22 days ago, I embarked on a challenge to raise awareness about post-traumatic stress disorder. The challenge is one of those things that sometimes flare up through social media. It’s easy to generalize such happenings and to dismiss them as nothing but annoying fads. Luckily, not everybody is prone to generalization. I decided to undertake this challenge not only because PTSD is a mental condition that is familiar to me, but also because a good friend inspired me (he posted a video every time after doing his 22 daily pushups).
For the past 22 days, aside from the 22 pushups that are the subject of the challenge, I also did daily reading about PTSD. During this process, I compiled a rather long list of notes and now, I’ll use that list to bring forth my own effort for raising awareness about PTSD.
Some PTSD history
There is a lot of information about PTSD out there, so I’m not going to repeat it. Instead, I’ll highlight what I consider to be of greater importance. Throughout the years, I’ve learned a bit about PTSD from various online sources. Now, I built upon that knowledge by reading the Wikipedia entry about PTSD^ as well as several other online sources.
In my understanding, PTSD is just a name for a condition that has been around for ages. That condition is an excessive behavioral adaptation of the brain in an attempt to make sure that a traumatic event does not occur ever again (emphasis intended). Seen in this light, PTSD shows itself as a natural protection mechanism. The problem is with shutting down this system when it’s no longer necessary.
PTSD research and treatment really took off after the Vietnam War. There was some study in this area during the World Wars but this particular name (post-traumatic stress disorder) became official in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (the DSM IV).
It is more common in women. Childhood trauma increases the chances of a person developing PTSD during subsequent traumatic events in adulthood. It has a serious impact on the physical health of people who suffer from it (for example it worsens outcome in chronic diseases such as cancer and diabetes).
Therapy over medication
One of the main take-aways from all of the reading I’ve done is that therapy is a better solution than medication. Not only does it offer better results (statistically speaking), but it also spares the human body from going through the nasty side effects that are caused by most drugs that are popular today. These drugs are messing around with neurotransmitters, often causing havoc in other areas of the organism.
Traumatic events trigger PTSD due to an over-reactive adrenaline response that creates deep neurological patterns in the brain. The generation of painful memories will make an individual hyper-responsive to future situations that share some similarities with the original traumatic event. Because information is tightly intertwined in our memory, a lot of unexpected situations can trigger flashbacks and other symptoms of PTSD. In other words, the traumatic event alters the neural pathways in the brain through the use of neurotransmitters. That is why tampering with these neurotransmitters could help in the process of curing PTSD (some form of therapy is probably still necessary).
Even though the trauma (or, in the case of Complex PTSD, repeated traumas over a long period of time) does change the victim’s physiology, this doesn’t mean that engaging in long-term chemical interference in the brain is a good idea. If medication is indeed the last resort, there are other options than getting patients hooked on antidepressants, including proven methods such as short-term treatment with MDMA combined with therapy sessions^.
Medication might still provide benefits but since we know so little about the inner workings of the brain, it’s difficult to decide which patients will be helped and which will be harmed by it (yes, long-term medication can cause lasting side effects). For now, what the studies show is that therapy works best.
The two main types of therapy used to cure PTSD are cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR). Due to a lack of differential studies, it is unclear if the eye-movement component of EMDR is really beneficial, but what is certain is that the therapy aspect of it does help patients. The main difference between CBT and EMDR is that in EMDR the patient usually thinks about the traumatic event rather than talking about it.
Awareness helps cure & prevention
Being aware of what PTSD is and how it manifests itself is imperative for both victims and their friends & families. Knowing that somebody has been through a serious trauma, proper measures can be taken. Early access to therapy has been shown to be of some benefit. Knowledge is empowering.
What is most important however is that those that are close to the victim provide social support, are good listeners, rebuild trust and safety, anticipate and manage triggers (probably sounds easier than it is), deal with volatility and anger (ouch) and take care of themselves (this is very important since helping a person weather the effects of PTSD can be quite taxing).
What could we do if a person hides a traumatic event and suffers quietly? Many of the symptoms of PTSD are easy to spot from the outside: intense distress or irritability, avoidance, bouts of anger, developing a destructive addiction, insomnia, and hyper-vigilance, to name a few. Victims of PTSD should be encouraged to seek professional help, but in a way that does not interfere with their feeling of being in control, which more often than not has been seriously affected by trauma.
The US military has developed certain programs to educate soldiers about PTSD and be able to deal with it on the battlefield. It’s a two-edged sword though, as the same knowledge can prevent a soldier to properly adapt back to life at home. It’s still probably better than the alternative, because veterans suffering from PTSD tend to have serious trouble with social integration^.
An explanation that really stuck with me was the fact that upon return, soldiers may feel that they have little in common with their civilian peers. The daily struggles that concern friends and family seem trivial after having experiencing the horrors of war. I can totally see how war can completely redefine one’s scale of suffering. It does not mean that the soldiers lose empathy, but rather that mundane concerns simply fail to register on their emotional radar.
It’s up to us after all
More often than not, PTSD in humans is caused by humans (natural disasters are one of the few stressors that are not human-related). Be it war, rape, child abuse or social abuse, unfortunately, PTSD is mostly a product of our own society. Therefore, the first line of defense against PTSD is improving our society through education and other means, towards a more peaceful approach regarding our peers and the ecosystem we are part of (respecting and acknowledging our surroundings will lead to less damage from natural disasters).
Sports and physical exercise have also been shown to speed up recovery. Not only does physical stimulate the production of euphoria-generating & pain-releving endorphines^, it also builds self-esteem and increases the feeling of being in control. However, the person suffering the effects of PTSD has to be willing to participate in such activities and that can be difficult while in a hurtful state of mind.
Friends, family and healthcare professionals are the ones that have to encourage the desire to get better within those that suffer from PTSD. The wish to get better is there, what is imperative is that the wish is reinforced from the outside.
Even if some sick parts of our society cause PTSD in our friends and family, the healthy part is fortunately there to clean up the mess. I wish that PTSD will slowly but surely become a very seldom occurrence, just like the savage behaviors that often cause it.
Thank you Markus!
The list of notes I made in the past 22 days is located here: www.mentatul.com/wp-content/uploads/2016/22.txt^