more on the disturbing emotions and symptoms that result from the event.
However, you don’t want to have tunnel vision when it comes to treatment. “That would be like having diabetes and only focusing on insulin. For PTSD, there is medication, therapy, good sleep, the Mediterranean diet and exercise. Not even drastic exercise, just small things you can incorporate in to make it a lifestyle,” says Dr. Capote. Additionally, he emphasizes that treatment is not one size fits all. “It’s about coming together with a plan that incorporate all domains of being a human being, and discussing solutions.”
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What to expect from your first visit
It can be scary and overwhelming when visiting a doctor for the first time. Here is what you can expect:
- A frank discuss of what is bothering you, with a thorough review of all the different contributors or potential contributors from the situation
An assessment for a fuller understanding of the problem
From there, we go on to discuss potential solutions
It is important that everyone understands that PTSD treatment is not a one size fits all kind of thing
Our goal at the DENT Neurologic Institute is to expand psychiatric services and to improve psychiatric care in Western New York. We treat adult patients for a wide range of mental illnesses and addiction disorders including depression, anxiety, schizophrenia, bipolar disorder, and more. Over the years, our psychiatric team has continued to grow which has allowed for increased access to care as well as an expansion treatment modalities such as ECT, TMS, and psychotherapy.
If you or someone you know is looking to see one of our medical professionals, call 716-250-2000 or learn more by clicking here.
The content of this post is intended for general educational and informational purposes only; it does not constitute medical advice. Readers should always consult with a licensed healthcare professional for diagnosis and treatment.