The True Toll of Trauma

Medical CareSo, late last night, I mentioned to a friend of mine an idea to do an entire week of blog posts about mental health issues, and how mental illness is also a physical illness that is just hidden from plain sight. He loved the idea. We’ll see how it goes. Today, I want to talk some more about PTSD and some of the other changes in physiology that occur. For obvious reasons, this topic is potentially triggering, as I will be discussing various forms of trauma. Continue at your own risk.

Most people who are exposed to a trauma never develop PTSD. Rape victims, for example, may show PTSD like symptoms within a couple of weeks of the occurrence, but after even 30 days, most will no longer have those same symptoms. This is because there are biological factors which predispose someone to having PTSD. One of the most telling signs of PTSD (predisposition to it or actually having it) is reduced volume in the hippocampus region of the brain – a region that has strong ties to memory and emotion. A study conducted in 2002 by a number of researchers including Mark Gilbertson followed monozygotic (“identical”) twins, one of whom went off to fight in Vietnam and the other who did not. When examining the brain structures of the twin who did NOT go to war, they found that the twin also had reduced mass in the hippocampal region, just as their PTSD possessing sibling did.

However, other studies have shown, both on humans and monkeys, that long term stress causes more and more damage to this region of the brain. Combat veterans who have seen the most combat have the greatest decrease in this region, as do children who grew up abused. However, this isn’t the only part of the brain that is affected. The amygdala is also affected. Firefly fans may remember the episode where Simon takes River to the hospital on Ariel to figure out what the Alliance did to her. If not, there’s a video of that scene here. While this scene is right in mentioning that the amygdala is tied to emotion, they’re wrong in the belief that it’s what allows you to suppress emotions. Quite the opposite, in fact.

The amygdala is where the most potent signals for emotion in the brain come from. Had they really stripped the amygdala from River’s brain, rather than being incapable of regulating her emotions, she would be incapable of feeling anything, especially fear and anger (the two emotions we see most often from her). In PTSD sufferers, the amygdala is increased in size. More importantly, the part of the brain that allows for suppression of emotion in most people (the prefontal cortex) is damaged in PTSD sufferers. In other words, in the case of River, what they would have removed to make her incapable of regulating her emotions would be the prefrontal cortex. So what does this all mean? It means that PTSD sufferers experience pain, fear, and anger far more acutely than your average person, and because of the damage to their hippocampus, the way their memory works is rather disconcerting as well.

I like to say that I have a terrible memory, yet this statement is neither true nor false… it’s a bit of both. In those who have a fully functioning hippocampus, when confronted with someone or something that is similar to a negative or even traumatic experience, their memory is clear enough that they are able to distinguish the differences between the two situations, and because they have a fully functioning prefrontal cortex, they are able to suppress the rush of fear that might come up because of the similarity. However, in PTSD victims, any similarities are enough for the hippocampus to cause them to remember the original incident, and because of the changes to the amygdala and prefrontal cortex, the PTSD sufferer experiences that same fear, pain, and/or anger all over again.

However, this can be taken a step further. Remember how I mentioned yesterday that the chemical changes brought about make even the smallest thing just as severe to someone with PTSD as a life-threatening incident? Well, that means that even events that aren’t technically traumatic can become traumas because of the way the brain works.

For an example of this, think back to a few weeks ago, when I mentioned having a super horrible day in class. The sheer level of stress brought about by that class, though not life-threatening to anyone, was treated as a life-threatening event by my brain. As such, now, even the thought of attending that class brings back those memories of that day, and thus the stress, pain, and anger caused by it. To borrow a double-negative from Simon earlier, I can’t not remember that day, and likewise, I can’t not feel that pain and anger. And this carries over to other things as well.

Last night, even after all of the other stressors, pain, etc. I’d dealt with during the day, I had to end up staying up all night to watch over one of my cats. See, shortly after getting home, I caught him eating a bug next to one of the ant traps we keep in the kitchen windows. Not sure if this was a fly he chased up there or some ants he caught coming out of the trap, I had to watch over him all night to ensure he wasn’t poisoned. However, because of all of the stress of the day, I needed something to help calm my nerves, so I had a cup of catnip and chamomile tea. It calmed me so much that I was struggling to stay awake, so my roommate, sure that my cat would be fine (he ended up being right, by the way), suggested I go to sleep. I told him about how when I was a teenager, my dog Anya passed away during the night without my being able to say goodbye, and after having explained to him earlier much of what I’ve said today and yesterday here, he understood this was not something I could let go, so suggested I take a nap while he watched the cat and then waking me before he went to bed. Try as I might, I could not sleep, with every creak of the house causing my heart to run, and the memories of that loss bringing me to tears. I was incapable of not remembering that loss and pain, but also incapable of not feeling them either.

So the next time you think that someone with PTSD just needs to “get over it,” stop yourself. Take a moment to remind yourself that they literally cannot get over it, it has forever changed their brains to such a way that it will be with them always. Therapy can help develop the skills to cope with the memory, fear, anxiety, etc. but one will never be truly cured of PTSD. Even now, as I look at maybe going back into the military after graduation, I have to be aware that trauma will always follow me.

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