PTSD Is A Physiological Response, Not Mental Illness

Warriors who return from combat bring to our collective attention consequences of facing danger and remind us how it can transform the brain’s “wiring.” It is possible and crucial to know how to  successfully “re-wire” it.

Anyone, not just uniformed warriors, who experiences a life-threatening event, and who has an overwhelming sense of helpless terror, can develop posttraumatic stress disorder. Examples in civilian life are plentiful:

a car accident (whether or not there were casualties), rape, child abuse, natural disaster. In these and similar situations invoking a sense of powerlessness in the face of a life-threatening event, our incredible brains produce a flood of biochemical reactions to help meet the crisis. The sympathetic system gears the body up to respond to danger, allows us to take action in the form of immediate fighting or fleeing. The heart rate increases, blood pressure rises, and senses are acutely attuned to the present details of the danger. This is normal, healthy, and amazingly effective in promoting survival.

This flood of biochemicals washing over the brain instructing the body to be agitated, is called a sympathetic response. It has a counteraction, the parasympathetic response, which calms that flood of “action” hormones and brings our heart rate, blood pressure, and sense of safety back to pre-crisis level. The parasympathetic system, then, returns the body to stasis.

Posttraumatic stress disorder is diagnosed only in the presence of several criteria. The first to consider, after exposure to a perceived threat to life and the sense of helplessness, is time. For up to six months after a traumatic event, most everyone will still have somewhat elevated levels of stress hormones. Again, this is a natural and healthy, though not necessarily pleasant response. It is common to be fearful, to have bad dreams, to feel disconnected from loved ones…for awhile. Eventually, these symptoms fade and the person returns to life as, almost, normal.

After that time, though, if the individual’s response systems do not return the body to stasis, but instead fluctuate between being on high-alert and being in an overly “calm” mode, his or her sympathetic and parasympathetic nervous systems need to be addressed therapeutically. High alert, when the danger itself is not present, may take the form of anger, irritability, agitation, jumpiness, inability to sleep peacefully, substance abuse, with unbidden memories of the incident. Its counter system intended to calm, may evidence itself with social isolation, dissociation, lack of focus and inability to concentrate, and a loss of interest in previously enjoyed activities.

 Not everyone who lives through a traumatic event develops posttraumatic stress disorder. And it is not the event itself that determines posttraumatic stress. It is, instead, the mind and body’s physiological response systems that, once learned, do not return to stasis. This is not mental illness, though it may look and feel like it. Neither is this a lack of character or faith. It is a physiological response gone automatically into overdrive.