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By: Daniel Sznajderman
In general, PTSD victims suffer from reduced quality of life mainly because of
intrusive symptoms that do not let the individual function but rather affect them into
a state of constant fear, nervousness and trauma.
Hyper arousal: reminders of the trauma experienced can cause flashbacks, causing instant
panic and fear. This re-experience can appear thanks to memories, nightmares, sudden
flashbacks that lead to bigger and more complete ones, and thoughts. Other ways of getting to
this point are trough the fear of the individual's own reaction: normal body signals such as
accelerated heartbeats become danger signals that then connect with the trauma.
•Numbness
•Insomnia
•Depression
•Anxiety
•Disconnection
from others
•Bursts of
anger
Symptoms of PTSD are likely to cause
Other problems such as depressive disorders,
Social phobia
These symptoms can endure from monts to a lifetime
The actual history of the existence of PTSD dates as
back as man does: The risk of exposure to trauma was
most likely the same for ancient man afraid of a wild
animal attack as it was for modern man afraid of a
terrorist attack, because both would experience the same
psychological problems having survived such traumas.
Although PTSD has existed over the years, it has been classified as a companion to disorders
such as anxieties and depressions, or given other names, such as shell shock, that
nevertheless did not cover the whole concept of PTSD.
PTSD is prove to affect 10% of American
The actual
women and 5% of American men
concept of
PTSD was
approved in
1980 by the
American
Psychiatric
Association and
classified as a
mental disorder.
PTSD has been
reviewed
intensively in the
years of 1980,
1894, 1994 and
2000
Nations worldwide who have most cases of PTSD
are Vietnam, Cambodia, Rwanda, Bosnia, Algeria,
Ethiopia and Gaza
PTSD concept starts of as a traumatic event experienced that acted a big stressor that was outside of
normal human experiences ( .i.e. Nazi concentration camps, wars, earthquakes, plane crashes).
Therefore, PTSD is not the diagnosed for those who experience more ¨normal ¨ expereineces such
as divorce, rejection or financial problems etc. These would be called ¨Adjustment disorders¨
Apart from the obvious fact that a patient must experience an abnormal traumatic event and show
signs of PTSD symptoms, PTSD studies stress on the fact that not all individuals cope with
situations the same way, which makes the difference when explaining why some people don't get
PTSD from a situation or why some get it worse than others.
The ¨risk factors¨ or,
steps of PTSD are:
There are no key theorists or discovers of PTSD, but more
contributors:
Pre-traumatic-Behavior
of the person before the
experience
Gallup (1977), Levine (1997), Van der Kolk (1994), Nadel
and Jacobs (1996) have been some of the contributors the
biological perspective of PTSD
Traumatic-the moment,
short or long, of the
event
Bremmer (1992) and Marmar (1994) are pioneers in the
studies of dissociation as a predictor to PTSD
Post traumatic-After the
moment, where PTSD
and its symptoms show
up
Pynoos (1993) is the pioneer in PTSD in children and
adolescents
Rothschild (1996) is leader in the studies of Psychoanalytical
solutions and origins of PTSD
Risk of acquiring PTSD come mainly form outside experiences that affect the brain/mind. However,
studies have shown that there are possibilities to get PTSD more easily genetically: The genes of a
certain parent whose abilities to cope with a problem easily fall to PTSD can ensure that the children
are also quite vulnerable
Since PTSD is initiated by traumatic events, the brain and nervous system are key for
these events to do their work in PTSD:
Arousal is mediated in the Limbic System located in the center of the brain, it is this
system which are in charge of primitive human responses, including the task of survival.
It also plays a key role in memory. Already we have two characteristics that relate with
PTSD: Survival emotions and situation Reponses, the ones that most work in dangerous
traumatic events, and memory, the factor that will keep traumatic evetns sin our minds
after they are over.
The limbic system in interconnected with the Autonomic Nervous system, in charge of
regulating heart beats, kidney, lungs and other physical changes in the body. This ANS has
two branches, the Symphatic, which deals with arousement and stress, and the
Parasympathetic, which deals with body reactions in moment of relax and no
arousement. These always work alone, never both at the same time.
Now we see a combination of psychological survival instincts, their connection with what
makes us change physiologically and the effect it has on our memory, its easy to see the
result:
TRAUMATIC UNUSUAL EVENT
Lymbic system activates primitive survival responses
Leads to stress and fear
Is responded by the ANS, who controls phsyyiiological changes
Sympathetic branch and Parasympathetic
branch because of overwhelming stress start
working both at the same time, resulting in a
freezing of the body
This overwhelming traumatic event
combined with the malfunctions of the
ANS stays in the memory, affecting the
person after the event is experienced
After the damage is done....
MRI studies on the brain of PTSD patients have successfully
shown biological differences between affected and not affected
people....
PTSD patients, thanks to sustained stress, create abnormalities in the Hippocamus ( key in
memory) by reducing Hippocamus volume. This is mainly cause because hippocammal neurons
are deformed because of a release of neurotoxic amino acids.
Most PTSD patients have problems in blood flow to the amygdala, therefore not making it
function right, something logical because the amygdala works in basic emotions and basic
memory, both of who are amplified in PTSD .
As can be expected, PTSD patients also decreasing workings in the parietal lobe, also key in
emotions.
In the case of PTSD, the eitiology of learning and behavior
are most often put together because of their similiraties
concerning this mental disorder
It is also clear in the part of these two perspectives that PTSD must be a traumatic unusual event.
Specifically, a traumatic experience filtered trough a cognitive, emotional and behavioral process
called appraisal.
Since the cognitive process is one that says that behavior can be understood, and therefore largely
works, in processes between an environmental stimulus and a behavioral response, then it is easy to
understand the connection: PTSD is an environmental stimulus that affects the inside (.i.e. memory,
information processing, the cognitive perspective) and trough our own brain processing we give a
behavioral response to this (the behavioral perspective, some stimulus form the outside changes our
behavior). And this behavioral response, backed dup by the cognitive processes of the brain, gives as
a result the symptoms and sickness of PTSD
Because PTSD has with it certain symptoms that are disorders, such as depression or anxiety,
biologic remedies for this have been a mix of finding drugs that work for these more well known
disorders but also products that can treat PTSD altogether, as a unique disorder.
These complicated drugs used for PTSD symptoms are meant to help in circulation in the amygdala,
hipocammal volume and parietal lobe functioning.
There is not a definite drug for PTSD. However, other drugs to treat its symptoms can lower
them , giving the patient less of a bad time and more importantly, opportunity to go to
cognitive-beahvioral treatments.
All these tests have been carried out with different types of antidepressives targetting depression,
anxiety and insomnia. The main antidepressives are imipramine, amitriptyline, phenezine and
fluoxetine. Other tests have been carried out with different approaches using antiadrenergic agents
such as clodinidess and propranolol.
Biological treatments vary with PTSD patients. This thanks either to each persons special
functioning or the level of gravity they have of PTSD
In the case of PTSD, the learning and cognitive perspectives work together as for treatments.
Exposure therapy: is mostly talking and writing about the traumatic experience like psychotherapy.
After expressing and remembering such thoughts, the patient becomes habituated to them: the
patient learns to accept the memories without seeing them as threats.
Another type of exposure therapy focuses more on behavioral techniques: though cognitive therapy
is used to bring back memories and feelings, behavioral techniques such as flooding and ¨behavior
training¨ of anxiety and relaxation.