Ok a follow up post, I can’t just leave it the way it was.
Why do traumatic events trigger this in some people, but perhaps not everyone, and how can it be treated.
So this is obviously complicated, but you will see a web weaved, common things.
Post Traumatic Stress Disorder
Ok, so we know a traumatic event is the cause for this. But why? Why are some more at risk?
It is true, some people are more at risk of developing this disorder. Now this doesn’t mean if you fit in this category that you will be. Perhaps though, chances increase.
So who is more at risk and why?
So the short list first.
long lasting trauma or experiencing trauma before.
suffering from anxiety or depression.
abused as a child.
relatives with depression, or mental health issues.
not having support from family and friends.
There is another factor, and it ties in with some of the above. It is believed that a part of the brain. The hippocampus or more importantly the size of the hippocampus has a lot to do with it. It has been found that people with PTSD have a smaller hippocampus.
So what is the hippocampus?
This part of the brain is tied into the ability to overcome fear and to enable one to store and retrieve memories. People that suffer from serious depression often will have a smaller hippocampus.
Now it becomes complicated, you can be born with a smaller hippocampus but it is possible that stress can cause it to shrink as well. Stress releases Cortisol, the stress hormone. This may damage overtime the hippocampus, killing the cells and reducing its size.
So if stress can damage the hippocampus, some situations can set you up to be at risk. A history of child abuse, or anxiety disorders. Depression, or pre-exposure to a stressful situation, this partially explains why that short list at the top of this post. Long term depression or stress releases more cortisol which is damaging the hippocampus. A childhood of neglect or abuse, or one where perhaps a parent is absent, usually a mother, sets up a long period of stress, where cortisol is released at higher levels.
The hippocampus has receptors on it. Some are for cortisol, to trigger the body into a defensive mode when it senses harm. Some are serotonin receptors, this is to tell the body to relax and calm down. A smaller hippocampus has fewer of these serotonin receptors. So the body doesn’t receive the instructions to calm down and relax.
People that have experienced a serious traumatic event, should seek treatment as soon as possible, earlier treatment is more successful. Not to say treatment at any time won’t be. But this doesn’t just go away, and the longer it festers the more powerful it becomes. This is why after a bad accident/incident, schools will call in therapists to help students deal with the situation, Police and Firefighters as well.
Medications are useful, but therapy is needed. PTSD has bad memories, you don’t want to deal with them or face them. They may even be hidden from you, lurking in you dreams. Your mind hides them from you, giving you gaps in your memory. So you don’t discuss it with people, understandably. A therapist will help you with this. To make you better.
So, what treatments?
Cognitive therapy: working with your therapist to help you deal with the event, how the thoughts from this event are bothering you, how they are enhancing the symptoms. This will help you deal with guilt (many feel remorse or guilt from some events) Anger too and fear. Therapists will help you replace those feelings, to cope with them.
Exposure therapy: To get you to face your fears, to gain control over them. Your therapist will show you that you don’t need to fear your memories. This can be a longer process, but over time stressful memories will not be feared by you. Starting small and working up to the more painful thoughts of the event. Working with some of the memories that are not so daunting, showing you how to overcome these, each step it becomes easier to deal with. Your therapist monitoring your stress during these talks, calming and reasoning with you, not taking things to scary levels. But there may be situations where this is reversed. This is called flooding. To overwhelm you with memories of the event, this is done in a relaxed, safe calming setting, and your reactions monitored, calmed. What this accomplishes is to show you how not to be overwhelmed, how to deal with that. Learning to deal with overwhelming stress in a safe environment.
Relaxing exercises will be taught, breathing exercises. Much like how to deal with a panic attack, as they are very much the same.
EMDR Eye Movement Desensitization Reprocessing. Somewhat new, but some are finding great success with this approach. It is lengthy and worthy of a blog of its own.
Some meds used to treat depression are used. There are many, and they will be monitored for effectiveness and possible side effects, changing them to what suits you best. Paxil, Prozac, Celexa to name a few. These help to raise your serotonin levels. Some meds may be used to prevent the body from breaking down your serotonin.
Medications may be provided to help with insomnia, nightmare blockers.
Antipsychotics to help with dislocation, agitation, paranoia, hypervigilance, to help with those times you seem to break with reality.
Mood stabilizers, tranquilizers for rapid relief to a stressful situation.
Like many mental illnesses. Group therapy is very successful. Finding out you are not alone with your fears, sharing, talking with people that truly understand what you are going through.
Your Therapist will help you discover your triggers and how to cope with them. Work with you to raise your self esteem. Possibly your family will be counseled, so they understand and can also help you. Making communication more open, how do deal with anger and emotion.
This doesn’t happen overnight, treatment can take months or even years. You are worth it though, never hesitate to seek help.
PTSD often accompanies other disorders. They should be treated together, not hoping that treating one will fix the other.
With therapy, openness is very important. Not everyone can read minds. You need to be satisfied with your therapist, to let them know if things are not improving, ask what the goals are, discuss the treatment and be clear on what each phase is trying to accomplish. They are trying to help you, but if you don’t communicate what is working or not, or how you feel, or conceal things…. help will be difficult to provide.
If you are dissatisfied with your therapist, seek another. Don’t give up.