The Biological Basis of PTSD

Post-Traumatic Stress Disorder (PTSD) is an anxiety disorder that occurs after a person experiences a traumatic event. PTSD can be the result of combat, abuse, assault, a natural disaster, an accident, or a terrorizing event (DSM-5). Symptoms can include a person reliving the event so much so that they live their life on guard as if they expect the event to reoccur. They may even isolate themselves socially so that they avoid reminders of the event. Sometimes people with PTSD develop anxiety, become depressed, or turn to drugs to escape.

Psychological distress following exposure to a traumatic or stressful event with or without fear-based symptoms can vary. A combination of symptoms has been recognized in the DSM to include adjustment disorders marked by reactive attachment disorder and social engagement disorder that can develop into PTSD. The DSM includes diagnostic criterion for trauma and stress related disorders such as reactive attachment disorder, disinhibited social engagement disorder, post-traumatic stress disorder, acute stress disorder, and adjustment disorders. Clinical characteristics of anhedonic and dysphoric symptoms resulting from demanding situations or the inability to feel pleasure because of circumstances are shown in the DSM-5 for both children and adults. The DSM considers direct and witnessed exposure to actual or threatened death, serious injury, or sexual violence leading to reoccurring involuntary, and intrusive distressing memories of the trauma. Flashbacks and other disassociative reactions are also listed to make the diagnosis.

These reactions to fear can cause problems in relationships and at work so what is happening? Neurobiological and physiological changes happen after a traumatic experience in the central and autonomic nervous systems. The brain rewires itself to cope with the experience by decreasing the volume of the hippocampus and activating the amygdala. The brain begins to act differently in an abnormal way so that processing memories is affected that can result in physical behavior that cause the body to act as if it is reliving the experience. These behaviors may cause other physical damage, but more research has to be done to find out what the physical and medical effects of PTSD actually are.

If symptoms are persistent and last for more than a month, a doctor can diagnose PTSD by gathering medical history and completing a physical exam on the patient. The physical exam rules out any physical causes of the symptoms.  After ruling out any physical or medical reasons someone shows symptoms of PTSD, the doctor can then refer the patient to a psychiatrist, psychologist, or other mental health professional that is specially trained to assess and use tools to evaluate a patient for PTSD.

Treatment for PTSD can involve both medication and counseling with the goal of reducing symptoms to help the patient cope and make daily life manageable. Psychotherapy can be used with both the patient and the family to teach new coping skills and to help work through the symptoms of PTSD. Patients that attend individual, group, and family therapies have better outcomes than patients that attend individual therapy or do not seek treatment at all. Medications may include serotonin inhibitors (SSRIs) such as Paxil, Celexa, Luvox, Prozac, and Zoloft; and tricyclic antidepressants such as Elavil and Doxepin, mood stabilizers such as Depakote and Lamictal, and atypical antipsychotics such as Seroquel and Abilify are sometimes used to control feelings of anxiety. Blood pressure medicines such as prazosin or propranolol are also sometimes used to control nightmares.

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Patty

I love life and people. I am a daughter, mother, and a grandmother.

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