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Biology 202
2004 First Web Paper
On Serendip

Fear and Anxiety: Post-Traumatic Stress Disorder

Amy Gao

Almost all of us, at some interval in our lives, will come to experience emotionally perturbed events such as bereavement of a loved one, violence, sudden disaster and other similar events that seem to spin our lives out of control. Even though time eventually may help to dim the memories of such tragic events and many people will come to terms with and accept these losses, many individuals may remain emotionally scarred from their experiences.

Post-traumatic stress disorder, or PTSD, is an anxiety disorder associated with the reactions that an individual has in response to a dramatic emotional event. The incident can be one that has directly affected the individual or one that the individual has witnessed. In adults, symptoms for the disorder include flashbacks and dreams associated with the event, feelings of detachment or estrangement from others, noted diminished interests in activities that the individual once avidly participated in.(1)

It is estimated that PTSD may affect 3 percent to 6 percent of adults in the United States(1), which account for around 5.2 Americans. (4) Women are twice as likely to be afflicted with this syndrome as compared to men, and reports indicate that substance abuse and other anxiety-related disorders may occur concurrently with PTSD.(4) Studies have also indicated that individuals who have had histories of emotional disorder, substance abuse, anxiety, and being part of a dysfunctional family, may be predisposed to PTSD more than other people who have not had such histories.(1)

One example of what triggers PTSD would be the tragic events on September 11, 2001. Indisputably, all of us have experienced some state of shock and disbelief at the horrendous acts committed, and some of us more than the others. Take, for instance, the study conducted that found high levels of PTSD found in New York residents who lived in the vicinity of the World Trade Center, which also found that the farther away from the disaster epicenter, the lesser the incidence of PTSD.(3) This appears to suggest that the closer an individual is to the disaster scene or related to it, the higher chance of the individual being afflicted with PTSD.

In addition to the aforementioned symptoms that may be exhibited by victims of PTSD, some studies have found that there is an association between poor physical health and PTSD. It has been found that individuals who are afflicted with PTSD are more likely to have physical health problems than those who do not have the disorder. (2) The research so far seem to suggest that for those who are not in the prime of their physical health, they are either more vulnerable or more perceptible to be diagnosed with PTSD. Further exploration of the causation and affect link between the two is necessary, since the data that support this theory have only come from veteran populations.

Researches that attempted to correlate PTSD with the brain have focused on the areas in the brain that are believed to be involved in anxiety and fear, which is an emotional response that is triggered when the individual faces danger. Studies have found that the amygdala, a complex structure inside the brain, is responsible for the fear response that activates many of the body's protective mechanism. Therefore, if the previous assumption holds true, it should stand to reason that if the amygdala malfunctions in some way, the results could lead to anxiety disorders, one of which includes PTSD.(4)

PTSD victims also have been found to secrete uncharacteristic levels of hormones when they respond to stress. Opiate is a substance that assists in pain-relieving that is produced when people are in danger, and it has been found that PTSD patients have maintained a high level of opiate even after the danger has passed, which may be associated with the dissociative disorder that is also observed in individuals afflicted with PTSD.(4) Moreover, it appears that cortisol, a steroid hormone released from the adrenal cortex during stress that prepares the individual to deal with the stress factors and insure that the brain receives adequate energy sources are lower than normal.(5) Epinephrine, which is secreted by the medulla, is also known as the "fight-or-flight" hormone that is responsible for increased metabolism and norepinephrine, a neurotransmitter that is released during stress to activate the hippocampus, which is the section of the brain that is responsible for long-term memory, are found in higher levels than normal in PTSD patients.(4) Therefore, deducing from the information above, if an individual is under extreme stress, it can be reasoned that norepinephrine (since it has been found to be present in high levels even after the moment that triggered the response has passed) may have a stronger impact on the hippocampus, which may explain the reason why individuals with PTSD often have recurring flashbacks.

There are many ways to rehabilitate a PTSD patient. Treatments for PTSD include anti-depressive medication that may help in reliving some of the symptoms exhibited by PTSD, behavioral therapy that focus on rehabilitation of PTSD-onset behavior and family therapy that work with the families of PTSD patients who may have been affected by the patient's PTSD-behavior.

PTSD is one way that an individual responds to extreme stress under traumatic events. If diagnosed in time and treated properly, it is an illness that can be successfully cured. Though further research will be necessary to observe if other parts of the brain play parts in the abnormal hormone levels secreted in patients with PTSD and more concrete evidence are needed to correlate situations in which an individual may be more pre-disposed to PTSD than others, this disorder is not so shrouded in mystery as many other mental disorders are anymore.

References

(1)The Mayo Clinic, The Mayo Clinic on PTSD

(2)National Center for Post-Traumatic Stress Disorder

(3)National Institute on Drug Abuse, National Institute on drug abuse, depression, PTSD, substance abuse in crease in wake of September 11, 2001 attacks

(4) National Institute of Mental Health, The National Institute of Mental Health on PTSD

(5) Medline Plus Medical Encyclopedia, Medline Plus Medical Encyclopedia on definition of cortisol


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