Post Traumatic Stress Disorder (PTSD) is a common, debilitating mental illness found in a variety of populations, affecting up to 8% of people. There is a large deficit in knowledge surrounding the disorder, partly because it is relatively new in the medical field and partly because there is an abundance of misinformation surrounding it. In this article, I hope to shed light on the disorder and break some of that misinformation down.
What is PTSD?
PTSD was first included in the mental health medical manual in 1980. Originally termed ‘shell shock’, so named as it was originally believed to occur as a result of soldiers’ exposure to exploding shells during World War One. It was described as a state of constant panic, including nightmares, fatigue and confusion. Interestingly, Hippocrates wrote about post battle nightmares in ancient times. Today, the modern understanding of PTSD is a heightened stress response as a direct result of a traumatic event, with three main symptoms; re-experiencing the event through nightmares or during waking hours, avoidance of any triggers or situations that may remind them of the trauma along with hyperarousal, and being in a state of constant, heightened anxiety.
Who develops PTSD?
One of the major myths around PTSD is that it only affects soldiers during war time. This is simply incorrect. There are a myriad of groups of people who suffer a variety of traumatic events who can go on to develop PTSD. People who suffer through large world events such as 9/11 or natural disasters, people who suffer sexual abuse or rape, and those who witness traumatic death or illness, are just some of these groups. Research has shown that PTSD is more common in women, however a debate exists around whether those figures are a result of a higher rate of sexual abuse. Children have also been seen to be more vulnerable, as well as adults who have experienced trauma in their childhood.
What’s happening in the brain?
There is still an ongoing debate around the neurology of the disorder. One of the most accepted theories centres around the brain areas that are responsible for integrating short term memories into long term ones for storage. The theory states, in basic terms, that there is a disconnect and imbalance between the processing ability of these parts of the brain, the amygdala, the hippocampus and the anterior cingulate cortex, resulting in the brain fixating on a specific traumatic memory.
Scientists have also discovered that the hippocampus, which processes conscious and explicit memory, tends to be smaller in those with PTSD, than in those who do not. Although, at this point in time there is a classic chicken and egg debate surrounding this, as experts are unsure if that is a result of PTSD, or if a smaller hippocampus increases the chances of someone developing it.
Myths surrounding PTSD
A significant challenge with PTSD, and mental illness in general, are the myths and stigma that surround these disorders. My goal here is to dismantle some of these persistent, harmful misconceptions.
Myth #1: PTSD is only an issue in military populations
The precursor for the development of post-traumatic stress disorder is trauma. There are a variety of different situations that classify as traumas, and whilst this disorder is certainly a significant issue within the military and police force, it also exists for victims of sexual assault, natural disasters, terror attacks, deaths, and more.
Myth #2: PTSD is a sign of weakness
President Donald Trump sparked outrage for alluding that war veterans who struggle with PTSD do so because they can’t handle the trauma of war. This could not be further from the truth. PTSD symptoms are not only psychological, but also physical and neurological. PTSD is a medical condition, which has nothing to do with the character or strength of an individual.
Myth #3: People with PTSD are dangerous
This myth is one that unfairly surrounds a myriad of mental health issues, mainly due a biased portrayal in the media. Aggression is not something that is symptomatic of or even common among those with PTSD. Re-experiencing events is not commonly linked with psychosis, hallucinations or delusions, but more commonly experienced in dreams or intrusive memories of the event.
Current and future research
As PTSD is so newly defined, research opportunities surrounding the disorder are thriving. There are many incredible research projects underway around the world, focusing on the best treatment plans, as well as understanding in more detail the neurology of the disease.
Academics at the University of Newcastle, NSW, are currently working on using magnetic resonance spectroscopy techniques to further study the chemical changes that may occur in the brain of a PTSD sufferer. This study comprises of MRI and MRS measurements being compared between both PTSD sufferers and non-PTSD sufferers, along with questionnaires to measure symptoms. These studies may lead to better medicinal treatment plans for sufferers, as the current psychopharmaceutical treatment options are based on generic anxiety medications such as selective serotonin re-uptake inhibitors (SSRIs) and benzodiazepine medication.
Another large-scale study is currently being undertaken by the University of Melbourne, Vic, in partnership with Pheonix Australia, the centre for posttraumatic mental health. Two studies, IMPACT and RESTORE are working with current and ex Australian Defence Force members who suffer from PTSD to examine to improve current treatment options and create a more condensed, accessible version of existing treatment plans.
Where can I go for help?
There are a variety of resources and helplines available to assist if you are struggling or know someone who is. The Headspace and Beyond Blue websites are two fantastic places to start, with resources and further information on a variety of mental health issues, along with the Lifeline 24 hour crisis support and suicide hotline which can be reached on 13 11 14.
If you are struggling or in need of help, JCU offer a free, anonymous counselling service for students. You can find more information on the JCU website.