PTSD—Post Traumatic Stress Disorder is a syndrome that causes a person to emotionally overreact to normal daily stresses, and to relive the feeling of terror that they felt when they experienced the traumatic experience that left them with this disorder. PTSD occurs in soldiers when they come home from war, or after they were POWs. It also occurs in rape victims for years after they were victim to that crime. People who are victims of abuse, violent circumstances, accidents and trauma often suffer from PTSD the rest of their lives.
Of course, PTSD is categorized as a“psychiatric condition” but like every other psychiatric disease, it is really caused by abnormalities in the secretion and or lack of the brain’s neurotransmitters and hormones. These abnormalities begin with the repeated trauma, and end with an imbalance of chemicals in the patient’s brain. These chemical imbalances cause severe nightmares that blur a person’s grasp on reality, and during which patients have violent reactions which make their partners afraid of them. In general, a patient with PTSD lives with the fear of reliving their trauma and often act out of context with the surroundings. They FEEL like they are caught in a bad dream and are in a state of high anxiety.
Consider what it would be like if you came home from an environment where guns were being shot all the time and your life was in danger minute to minute, and then you hear the backfire of a car or a fireworks show, and it immediately transports you back to the traumatic place where you were constantly in fear of your life. It triggers anxiety and it is hard to tell what is real and what is just a normal “sound”. You might react like you did in your initial traumatic situation and scream or hide in the closet. You actually believe you are experiencing a life threatening circumstance that caused your fear to begin with but know one else knows what is going on inside your head.
My process for exploring a disease or condition, is to learn all of the steps that are taking place in the body resulting in the visible symptoms. I ask myself and research to find where did the disease start and what happened next, until I get to the physiologic external reaction-the symptom that I can see or that the patient relates to me.
In PTSD the first physiologic response begins during the initial trauma when the brain sends a chemical signal to the adrenal gland to make a large amount of adrenaline which causes the heart to race, dilates the pupils, causes us to breath deeper and faster and directs our brain to focus on surviving the trauma, and block out everything else. This heightened state of awareness sends out the hormone adrenaline to the brain which also makes people feel anxious, fearful and combative. This response that can save our life, but after the first incident of trauma, or after many repeated traumatic ones, some people relive the circumstance and continually trigger the adrenaline in their brain and body.
The excess adrenaline triggers low dopamine, the hormone that gives us sexual pleasure, and keeps our brain in the current reality. Without it, PTSD patients generally can’t experience normal sexuality or libido. Because Dopamine also helps with facial expression they often look blank, which is disturbing to others. Recurrent anxiety and elevated adrenaline decreases cortisol production from the adrenal gland which makes these people weak, dizzy, faint, and without motivation.
The last brain neurotransmitter that is affected is serotonin, the feel good hormone of the brain. Depression is a common side effect of PTSD.
The hormone over reaction that is involved in PTSD are as follows:
- Cortisol from the adrenal cortex is low — Low cortisol makes you dizzy, thin, low blood pressure, increases allergies, decreases your ability to tolerate any stress.
- Adrenaline and noradrenaline from the adrenal medulla and brain, is high – These two hormones are the “first responders” and are excessively elevated in PTSD. They increase blood pressure, pulse, anxiety, fear reaction, irritability, and prevent sleep.
- Dopamine from the brain is low — Dopamine is a neurotransmitter from the striatum nigra of the brain. When dopamine is low (as in PTSD) patients have tremors, lose the ability to respond normally to stress and to engage in social situations. They forget things and seem spacey. They also lose their facial expressions.
- Serotonin is low — it is an antidepressant hormone/neurotransmitter in the brain and gut. It decreases sex drive and orgasms when it is low.
In PTSD, every episode of traumatic memory stimulates a neurologic and hormonal “explosion” of adrenaline in the body and brain. That is the first step in the physiologic chain reaction, and research is now available that suggests that blocking the receptors of adrenaline can stop this cascade of neurologic chemicals that surge after adrenaline increases. The name of the class of drug recommended is Beta Blockers, which are approved for high blood pressure and heart disease, but now Propranolol (RX) a beta blocker is recommended for PTSD. This makes sense to me—stop the first step—the adrenaline–i before it causes other hormones to be unbalanced.
This is how Propranolol works for PTSD: When the PTSD response is triggered, adrenaline and epinephrine surge out of the adrenal into the blood to every cell. The pre-treatment with propranolol blocks the receptors for those two hormones and blunts the fear response, anxiety, and all other symptoms of PTSD that usually occur down the line. The drug Propranolol nips the response in the bud. It doesn’t always take a NEW drug to solve a seemingly difficult disease.