June is PTSD Awareness Month

Cherryville, NC (WNN) - The month of June is being dedicated to bringing awareness to Post Traumatic Stress Disorder (PTSD). Combat veterans are the first people that come to mind when one hears the term PTSD, as it is true that they suffer at a very high rate. Many people are unaware that PTSD can occur after any traumatic experience, not just combat veterans, first responders, or police officers. The Department of Veterans Affairs (V.A.) and the National Center for PTSD have set up an informative website www.ptsd.va.gov, which gives more information about this condition and resources for coping either as a victim or family member. Their goals are to offer help, bring awareness, reduce the stigma, and educate the public that effective treatments exist.

What is PTSD?

Post-traumatic stress disorder is a mental health problem that can occur after being part of or witnessing a traumatic or life-threatening event. It is most commonly associated with military members who have served in combat zones. However, any experience of trauma, such as a vehicle accident, natural disaster, fire, or sexual assault, might produce the disorder. It is normal to have increased stress after experiencing trauma. Some symptoms might be flashbacks where the experience is relived again after a memory of the event is triggered, nightmares, intrusive thoughts where the event becomes the focus, being emotionally numb, or severe anxiety. The four main symptoms are reliving the event, avoiding places or people that are reminders of the event, a negative change in beliefs or feelings, and constantly feeling on edge or wound tightly. Symptoms normally develop shortly after the trauma, yet might be delayed for weeks or months and sometimes years. There is also the outside chance they could come and go. If these symptoms persist for longer than four weeks, it might be an indication of PTSD. All four main symptoms will be experienced if PTSD. According to the National Center for PTSD, roughly 6 out of every 100 people (6%) will experience PTSD at some point in their lives.

Impact of Daily Life

The stigma surrounding PTSD for many years kept those suffering its effects from talking about it or even acknowledging they were having trouble coping. Left untreated, the disorder can have negative impacts on the sufferer as well as their family and friends. Many marriages and relationships end due to the dramatic behavioral changes experienced. Constantly being in a state of paranoia, experiencing sudden and uncontrollable reflexive actions during flashbacks, or waking suddenly in a frightened state during a nightmare can be very unnerving for those close to the individual and can create their own fear. Along with relationships, the ability to work can be directly affected by lost sleep and reactions to emotional triggers. The loss of enjoyment from everyday interactions with people and normal activities can lead to substance abuse, high anxiety, and depression. This is a major contributing factor to veteran suicides. 

Trauma Rewires the Brain

How does trauma so drastically change someone? The short answer is that the roles of three major brain areas are alternated and, in effect, rewired. The brain is altered both physically and chemically. Think of it as the nervous system becoming trapped in a constant state of awareness. The brain has a naturally occurring alarm system that ensures survival, that is when everything functions as designed. During PTSD, that system becomes overly sensitive, triggering easily and perceiving everything as a threat in severe cases. 

Photo By: Arestoredmind.com

What is happening in the brain? The brain’s natural alarm system will produce the “fight or flight” response due to three regions functioning properly. 

1. The Amygdala: Its main job is survival through fear. Under normal circumstances, it acts as an early alarm system when a potential threat is detected. PTSD causes it to be oversensitive, seeing almost everything as a threat, in turn releasing a rush of stress hormones. This produces exaggerated responses and a state of hypervigilance. Being oversensitive results in an overreaction to the slightest trigger, such as a loud noise, as rational thinking has been impaired.
2. Prefrontal Cortex: the front part of the neocortex. It can be thought of as a regulator or a brake system. Logical and emotional regulation determine whether the perceived threat is an actual threat and, if so, what response is required. If no threat is detected, it signals the amygdala to relax and reset to a calm state. PTSD decreases the activity of the prefrontal Cortex, thus making it more difficult to signal the amygdala that all is ok. The signal to return to a calm and relaxed state is either blocked or delayed. An overactive amygdala and underactive prefrontal Cortex are a bad combination. The signals are scrambled and produce an overreaction and rush of adrenaline with no way to stop it, like a speeding car racing downhill without brakes.
3. Hippocampus: Its main functions are to organize memories and differentiate past events from the present. Think of it as a data processor and storage center. During trauma, it shrinks, which impairs the ability to contextualize fear correctly. Flashbacks and traumatic memories result from this region failing to separate memory from present events. It makes the memories feel as if they are happening now, not just a memory of a past event. 

Normally, memories are sorted and filed away. If trauma is overwhelming, portions of memories could be altered or completely forgotten. There is also the possibility of obsessive overthinking of a past event, which never leaves the mind. These are occurrences of the brain working too hard to make sense of what has happened. As these important details of a memory get blocked or forgotten, it is like looking at a jigsaw puzzle missing critical pieces needed to make sense of the image.

Attempting to explain what you are going through to someone who has never suffered from trauma can be frustrating and difficult to verbalize. One analogy could be imagining the sufferer as a smartphone, and the open tabs or apps running in the background as the brain. When there are too many tabs or apps open, storage memory is reduced, and no new programs can run properly. Similarly, during PTSD, the brain is trying to process too many stimuli at once, such as old memories, making it difficult to recognize the difference between past and present events. The same as when the phone has too many photos, videos, and open apps clogging up the storage memory, which prevents anything new from being downloaded. The brain becomes overwhelmed trying to process everything at once without the available storage memory to process it properly.

Another example is that emotional and physical responses are left in constant flinch mode. This is like when an object is suddenly thrown toward your face, and without thinking, you flinch and possibly duck as well. The response is reflexive; no thought is required before action is taken, in this case, flinching. 

Next Steps

If you or someone you know is suspected of possible PTSD, a good first step is to take a self-screen. June 27th is being recognized as PTSD Screening Day, although self-screening can be done at any time by going to www.ptsd.va.gov and answering five short questions. If the answer to three or more is yes, there is a good chance that PTSD is occurring. Next, print out the questions with your answers and take those to an appointment with a primary care doctor or mental health provider. Explain to them what has been recurring and discuss why the questions were answered as they were. Other options include talking with a trusted source, such as a clergy member, family member, or family friend. Another option is to call the Veterans Crisis Line at 988 and press 1 if a veteran. Anyone can use the hotline. Help is also available by texting 838255. Only a trained mental health provider can accurately diagnose PTSD; however, these are good steps to take. Self-screen is a great tool to determine if there is enough concern to seek out an appointment with a provider. 

Another valuable tool for family members is the PTSD coach app, which is free to download. This app is designed for family members dealing with people living with PTSD. It offers support, education, self-care, and resources. This is an evidence-backed mobile app and is free to download. If you have experienced any form of trauma or have witnessed a traumatic event, do not hesitate to talk with someone and make an appointment with a medical professional if needed. Get the help you deserve.

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