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PTSD

Understanding the History and Development of PTSD

Author| Ben Bobrow, MD

Everyone experiences frustration, and some of us handle frustrations better than others. There is, in fact, a continuum of frustration that goes from handling frustrations effectively, to handling frustrations very ineffectively, and if we can stay in the middle of that continuum then we are really doing pretty well. We all have a metaphorical “frustration bucket.” Some have a small bucket, others have a large bucket, but all of us have a frustration bucket—which can get over-filled.

Post-traumatic stress disorder can be viewed as the end of a trauma continuum.
Each individual responds differently to traumatic events. Like the above mentioned “frustration bucket,” we too each have a metaphorical “trauma bucket.” The size of our “trauma bucket” is determined by several things such as prior traumas, how old we are when we experience traumatic events, a family history of severe traumas and continued exposure to traumatic events.

So just what is PTSD? Mayo Clinic defines it as “a mental health condition that's triggered by a terrifying event—either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.”1

The medical history of PTSD

The abbreviation, PTSD, was a controversial classification coined in the 1980s for use by the American Psychiatric Association as a “diagnosis” code to recognize that a series of emotional and physical symptoms experienced by individuals were the result of trauma and were NOT an inherent weakness of the individual.

On the plus side, this opened new ways for the medical community to relate to the effects of trauma in the individual.

On the negative side, the abbreviation took on the “label” of being a “mental health disorder” as it was officially listed in the psychiatric Diagnostic and Statistical Manual of Mental Disorders (DSM).

Let us look closely at the abbreviation or acronym, PTSD. The elements of this acronym consist of the relationship of the timing (post [after]) of a traumatic event (trauma) to emotional and physical symptoms (stress) experienced in an individual. The expression of these emotional and physical symptoms is then “labeled” as a disorder. The label, PTSD, is in itself a neutral label; however, because it is associated with a label of “mental health disorder” it evokes, in many, an image of individual weakness, lack of strength and/or an inability to be in charge of oneself.

Nothing, of course, could be further from the truth.

When viewed from a neurochemical and neurophysiological output of the brain, PTSD is more appropriately discussed and viewed as a medical disorder much like hypertension is a disorder of the cardiovascular system and diabetes is a medical disorder of the endocrine system. Remedies for high blood pressure, such as relaxation and medications that block the effect of adrenalin (beta-blockers) or diet therapy, exercise and insulin for diabetes are nonjudgmentally accepted by our society and, in fact, are encouraged by society to be used to help decrease the overall cost of medical care.

Unfortunately, in PTSD, the mental health “label” generates a major obstacle of misunderstanding for employers, supervisors and individuals alike.

This is no minor obstacle.

A clearer understanding of how the brain operates in the face of trauma by all parties can mitigate a tremendous amount of suffering, loss of productivity, loss of health and suicide. Symptoms of PTSD are at the end of a continuum of resiliency to decreased resiliency and are a result of how our body is programmed to respond to traumatic events.

How memory affects PTSD

Much has been learned about how our body responds to trauma in recent years by scientists through the use of emerging technologies, particularly, functional magnetic resonance imaging (fMRI).

Since the beginning of the 21st century, functional magnetic resonance imaging research has expanded our knowledge and confirmed much about how areas of the brain process information and store memories.

Our brain utilizes several different areas to store different types of memory. For example, the simple act of riding a bike is reassembled by the brain from many different areas: the memory of how to operate the bike comes from one area, the memory of how to get to our destination comes from another, the memory of the safety rules of the road from another and that anxious feeling when a dog chases us on our bike comes from still another part of the brain.

Memories are handled differently by individuals during traumatic events as a result of how their bodies' chemicals and hormones react in their brains at the time of an incident. For instance, often when a person is seriously injured they may not initially feel pain, or during a traumatic event some people may experience confusion, loss of memory, or even giddiness—all of these responses are the result of chemicals and hormones released in the brain. Traumatic events affect how a person's brain stores (encodes) the memory of an experience. Because of the individual variance of chemical and hormonal levels, traumatic memories can be fragmented (stored in a haphazard manner) and can seem disconnected.3

Have you ever smelled something that brought back a memory from many years ago?

Our brains can suddenly re-experience memories from many years prior just by hearing a familiar song, revisiting a favorite spot or experiencing a distinct smell associated with a memorable event. As you are reading this sentence your brain is actually processing everything you see, feel, hear, taste and smell without you noticing it.

The same thing happens during traumatic events, so it is not difficult to appreciate why, sometimes many years after a traumatic event, that a certain smell, taste or sound associated with the traumatic event, experienced in an unrelated situation, can make the brain replay the traumatic event as if it were really happening right then.

How our brains handle our exposure to trauma depends on what, if any, symptoms we might experience. The good news is much has been learned as to how to best treat symptoms of post-traumatic stress.

Treating PTSD

Because your brain is like no other brain on this planet, the best and only approach to treating PTSD is an individualized approach.

Just as in the treatment of high blood pressure and diabetes, there is no one approach that works for all individuals.

Along the trauma continuum, symptoms from anxiety to night terrors create a feeling of helplessness and rob the individual of their happiness. Happiness is a wonderful indicator of an individual’s resilience. The goal therefore for the person experiencing traumatic symptoms is to be empowered to regain happiness. Very effective treatments are now available to do just that.

The Pain Project is designed to provide a better understanding of issues concerning PTSD. It's also a gateway for immediate contact with those who not only understand your issues but who can empower you to find your best treatment path.

We are here to help, schedule an appointment today with on of our licensed therapists and begin to take back your life!


References

  1. Mayo Clinic Staff. (2015, April 15). Post-traumatic stress disorder (PTSD) Definition. Retrieved from www.mayoclinic.org.
  2. Friedman, Matthew J. (2016, Feb 16). PTSD History and Overview. Retrieved from www.ptsd.va.gov.
  3. Campbell, Rebecca (2012 December 3). The Neurobiology of Sexual Assault retrieved from www.nij.gov.