Category: Psychiatry

PTSD: The Evolutionary Truth | PTSD Awareness Day

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.

 

The criteria

 

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
  • Nightmares
  • 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.” 

Seeking an experienced doctor in this field? Learn more here.

 

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.

We are what we eat: a link between diet and PTSD symptoms

With 4 out of 5 people experiencing a traumatic event, there is a good chance you or someone you know has Post Traumatic Stress Disorder (PTSD). The symptoms of flashbacks, intense fear and nightmares are quick to appear, but slow to disappear.  Research tells us how to effectively treat PTSD. 

 

Diet and PTSD

 

Traditional treatments, like medication or therapy, are life changing treatments for some who experience PTSD symptoms. Many people are looking to incorporate other methods to improve mental health. Improving your diet is something that everyone can, and should, do. Not only is our diet something we relatively can control, eating is something we do several times a day.

Additionally, nutrition plays a key role in the function and structure of our brain and body.  A link between mental and and food was recently found. A study was conducted to see if a dietary intervention would impact those with moderate to severe depression. In this trial, 67 adults meeting the DSM-IV criteria for a major depressive episode and reporting poor dietary quality were evaluated.  They were randomly assigned to either seven sessions with a Dietitian for Dietary Support, or to an intensity matched social support control condition. This study also did an economic evaluation, taking into consideration the costs. After the study was complete, they found that a dietary support intervention was found to be a cost-effective treatment for depression from both health sector and social perspectives. 

 

We are what we eat

 

In Australia, a study aimed to investigate the association between fruit and vegetable consumption and psychological distress in those who are 45 years or older. They concluded that increasing fruit and vegetable consumption could help reduce psychological distress of middle age and older adults. Furthermore, an additional study was conducted that linked depression and anxiety with unhealthy dietary patterns. These studies are a big reminder that mental health and physical health are fundamentally connected and aggravate each other.  PTSD involves oxidative stress, brain chemical irregularities and mitochondrial dysfunction. A change in your eating lifestyle can have a positive influence on this. 

 

Eating tips for good mental health

 

  • Incorporate coping strategies that do not involve food
  • Include foods that promote gut health: garlic, yogurt, leeks Jerusalem artichoke, kefir, foods rich in dietary fiber (whole grain and plant foods), and colorful fruits and vegetables
  • Moderate red meat consumption may be beneficial for depression and anxiety
  • Implement sustainable changes, as evidence supports the importance of long-term diet for mental health
    • Swapping out an unhealthy snack with a healthy one
    • Eating vegetables at each meal
  • Limit intake of processed food
  • Follow traditional dietary patterns 

 

Other PTSD treatments

 

Psychotherapy Services
DENT Neurologic Institute offers psychotherapy services to assist patients with managing psychiatric symptoms, behavioral issues and interpersonal difficulties. These symptoms and struggles often have a significant impact on the patient’s ability to function as well as on their quality of life. Our providers work with patients and their support systems to create a treatment plan that is tailored to the patient’s specific short and long-term goals.

TMS Therapy 
Transcranial Magnetic Stimulation (TMS) Therapy is a state-of-the-art treatment utilized by our doctors to help treat adult patients with major depressive disorder. The treatment utilizes short pulses of a focused magnetic field to stimulate nerve cells in the area of the brain thought to control mood. This brief painless treatment is performed in a quiet, comfortable setting under the supervision of a psychiatrist and is done while the patient is awake and alert.

Electroconvulsive Therapy (ECT)
Finally, Dent Neurologic Institute offers ECT for relief of major depression, bipolar disorder and other serious mental illness. We are proud to be the first and only in Western New York to provide this highly effective treatment in an office-based setting as opposed to the traditional hospital setting. Our welcoming atmosphere helps ease the anxiety and tension that often accompanies patients who undergo ECT.  

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.

PTSD affects everyone differently

 

The brain responds differently for every person after being exposed to trauma. After a traumatic event, it is normal to feel anxious, afraid or upset. These events include, but are not limited to: violent crimes, car accidents, loved ones in danger, war, and natural disasters. For some people, these feelings fade within a few weeks. Others continue to have these feelings for months or years afterwards.  They might experience reliving the event, flashbacks, negative thoughts, and a sense of nervousness.  This is Post Traumatic Stress Disorder (PTSD).

 

How do the symptoms differ?
 

Females may have PTSD symptoms longer than males. Before diagnosis and treatment, females have symptoms for 4 years, and males for 1 year. Females are more likely to:

  • Feel depressed and anxious
  • Be easily startled
  • Have more trouble feeling emotions
  • Avoid any triggers of the trauma

Males are more likely to have problems with alcohol and drugs after the traumatic event.

“It’s very common that people will try to self-medicate. They’ll try to use alcohol and drug substances to change that experience that they are having” says Dr. Horacio A. Capote, Medical Director of the Division of Neuropsychiatry at DENT.

Males and females both develop physical health problems in tandem with their PTSD symptoms.

 

Different brain responses
 

In experimental studies, the right amygdala, right rostral anterior cingulate cortex (ACC) and dorsal ACC showed more activation in females than males, when exposed to fearful stimuli.  This side of the brain is particularly associated with negative emotions.  These same brain areas are involved in stress response, mind-body awareness and emotional reactivity.  A different study used physiological measures to show that females experience fear more easily than males when exposed to fearful stimuli.

In terms of stress, females show more of an emotional and ruminative response. Ruminating about your triggers can make impact worse if it stops you from taking action. Males are more likely to engage in problem-solving.

 

Who is at risk?
 

An intensely scary or dangerous event can cause anyone to have PTSD. At least 4 out of 5 people experience a traumatic event in their lifetime.  The more serious the trauma is the higher PTSD risk.

Females are twice as more likely to develop PTSD than males.  About 1 in 10 females will develop PTSD in their lifetime. However, medical data from several VA centers have noted that male veterans were more likely to have healthcare visits or diagnosis of PTSD than females (22% vs 17%).

 

How is PTSD diagnosed?
 

PTSD is diagnosed by a medical professional.  Our goal at the DENT Neurologic Institute is to expand psychiatric services and to improve psychiatric care in Western New York. “Many of these problems are brain diseases, and we are very well situated to understand the brain. We work with it in an appropriate and helpful way, without being confrontational and stigmatizing” adds Dr. Capote.

We treat adult patients for a wide range of mental illnesses and addiction disorders including PTSD, 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 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.

 

 

 

Can exercise help with PTSD Symptoms? 

Recent research has revealed that exercise can help patients with anxiety disorders reduce their symptoms.  Post-Traumatic Stress Disorder (PTSD) is a severe anxiety disorder resulting from exposure to trauma. Flashbacks, personality changes, disturbed sleep, mood swings, startle responses, nightmares, anxiety, low self-esteem or depression are often experienced in those with PTSD. Understanding the way that PTSD impacts someone’s mental and physical health can be crucial for a successful treatment plan.

“Part of what we do is to educate the patient. To tell them, ‘Hey, this is an expected problem with this condition. It is part of your condition’… We can study it to understand what is going on and treat it.” – Dr. Capote, Medical Director of the Division of Neuropsychiatry at DENT.

 

Previous Research
 

It is thought that those who exercise regularly are less likely to suffer from anxiety and depression, which are severe symptoms of PTSD.

A study conducted in 2005 asked PTSD sufferers to participate in a 12 week long aerobic exercise program. Researchers reported positive results in participants’ moods and reduced levels of anxiety. This study was published in the International Journal of Emergency Mental Health. They saw results as early as one month into the study.

 

Evolved Studies
 

More recently, a study was done through the University of West Florida. This study was part of a master’s thesis in Exercise Science, and was designed to provide the control group empirically validated treatment for comparison that had been missed in the previous studies.

This study followed 14 women who had been survivors of rape through an eight-week treatment period. All women attended cognitive-behavioral therapy sessions, held bi-weekly. Seven of the women (50%) also participated in physical training classes two times per week. At the eight week mark, those who have engaged in physical exercise revealed more progress. Their progress was measured by the Checklist for Post Traumatic Symptoms. This is a questionnaire used to assess trauma.

 

Results in veterans
 

Researchers at Loughborough University have looked over many studies that reviewed the impact of sport and physical activity on combat veterans diagnosed with PTSD. They found that physical activity enhances the well-being of the veterans.

Aerobic exercise reduces depression symptoms and helps prevent the abuse of drugs. However, some veterans might have complications that prevent them from completing vigorous exercise.  Less physically demanding exercise, like yoga, is another option. Recent research shows that yoga may help individuals with PTSD focus on the present, reduce rumination, and combat negative thinking patterns.

 

Why does exercise help?
 

Exercise stimulates the brain’s release of endorphins. These chemicals are responsible for producing feelings of well-being. Exercise can suppress and reduce chemicals within the body related to anxiety and depression.

Exercise tires the body, which results in sleep coming a little more easily.  Physical activity can also lead to a boost in self-esteem and positive feelings of control over one’s body.

 

The importance of hope
 

The reduction of symptoms seems to appear due to the sense of determination and hope, increased quality of life and the cultivation of positive self-identity. Participating in physical activity helps one gain or regain a sense of achievement.

 

Here at Dent, our goal 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 expansion treatment modalities such as ECT, TMS, and psychotherapy.

“Because of all our different focuses at Dent, we actually have a more complete, holistic approach.” – Dr. Capote. If you or someone you know is looking for our Psychiatry Center, click here for more information.