Post Traumatic Stress Disorder (PTSD) had a somewhat bad rap. When it began being referenced in the early 80’s, it suffered a negative evaluation as a ‘soft disease’ or a syndrome that was not a ‘real illness’. As we know with so many of the chronic diseases that seem to defy diagnosis, early investigations are often met with resistance as information from research and scientific fields filters into the population at large. As a consequence, more people become aware of the nature of these diseases and instead of just brushing them off as ‘a bad day/week/month’ or worse still, choosing not to discuss them in medical circumstances until the unthinkable becomes a reality, people are getting assistance with how to identify, manage and treat these diseases.
PTSD has been recognised as clinical disease since the Vietnam war after science began researching the effects of the war on returning soldiers. There were earlier references to PTSD in journals following other major conflicts including the two World Wars and The Russo-Japanese War , where psychological evaluations of shell shock, soldiers heart and war neurosis (névrose du guerre) began to give rise to the effect of what witnessing massive acts of trauma was doing to soldiers mental state off the battlefield.
Interestingly when soldiers were sent to the Vietnam War, Forward Treatment which came out of the investigations of the preceding conflicts was already in use for many US soldiers. The result was the immediate effects of post trauma neurosis were abated but the longer and more chronic forms took hold long after the conflict with 25% of ALL soldiers from 1964 -73 suffering long term issues of post trauma episodes. This led to more widely spread investigation into PTSD and hence the term was coined in the American Psychiatric Association’s - Diagnostic and Statistical Manual of Mental Disorders in 1980.
What scientists have discovered is PTSD has a very real impact on brain function. The anatomy of PTSD involves traditionally the Amygdala, the Hippocampus and the Pre Frontal Cortex.
The Amygdala, our brains stress meter, determines when we should act in a threatening situation. It rules the Fight or Flight mode and stores the stimuli of sounds, sight, taste and smell so that if these triggers are encountered again, we learn to activate our survival mode. With PTSD the Amygdala becomes overexcited and hypersensitive and thus begins to trigger responses during sleep or during safe situations.
The Hippocampus is essential to memory formation and stores the memory as well as retrieves it and controls the Amygdala response to the memory. It is believed the hipppocampus is overactive in sufferers of PTSD and retrieves memory during times of waking (flashbacks) and during sleep (dreams). This response then excites the amygdala resulting in reliving the trauma during both wakefulness and sleep periods.
Prefontal Cortex lies directly behind the forehead and is also responsible for downgrading the Amygdala response. It tells the Amygdala once the situation has passed that it is ok to calm down. In PTSD, the Prefontal Cortex is said to be underactive and unable to override the hippocampus and communicate with the Amygdala to calm down.
It is not only soldiers that this research has included but also Refugees and Asylum Seekers are included as some of the most affected persons with PTSD. It can also be applied to those who have ‘witnessed’ trauma and not necessarily been involved in the trauma. The advent of large industrial accidents with trains and highly powerful machinery is said to also have been at the advent of this condition at the dawn of the Industrial era.
The brain gets disorganised after Trauma and this affects brain activity and the refined co-ordination of the brain waves. Mirjana Askovic, a psychologist with Service for Treatment and Rehabilitation of Torture and Trauma Survivors (STARRTS) works with people at the extreme end of PTSD and she cites brain wave activity as being fundamentally changed by trauma. “Slow, sleep like brain waves occur during waking hours and hyper-vigilance and excitable waves dominate when the brain is relaxed”. Reliving of traumatic experiences due to the excitability of memory recall and the inability to counteract this with our reasoning centres creates symptoms such as nightmares, flashbacks, severe insomnia and even an inability to control our emotional responses.
A new direction in treatment that Dr Askovic is working with, involves Neurofeedback for PTSD. Dealing directly with retraining brain wave activity rather than just analysing psychological responses through talking. The technique focuses on the neuruoplasticity of the brain and its ability to reorganise itself. Manipulating the way brain waves work in order to overcome the results of disorientation, consciously harnessing the brain wave pattern into the desired calm and slow steady state via computer generated games and activities. This therapy helps with people who don’t want to talk about their experiences and is making real differences with an 80% success rate with the STARTTS program
PTSD is now much more broadly recognised in the medical field and practitioners are now far more aware of the signs and symptoms and quicker to assess potential PTSD patients. Seeking help for traumatic events is always advisable when you are experiencing sleeplessness, anxiety, cognition issues and nightmares. Reaching out to the Black Dog Institute https://www.blackdoginstitute.org.au/ or Beyond Blue https://www.beyondblue.org.au/ is always a good move if you suspect you may be a candidate for PTSD. It’s not something to be brushed off and dismissed and mental health should always be a priority for you and members of your family and community.
