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Hi and welcome to my blog. I’m Jeff Aronson, TheFearMonsterSlayer. In this and future blogs I’ll share some simple, effective and fun tools for managing fear and anxiety. So, welcome aboard!

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THE PHYSIOLOGY OF PTSD

9/28/2015

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"...and the vision that was planted in my brain still remains..."--The Sounds of Silence-- Simon & Garfunkel


In my last post I described some of the traumatic events Odysseus encountered on his ten-year voyage home from the Trojan Wars that, while it wasn't mentioned by Homer in The Odyssey, no doubt left him with a good case of PTSD. So let's look at what was going on in Odysseus'  brain and body when he was shipwrecked, attacked by a sea monster and battling The Cyclops on his voyage.

Physiologically the human brain's reaction to threat hasn't changed in four million years, whether it's a saber-toothed tiger, a Cyclops or a rattlesnake on the trail in front of us. the brain  registers an immediate threat in the environment and initiates a series of emergency reactions before we're even conscious of the trigger and activates the alarm system in the body necessary to flee or battle the threat. The old fight or flight response. By the way, this alarm system is present in all mammals as well.

Humans also have this remarkable ability to intuitively sense danger before we're consciously aware of it. Intuition is knowing something without knowing why. The hair on the back of our neck stands up, we have a feeling that something's just not right so we stop and stand silently on a jungle trail. We ignore this warning at our own peril, sometimes with deadly outcomes. Gavin deBecker describes this compellingly in his book The Gift of Fear (on THEFEARMONSTER's Banned Book List). 

In my post OUR FRIEND THE AMYGDALA I described the mechanics of this system and will go over it again here. When our senses, sight, hearing, smell, touch identify a potential threat, a bear, an incoming vehicle in our lane, the smell of smoke in the middle of the night, a message is sent to the amygdala in the brain. The amygdala is the alarm center, first line of defense that releases cortisol and adrenaline, hormones that kick the body into defense mode.
Heart rate increases, pumping more blood and oxygen to the muscles, respiration increases maximizing oxygen intake. It's a remarkably efficient system whose sole function is the defense and survival of the organism.

However in the case of PTSD the amygdala doesn't always get it right. It forms and stores memory associated with emotional events, collecting and storing as much sensory input such as sight, sound, smell, as it can from the traumatic event. And it has a remarkable memory and can store data for a lifetime. So some time down the road, maybe years later, triggers may occur that kick the amygdala into action. It's always going to error on the side of caution, better safe than sorry even though there may actually be no real threat.

A bank teller who was held up at gunpoint by a robber wearing a backwards baseball cap may re-experience the trauma years later encountering a young man wearing his ball cap backwards in the mall. The amygdala doesn't differentiate between real threat and something as benign as a baseball cap when survival may be at stake.

It's the job of the pre-frontal cortex to objectively assess the possibility of threat and then send the signal to shut down all activated defense systems but information from the senses reaches and is processed by the neocortex milliseconds later so conscious, rational thought always lags behind the alarm reaction.

So PTSD has been with us throughout millennia and will likely be around for a long time in the future. Next time I'll talk about some strategies for combatting PTSD and hopefully lessen its impact. See ya then.

Next Time: PTSD--BATTLING BACK


 


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PTSD-- SURPRISE ATTACK!

9/8/2015

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"Must you have battle in your heart forever? The bloody toil of combat?"--The Odyssey by Homer

PTSD, or Post Traumatic Stress Disorder, has been around since humans first started clubbing each other to death over food sources or fleeing hungry predators. One of its first mentions in literature is in Homer's The Odyssey which chronicles the Greek warrior hero Odysseus'  ten year journey home from the Trojan War somewhere around the 12th or 11th centuries B.C.

As well as the trauma of combat and the deaths of his fellow warriors at the hands of the Trojans, Odysseus encounters continuing terrors on his voyage home such as being shipwrecked, encountering a six-headed sea monster that swallows twelve of his men, a cyclops that eats two of his men before Odysseus slays him. And if that's not enough, when he returns home he's forced to do battle and slay numerous suitors hitting on his wife who's never given up hope that he'll return. Wow! If that's not enough cause for PTSD I don't know what is.

PTSD has been reported by various names in all of our modern wars: "Soldier's Heart" in The Civil War, "Shell Shock" in WWI, "Battle or Combat Fatigue" in WWII and PTSD in Vietnam and now the wars in Iraq and Afghanistan. It was Vietnam and the experiences of Viet vets that really brought PTSD into the forefront of public, government and medical awareness and recognition as a real disorder.

But while combat is most prominently associated with PTSD, it's not limited to that. By its most simple definition by the American Psychiatric Association (APA), PTSD is being personally exposed to or witnessing a life-threatening situation such as a motor vehicle accident, natural disaster, being the victim of violent crime, wild animal attack, to name just a few. It was found that people developed PTSD symptoms watching the 9-11 Twin Tower attacks on TV.

So what are the diagnostic criteria for PTSD as defined by the APA? Symptoms are generally grouped into four types:
* Intrusive memories such as nightmares about the event, distressing memories of the event, reliving the event as if it were happening again (flashbacks).
*Avoidance--Trying to avoid thinking about the event or avoiding places, activities or people that are reminders of the event.
*Negative changes in thinking or mood--Hopelessness about the future, lack of interest in normally enjoyable activities, emotional numbness, memory or concentration problems, inability to experience positive emotions, suicidal thoughts.
*Changes in emotional reactions--Irritability, angry outbursts or aggressive behavior, easily startled or frightened, hypervigilance, always on guard for danger.

The above symptoms are only a few that define PTSD and a certain number have to be present and persist longer than thirty days to be diagnosed as PTSD. A person's boss may have yelled and humiliated them in a staff meeting and, while they were shocked and felt threatened, can't stop thinking about it and are having difficulty sleeping, they do not have PTSD. Remember the life-threatening requirement.

Symptoms may vary in intensity over time and circumstances such as being under stress or running into reminders of the event. A car backfire or balloon popping at a kid's birthday party may cause a combat vet to dive for cover. And people may experience some of these symptoms immediately or shortly after the event or months and even years later. It's still PTSD.

If you have disturbing thoughts and feelings that last more than a month or are getting more severe, feelings of losing control over life or are having suicidal thoughts, talk to a health care professional as soon as possible to prevent PTSD symptoms from worsening. We don't have a time machine yet that can go back and undo the past and delete the traumatic event, but with timely professional help it's possible to control the symptoms of PTSD rather than them controlling us.

Next Time: THE PHYSIOLOGY OF PTSD




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    Hi and welcome to my blog. I’m Jeff Aronson, TheFearMonsterSlayer. In this and future blogs I’ll share some simple, effective and fun tools for managing fear and anxiety. So, welcome aboard!

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