A professor reveals 5 surprising facts we never knew about PTSD
Last week, Interesting Engineering organized the first Reddit AMA (Ask Me Anything) with Dr. Sanne J.H. Van Rooij, an assistant professor in Psychiatry and Behavioral Sciences at Georgia's Emory University. In July, we featured van Rooij in a story on amygdala ablation, a neurosurgical procedure in which an MRI-guided laser is used to precisely heat the area that needs to be ablated. According to van Rooij, it is used for treatment-refractory epilepsy.
Now, van Rooij has been studying the effects of stress and trauma on the brain for over a decade and amygdala ablation for years. The amygdala is the emotion or fear center of the brain and is hyperresponsive in post-traumatic stress disorder (PTSD). Van Rooij studied two patients with epilepsy who also had PTSD characterized by heightened fear responses to things that reminded them of their trauma. After a surgery that targeted the right amygdala, both the patients no longer suffered from PTSD.
The AMA went well, and we received some excellent questions from the public. Here are a few insights we gathered from the session.
1. PTSD is usually displayed as a disorder of flashbacks, but this is not the most common symptom
One of the Redditors had asked if there were any character aspects of PTSD that may be underappreciated by the public or healthcare providers. To this, van Rooij said that symptoms could be less explicit, "like unwanted thoughts of the traumatic event, avoiding reminders of the trauma and negative beliefs about yourself or the world." van Rooij added: "Relatedly, PTSD is usually associated with war or sexual trauma, and while the prevalence of PTSD in war veterans or victims of sexual abuse is indeed high, more recent research in the last 10-15 years has shown the prevalence in civilians." Spreading more awareness of these symptoms could help people better understand PTSD and seek treatment accordingly.
2. There is a clear definition between an anxiety disorder and PTSD
Van Rooij stressed that PTSD used to be considered an anxiety disorder but is now classified as a trauma- and stressor-related disorder. This is because "in PTSD, you will need to have experienced a criterion A traumatic event. This is an event in which you feared for your life, were seriously injured or involved sexual trauma, or you can witness or learn about a loved one experiencing this," van Rooij answered to a question that asked if they were just different names for the same thing. However, there are several similarities between an anxiety disorder and PTSD, and "overlapping neurobiological mechanisms and treatment approaches."
3. There is no 'absolute difference' in PTSD symptoms between different types of trauma
Though these are different traumatic experiences that can result in various presentations, there is no absolute difference in PTSD symptoms between different types of trauma. "Someone who has experienced war can have similar PTSD symptoms (for example, symptoms of hypervigilance, unwanted thoughts of the trauma, sleep problems, etc.) as someone who experienced sexual trauma, whereas two people who experienced trauma from war can show very different responses," said van Rooij. As PTSD is a heterogeneous disorder, you could experience PTSD in different ways. It is not directly related to the type of trauma.
4. Constant anxiety from generalized anxiety disorder could have similar effects as PTSD in the brain
Anxiety and PTSD are similar in many ways; there are similar brain regions that are related to the symptoms that individuals experience. Van Rooij cited an example to corroborate her statement: "For example, the amygdala, the emotion center, is hyperactive in both PTSD and anxiety. An important difference is that for PTSD, a trauma reminder triggers a physiological stress response. The prefrontal cortex, which is a regulatory brain region, should regulate your emotions or responses when you are in a safe environment." This is apparently one of the main issues in PTSD.
Patients with PTSD have "strong fear responses" to a stimulus that reminds them of the trauma, even when there is no real danger.
5. Are certain personalities more or less prone to the effects of PTSD? A key question in PTSD research
Van Rooij mentioned that the team is working on a study investigating personality as a predictor for PTSD. Other factors that researchers know contribute to a greater risk for PTSD include more severe trauma. "Women are also twice as likely to develop PTSD after a traumatic event. Then we know that early childhood adversity increases your risk of developing PTSD later in life," she said. Researchers also view this as the adaptability of the brain to the environment one grows up. Van Rooij stressed that the presence of a warm caregiver could mitigate the negative effects of trauma.
In general, when experiencing symptoms of PTSD, it's good to seek a therapist and "discuss the possibility of trauma-focused therapy or explore interventions like mindfulness or resilience training," van Rooij said.
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