Two bombs explode yesterday in the crowded streets near the finish line of the Boston Marathon. Three people are killed, including an 8-year-old watching his father run, and more than 130 are injured. But there are thousands that will leave the race with posttraumatic stress symptoms. Although not all will develop what we define today as Posttraumatic Stress Disorder, an understanding of PTSD is crucial these days with the increase in terrorist attacks and mass shootings in this country.
Here are five things you should know.
1. The Numbers
- Approximately 7.7 million American adults age 18 and older, or about 3.5 percent of people in this age group in a given year, have PTSD.
- PTSD can develop at any age, including childhood, but research shows that the median age of onset is 23 years.
- About 19 percent of Vietnam veterans experienced PTSD at some point after the war.13 The disorder also frequently occurs after violent personal assaults such as rape, mugging, or domestic violence; terrorism; natural or human-caused disasters; and accidents.
- About 60% of US adults experience at least one trauma in their life.
2. The Symptoms
Symptoms of PTSD vary widely. The most common include:
- Reliving or re-experiencing the event, either as flashbacks – where you feel as though you are going through it again – or as nightmares or night terrors.
- Avoiding situations that remind you of the event.
- Feeling numb, unable to express emotions and an inability to discuss parts of the trauma.
- Feeling keyed up, jittery, angry, paranoid, or irritable—a state called hyperarousal.
3. The Genes
Understanding how fear memories are created may help us to refine or find new interventions for reducing the symptoms of PTSD, according to NIHM. PTSD researchers have pinpointed genes that make a protein called stathmin. According to one study mice that did not make this protein did not freeze in response to danger and were less fearful of exploring open spaces. Also relevant is gastrin-releasing peptide (GRP), a chemical released in the brain during emotional events. In mice, this chemical helps to control the fear response. The 5-HTTLPR gene, which controls levels of serotonin (a brain chemical that fuels a fear response) influences fear memories.
4. The Old and New Brain
The almond-shaped structure knows as the amygdala plays a central role in emotion, learning, and memory. Part of our older, primal brain, it’s most active when we experience fear, which was essential to survival back when our ancestors were running away from apes, but not so helpful now in the middle of Manhattan, where we sit crippled with fear of being killed by a bomb. Our prefrontal cortex, on the other hand, is the more sophisticated part of our brain that is involved in decision-making, problem-solving, and judgment. Within this anterior part of the front lobes of the brain lies an opportunity for recovery from fixed memories.
Cognitive Behavioral Therapy
The most effective treatment today for PTSD is cognitive behavioral therapy, a kind of counseling that involves meeting with your therapist once a week for up to four months. The purpose of CBT is to identify distorted thoughts and replacing those thoughts with more accurate, less distressing thoughts.
Exposure therapy attempts to help the person face that which he is afraid of and gain control of the fear and distress. Depending on the kind of trauma, different variations can be used: “flooding” in which a person confronts the trauma memories all at once, or “desensitization,” which is a more gradual approach.
In eye movement desensitization and reprocessing, a person talks about his memories while focusing on other stimuli like eye movements, hand taps, and sounds. According to Francine Shapiro, Ph.D.: “In EMDR therapy, the emphasis is on allowing the information processing system of the brain to make the internal connections needed to resolve the disturbance. So, the person only needs to focus briefly on the disturbing memory as the internal associations are made.”
Selective serotonin reuptake inhibitors (SSRIs) like Celexa, Prozac, Paxil, and Zoloft have also proved to be helpful in the treatment of PTSD, especially when taken in combination with CBT.