Article by Siân Quipp ~ Published in the Winter 2013 issue of Perception – The Cognitive Hypnotherapy Review.
Most people associate PTSD with soldiers in battle but any overwhelming life experience can trigger it, especially if the event feels unpredictable and uncontrollable. Adversity is inevitable, it is estimated that 75% of us experience some form of trauma in our lives. However, 20% go on to develop PTSD.
How do I know if I have PTSD?
Following a traumatic event, it is normal to have bad dreams, find it difficult to stop thinking about what happened and feel fearful. For the majority of people, these symptoms are short lived and can last days or even weeks before they eventually lift. With PTSD people don’t feel better over time and can often feel worse.
What is PTSD?
When we are under threat our amygdala raises the alarm, we go into flight or fight stress response. This involves large amounts of adrenaline being released causing the heart to pound, a rise in body temperature and increased respiration. Blood is diverted from our stomach to our limbs to help us to run or to fight. Who hasn’t experienced an upset stomach, palpitations or sweating when they are nervous or stressed?
In traumatic experiences, blood flow is reduced to our rational thinking part of the brain and the amygdala takes over, helping us to respond rather than think about it. This happens before the neocortex, the rational thinking part of our brain, has time to add information. An increase in the stress hormone cortisol prevents the hippocampus from being able to communicate properly with the amygdala to create narrative for an event – such as ‘we were driving in the car and lost control due to the icy road.’ As neuroscientist Joseph LeDoux puts it: “strong emotions makes us stupid.”
Without context or narrative from the neocortex and the hippocampus, the amygdala takes a low resolution snapshot of the event and anything remotely like it should be avoided at all costs, so in the above example, cars or forms of transport might be avoided not just icy roads. It pattern matches a situation in the present with a past threat, which results in factors such as sounds, colours, or smells, that may only have peripheral connections to the event, becoming triggers for the stress response. As we’re not consciously aware of how our brain is pattern matching, the triggers seem to come out of the blue, which can cause a person to be hyper vigilant as there is a feeling of constant danger which causes people to avoid situations that might trigger the same reaction. Without context, pattern matches from an event in childhood can still trigger a stress response as an adult if the memory hasn’t been processed.
The British Psychological Society defines the symptoms of PTSD as:
- Flashbacks and nightmares – re-experiencing of trauma in a vivid and distressing way.
- Avoidance of reminders of trauma – such as activities, places or people.
- Being on high alert – anxious, exaggerated startled response, sleep problems.
In PTSD as the amygdala is still on high alert there are many innocent events that trigger the stress response; ‘re-living’ of the event continues this means that the stress levels don’t get low enough for the hippocampus or neocortex to add context or narrative. If we think of PTSD as an over stimulated defence response then the symptoms – flashbacks, avoidance and being on high alert- make sense.
How PTSD develops depends on the person, it can happen in the first month but can take months or even years to develop. Later development can cause confusion, ’why is this happening to me now?’