Post-Traumatic Stress Disorder (PTSD) is a condition that is characterized as a development of symptoms following exposure to a traumatic event; witnessing, in person, event(s) as it occurred to others; learning of a traumatic event that occurred to a close family member or friend; and/or experiencing repeated or extreme exposure to aversive details of the traumatic event(s). The definition and criteria have changed over the years as we have learned that one does not always have to directly be involved in the traumatic event(s) to develop PTSD.
Many in the military community may remember the syndrome referred to as ‘Irritable Heart’ or ‘Soldier’s Heart’ during the US Civil War due to the presence of autonomic cardiac symptoms or ‘Shell Shock’, hypothesized to result from brain trauma related to exploding shells during World War I. World War II veterans, survivors of Nazi concentration camps, and survivors of atomic bombings in Japan all had similar symptoms that were referred to as ‘Combat Neurosis’ or ‘Operational Fatigue’. In the late 1980’s, the term Post Traumatic Stress Disorder was coined and added to the Diagnostic and Statistical Manual of Mental Disorders-III (DSM-III). This is the terminology we use today in the field of psychology and psychiatry, although the criteria have changed to include those who are affected by the threat of a loved one experiencing a traumatic event(s) or repeated exposure to violent and disturbing details of a traumatic event(s); rather than it only applying to those who were directly exposed to an event(s).
The following are often symptoms associated with PTSD: fatigue, shortness of breath, heart palpitations, headaches, excessive sweating, dizziness, disturbed sleep, fainting, forgetfulness, difficulty with concentration, muscle and joint pain, irritability, a sense of numbness, and feeling of dissociation or a disconnect with reality. There are often comorbid (meaning occurring with) conditions associated with PTSD that include but are not limited to: depressive symptoms, substance use/abuse related problems, and anxiety. Some persons are biologically and psychologically more resilient than others; therefore, not everyone exposed to a traumatic event(s) will experience PTSD and it is not clearly understood why. There is much research into the field of ‘Resilience’ to try to better understand why some will develop PTSD symptoms and others will not.
These symptoms were once thought to be solely psychiatric in nature, meaning that they were all thought to be created by the mind. More recent research, within the past 10-15 years, in the field of neuroscience has revealed that there are actual changes in the brain and biochemistry of the body that produces many of these symptoms. For instance, structural changes in the hippocampus (responsible for memory learning and consolidation) for PTSD veterans, and changes in neurotransmitters of the brain. Trauma and repetitive stress causes the Central Nervous System (CNS) to become over activated on a continual basis. This results in cardiac symptoms, panic, excessive sweating, obsessive thought patterns, etc.
Think of your brain as the idling of your car. When stopped at a stop light, you want your car to idle around 1000 rpms (calmly but efficiently when it is time for you to take off from the light). Now think about PTSD as your brain idling around 3000 rpms all of the time. This is an example of your Central Nervous System being over activated on a continual basis. When this is the case, a person is much more prone to things such as heart palpitations, easily irritated, prone to anger outbursts, the inability to sleep, etc.
If you would like to learn more, I will be presenting a 3-part series on Post-Traumatic Stress Disorder this summer through the Pillar Institute. The series modules are as follows: Part I- The Neurobiology of PTSD, Part II- Vicarious/Secondary Trauma in the Family Unit, and Part III- Current Treatment Options and Live Testimonials.
J. Blair Cano, PsyD
Licensed Psychologist in Colorado & Hawaii