PTSD

What exactly is post-traumatic stress disorder (PTSD)?  Recently it has been gathering much attention within the military and veteran community.  It plays a considerable role in the unfortunate statistic of 22 suicides a day.  PTSD from a diagnostic standpoint is considered a psychological disorder under anxiety, but new research is challenging this.  
Common Symptoms:
  • Nightmares
  • Flashbacks
  • Irritability
  • Fatigue
  • Fear
  • Anxiety
  • Decreased Motivation
  • Guilt
  • Insomnia
Any psychological disorder at its core really a neurochemical issue, which is why most traditional treatments are aimed at neurotransmitter levels.  We know from research that PTSD is not purely a neurochemical issue, but results in structural alterations as well.  This would create a basis for it being considered a primary neurological disorder with psychological characteristics.  Why does this matter?

Unfortunately, the majority of individuals diagnosed with PTSD are sent to psychiatrists to be treated for anxiety, depression, and other emotional signs.  This works for a few, but unfortunately, the majority have pervasive symptoms.  By having an understanding that the brain from a structural and functional level plays a role in the development and symptoms of PTSD offers much more promise for treatment.  


Factors Involved with PTSD

Many individuals suffer from traumatic events, but it is estimated about 10% will develop PTSD.  There are many causes such as TBI, concussion, car accidents, and rape.  Below we are going to briefly explore areas of dysfunction: hypothalamic-pituitary-adrenal axis, amygdala and hippocampus, and parasympathetic system.  It is important to note that these systems all interact and influence each other.

Hypothalamic-Pituitary-Adrenal Axis (HPA Axis)

When a stressful event occurs our body will go into a fight or flight response (sympathetic).  During this time epinephrine and cortisol are released.  Epinephrine is what allows for our heart and breathing rates to increase.  Cortisol is responsible for breaking down stored forms of energy.  These responses should only occur during and shortly follow the event.  In PTSD, the response is prolonged.  This leads to release of inflammatory chemicals.  Leading to commonly seen symptoms of anxiety, poor sleep, altered immune system, and fatigue.

Amygdala and Hippocampus

The amygdala is involved in a circuit to process the meaning of stimuli.  The hippocampus is involved in forming memories.  In PTSD, the amygdala is not regulated correctly and designates things as bad.  The hippocampus takes the input from the amygdala and creates a memory of the event.  This is why an individual can have so many triggers such as sight, sound, and smell.  The amygdala hippocampus loop is also involved in the fear response, flashbacks, and nightmares.

Parasympathetic System

As mentioned above the HPA Axis creates a shift to a sympathetic response.  This is the opposite of the parasympathetic (rest and digest).  Normally the higher centers of our brain fire down to our parasympathetic to decrease the sympathetic response.  In PTSD, especially those with a brain injury the higher centers and parasympathetic centers in the brainstem are impacted.  This leads to an overly expressed sympathetic response.


Our Patient Specific Approach

Our staff understands the uniqueness of each patient that presents to our office.  We especially understand the impact of a diagnosis of PTSD when it is only viewed from a psychological perspective.  This is why we perform a comprehensive history, physical, and diagnostic workup on each patient.  To best help you, we need to identify areas in the brain not functioning as correctly.  Lab work is done to assess markers of inflammation and HPA Axis function.

We have a unique environment where you will have adequate time to be understood and have all your questions answered.  Part of our environment is one of positivity and laughter.  Creating this environment will facilitate rejuvenation and healing.  
We have many therapies, diet, stress reduction techniques, and supplements that we use together to help you.  Some of the therapies we use are rTMS (repetitive transcranial magnetic stimulation, hyperbaric oxygen therapy (HBOT), eye movements, sensory stimulation, and balance training.  We are going to explore rTMS and HBOT specifically which allows for our specific brain-based exercises to have a greater impact.

Repetitive Transcranial Magnetic Stimulation (rTMS)

rTMS is becoming widely researched due to its ability to increase our understanding of function as well as therapeutic benefits.  rTMS has the ability to either increase or decrease the firing of areas, which is essential in restoring balance to the brain.  The benefits of rTMS are beginning to be understood on a cellular level.  One of the major influences is the increased production of BDNF (growth protein).  This allows for better connectivity.  rTMS in multiple studies have shown to decrease symptoms and thereby allowing for increased function.

Hyperbaric Oxygen Therapy (HBOT)

HBOT has been shown to increase stem cells and improve cognitive function in those suffering from TBI.  In addition to this, it has been shown to decrease neuron damage, improve anti-oxidant status, decrease inflammation, and increase growth proteins such as BDNF.  Simply put, this creates a fertile environment for the brain to increase in function and ultimately a reduction of symptoms.

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