PTSD: Maybe This Will Make Sense, or Maybe Not

PTSD: Maybe This Will Make Sense, or Maybe Not
Suzanne Salhab Dermatologist Temple Terrace, Fl

Dr. Suzanne A. Salhab, is a multi-specialty Medical Physician, board certified by the American Board of Family Medicine, American Board of Multi-Specialties, and Board Certification in Addiction Medicine by the American Board of Addiction Psychiatry and American Society of Addiction Medicine. She recently opened up a brand... more

PTSD AKA Post-Traumatic Stress Disorder is not a mental illness. It's an injury to the brain, causing psychological symptoms that lead to significant changes in the brain as a result of trauma. Diagnosed, and even worse, undiagnosed, PTSD is confusing, and understanding your own mind is confusing. Recent studies show that major areas of the brain change due to the traumatic event causing severe symptoms; The Amygdala, the ventromedial-prefrontal cortex, the prefrontal lobe, and the hippocampus. 

  • The prefrontal lobe is responsible for language and expressing thoughts
  • The amygdala is responsible for regulating your emotion
  • The hippocampus is responsible for remembering things like memory and experience assimilation
  • The Ventromedial prefrontal cortex controls the way you react and respond to a situation

So if you think about it:

  • PTSD victims suffer from finding the right words to express how they feel and think. Why? Their frontal lobe has been affected, therefore disrupting their ability to function through words. 
  • PTSD patients cannot control their emotions and often are triggered into what can be almost said as "overdrive", or as many say, freaking out more than normal. Why? The amygdala which regulates emotion increases in size after a traumatic event, causing this.
  • PTSD patients experience short-term memory loss. The hippocampus, which is responsible for memory, shrinks after a trauma, so less space for you to remember. 
  • PTSD leaves you frightened no matter what you're doing, and of course, "It's okay, calm down" usually makes things worse, but why? And the worst part is you can't nor will you ever be able to "just calm down". Why? because your prefrontal cortex, which regulates emotions and fear responses, can no longer function properly post-trauma. 

The hippocampus, when it functions normally, takes a memory and blends it with other elements of another memory, creating short-term memories that make sense. Once it's damaged, you no longer have "conscious memories" so these short-term memories are then processed into other parts of the brain, creating long term-memories. So, as said before, the hippocampus shrinks in volume with PTSD, so this change distorts the ability of the brain to distinguish between new and old memories. Therefore, PTSD makes you lose your ability to discriminate between the past and present experiences, causing flashbacks. 

So, you've lost your ability to distinguish the past and present, and then you also have damaged the area that regulates negative emotions or fear. The ventro-medial prefrontal cortex is supposed to regulate your negative emotions, or as you say, control one's fear. Once trauma occurs, it shrinks, therefore the ability for one to regulate that negative emotion is reduced, so if you can't regulate something like fear, of course you're going to have an extreme stress response, an anxiety to not only triggers, but even if things are not connected, you still get the "exaggerated fear response". Can you help it? Nope.

We can't distinguish memories causing flashbacks; we can't control negative emotions, so flashbacks of the trauma of course would make you have an episode, or even without a flashback you tend to have these anxious panic episodes you can't control and don't know why. Well, it may have to do with the amygdala, which after a trauma, becomes hyperactive. Under normal circumstances, the amygdala controls/regulates an emotional response. Trauma causes increased activity in this region. So what's the link? The amygdala and hippocampus "talk to one another" so the distorted hippocampus is normally using the hippocampus to access certain situations, especially from the past, to trigger the normal: "Do I like this? Is this safe?"

So a hyperactive region is using a distorted other region of the brain to respond to a situation. It would only make sense that PTSD would cause you to suffer from extreme fear and anxiety, as it cannot regulate emotion as well anymore during a normal stimuli, and of course, throw in the triggers causing flashbacks from the broken hippocampus, and an amygdala that already causes fear from normal  situations. No wonder PTSD victims not only cannot think straight, but if they do get flashbacks, and no longer can control themselves, the amount of fear and stress they now exhibit makes perfect sense. 

With PTSD, you can't think properly and can't regulate your emotions due to damage of the prefrontal cortex. No matter what. Even if you're just sitting there, you may experience extreme fear for no reason and can't help it. So basically you live in fear or feel frightened almost 99% of the time because of this change, combined with the flashbacks due to short-term memory loss mixing with long-term ones, giving you distorted thoughts. 

So, in summary, you're in fear 99% of the time due to the damage it caused in one area. Then during the day, every day, your brain is creating memories that are mixing together and causing you to have all these weird crazy flashbacks, and you have no idea why. So you're living in fear already and feel like you're pretty much crazy. To have another part of the brain that's damaged to make a response even if it was fear to be so horrible, you think your life is in danger. So you can't help the fact that you feel like you live in fear because you need your frontal lobe to be alive, and if you're alive, it's normal for your brain to function and make memories, so now all these short-term, long-term memories are constantly mixing together without your consent, making you feel crazy and scared, but then that triggers your other part of the brain that's also damaged whether you like it or not.

It's not a mental illness; it's a traumatic event that leads to a traumatic injury that you will live with for the rest of your life. No one understands it unless they have PTSD as well. Others who do not know about PTSD will only say things to make things worse because they will never get it. Some will think you are crazy for the way you react to certain things, yet they have no idea that you have 0% control over it. This leads you to feel even more crazy. This is all day, all night, and will forever affect the rest of your life. There is no cure. 

For all the victims of PTSD, I understand; say no more. For the supportive ones that do not have PTSD, but do their best in reading about it and not saying "stupid things," I thank you for that and for helping out your loved one. For those who don't know anything about it, yet are the first to make negative comments about someone with PTSD, even though that makes me so mad, PTSD is so horrible; you would not wish it upon your worst enemy. So please watch what you say. Seriously. 

PTSD will always haunt the victim. The victim may not be able to control it, but hopefully they have a good physician that educates them that their response is normal and that they are not crazy. You cannot undo PTSD.

However, uneducated people could be educated more about PTSD, because so many victims that suffer from this are surrounding by these negative people. Symptoms maybe helped in the sense of avoiding triggers to reduce the huge amount of fear you get, and even without a trigger, but that's it. However, after writing this and thinking about it, a huge change would be focusing on educating people without PTSD, and not just slightly educating them. Multiple times. You cannot heal a wound that's not been properly closed and never will, and still people without PTSD will never understand the way a victim feels, but knowing what to say or how to respond during a certain situation would change the world. More than you'd ever think possible.

To all the victims of PTSD, it doesn't matter whose trauma's worse; victims all end up at the same endpoint and suffer. I understand. I get it. You are not crazy. It's okay that you act or feel that way. Never feel like you're not normal. You are a human being. Life will continue this way, but there's many that get it. Surround yourself with others that have PTSD because for some reason, they get it too. And for some reason, you'll actually feel sane and happy around them. Trust me.