Post-traumatic stress disorder (PTSD) occurs after a traumatic event that may or may not be consciously remembered by the patient. When you experience an event that’s extremely emotional, whether it's a traumatic or happy experience, it triggers a flood of neural chemicals in your brain that permanently implants the memory and creates a very strong neural pathway for re-experiencing that memory.
That's why we tend to remember very emotional events, either good or bad, more than other less-exciting events in our lives. You'll always be able to pick out those emotional moments in life because those strong emotions create this very strong neural pathway.
With PTSD, a patient typically experiences a strong emotional and traumatic event, and they remember very specific sensory details associated with that event. A PTSD patient neurologically associates sounds, lights, visuals and sometimes smells with the terrible event, and when they see, hear or smell those same things they re-experience the event over and over again.
How Does PTSD Lead to Anxiety and Depression?
As we continue to associate simple sounds, smells and other sensory input in our brain with the traumatic event, we experience the original trauma all over again. Pretty soon, it becomes a constant fixture in your life, where you dream about it and you constantly think about it, and that can become very paralyzing.
It’s not a far leap from that experience to developing persistent anxiety and eventually depression. PTSD, anxiety and depression can stop you from doing so many things in your life. These mental disorders can stunt your emotional growth and prevent you from participating in certain social situations. You may not be able to hold a job or maintain relationships with others, either intimately or professionally. You feel very ineffective in your own life.
PTSD Effects Anyone Who’s Experienced a Traumatic Event
Anyone can struggle with PTSD. I see it a lot in my patients, but it isn’t always the result of what we traditionally think of as a traumatic event. Most often, we think of things like people in war, people who’ve been victimized by crime, or people who are victims of physical and emotional abuse.
Smaller things can trigger PTSD in some patients. For instance, it might occur after somebody tries to break into your home or watching the vet put down your favorite pet. PTSD can result following traumatic events for the population at large or something that happened only to you. If the event is traumatic to you, your reaction can potentially lead to PTSD.
Symptoms of PTSD
The big hallmark of PTSD that separates it from other anxiety and depression type disorders is re-experiencing the situation, often with small stimuli triggering the event. A soldier who experienced wartime battle may hear a loud noise that resembles gunfire and re-experience the wartime event. A rape victim may struggle to form intimate relationships with others based on a certain touch triggering the traumatic crime. Also, patients can experience re-occuring nightmares. That neural pathway becomes so strong it’s even active when we’re sleeping.
When PTSD patients are reliving these events, they experience acute symptoms associated with panic or anxiety, such as rapid heartbeat, sweaty hands, tremors, racing thoughts, trouble breathing, and feeling like you are going to die. The chronic symptoms of PTSD can lead to chronic anxiety, insomnia, constantly being in the fight-or-flight state, always feeling like you’re on edge, emotional dysregulation and clinical depression.
PTSD Treatment Options
There are traditional treatments for PTSD and some new things on the horizon. Traditionally, we use lots of different therapy techniques. Exposure therapy is one of the most widely used, where you slowly, in a very safe environment (usually a clinical setting), re-expose patients to small pieces of the trauma so they can re-experience that event.
PTSD patients can also be treated with traditional anti-depression and anti-anxiety medications, which help change the patient’s neurochemistry, so they don't have these big physical reactions to certain types of sensory input or reminders.
A relatively new therapy used by PTSD specialists is called Eye Movement Desensitization and Reprocessing. EMDR is an integrative psychotherapy approach that directs the PTSD patient to attend to emotionally disturbing material in brief sequential doses while simultaneously focusing on external stimuli. I’ve had good success with referring patients to therapists in the Indianapolis area who specialize in EMDR.
If you feel like you’re experiencing the symptoms of PTSD, anxiety or depression, please reach out to me at Olp Family Medicine of Carmel or call 317-343-0611.