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  • Writer's pictureMatthew Meleg

On PTSD and Mental Illness

Updated: Feb 7

I advocate for mental health awareness because I've been diagnosed with PTSD by a military physician.

I pride myself in trying to be as optimistic and logical as I can, but the brain, the human brain, just like all other animal species - is not a perfect machine.

The purpose of this post is not to bum anyone out, and I certainly don't want anyone to feel sorry for me.

But if you are at all curious, read on.

If you're not interested in learning more about PTSD, mental illness or the brain, please move on to less serious posts! :-)

What's PTSD?

PTSD is a mental health condition that can occur after experiencing or witnessing a really scary or traumatic event. In my case, a friend was violently attacked, I was unable to help and had no one to talk to.

People with PTSD might have flashbacks or nightmares about the event, and they may avoid things that remind them of it. In my case, I don't often have nightmares, but without medication I'm extremely edgy, paranoid and avoid going out of the house. I have cyclical obsessive thoughts and feel a great deal of shame and self hatred. Yes, people with PTSD can also feel down, detached, or on edge.

If you think you might have PTSD - It's important to know that there are treatments available, like talking to a therapist or taking medications, to help manage the symptoms and feel better.

The biological mechanics of PTSD

The brains alarm system

The amygdala triggers your natural alarm system.

When you experience a disturbing event, it sends a signal that causes a fear response. This makes sense when your alarm bells buzz at the right time and for the right reason: to keep you safe.

Those with PTSD tend to have an overactive response, so something as harmless as a car backfiring could instantly trigger panic.

The amygdala is a primitive, animalistic part of your brain that's wired to ensure survival. So when it's overactive, it's hard to think rationally.

In my case, it isn't loud noises, but people that set me on edge. And as even headed, self reflective and as logical as I desperately try to be - my amygdala does sometimes take over. Unfortunately, without medication I have a very difficult time socializing with others.

The "brake system" (the logical side of the mind)

The prefrontal cortex (the front-most part of your neocortex) helps you think through decisions, observe how you're thinking, and put on the "brakes" when you realize something you first feared isn't actually a threat after all. The prefrontal cortex helps regulate emotional responses triggered by the amygdala. In people with PTSD, the prefrontal cortex doesn't always manage to do its job when needed.

A bad combination

An overactive amygdala combined with an underactive prefrontal cortex creates a perfect storm.

It's like stomping on your car's accelerator, even when you don't need to, only to discover the brakes don't work.

This might help you understand why someone with PTSD might:

1. feel anxious around anything even slightly related to the original trauma that led to the PTSD. In my case, this is very true. As irrational as I KKNOW my mind is, without medication I am a very anxious and negative and depressed human beings.

2. have strong physical reactions to situations that shouldn't provoke a fear reaction. For me, my heart races, I feel faint, my face flushes red. And I either get ready to fight, or run.

3. avoid situations that might trigger those intense emotions and reactions. In my case, this is very true. From ages 17 to 25 I never left home if I wasn't forced to. I was very mentally sick.

System recall errors

Other common PTSD experiences—such as unwanted feelings that pop up out of nowhere or always being on the lookout for threats that could lead to more trauma—seem to be related to the hippocampus, or memory center of your brain.

The hippocampus is a lot like your computer's memory that writes files to its hard drive. After a trauma, your hippocampus works to remember the event accurately and make sense of it.

But because a trauma is typically overwhelming, all the information doesn't get coded correctly. This means that you might have trouble remembering important details of the event, or you might find yourself thinking a lot about what happened because your hippocampus is working so hard to try to make sense of things. This is very much the case with me, I have an incredibly difficult time remembering things. I leave notes all around my house, and have devised several "systems," to help me become a more organized human being.

Debrief/Bottom line

The amygdala, prefrontal cortex, and hippocampus all contribute to the feelings and actions associated with fear, clear thinking, decision-making, and memory.

Understanding how they work also might explain why some therapies can help you work through PTSD.

PTSD is characterized by four major symptom clusters:

Intrusive re-experiencing: Individuals with PTSD often have recurrent, distressing memories or nightmares related to the traumatic event. They may also experience flashbacks, during which they feel as if the event is happening again.

Avoidance: Individuals may actively avoid reminders of the traumatic event, such as people, places, or activities associated with the experience. They may also avoid discussing or thinking about the event, leading to emotional numbing and detachment.

Negative alterations in cognition and mood: PTSD can lead to negative changes in thoughts and emotions. Affected individuals may experience persistent negative beliefs about themselves or the world, distorted blame or guilt, and a diminished interest in previously enjoyable activities. They may also exhibit difficulties in memory, concentration, and maintaining positive emotions.

Alterations in arousal and reactivity: PTSD often causes individuals to become hypervigilant, easily startled, and irritable. Sleep disturbances, including insomnia and nightmares, are common. Additionally, individuals may engage in self-destructive behaviors and have difficulty concentrating.

To be diagnosed with PTSD, the symptoms must persist for more than a month and significantly interfere with daily functioning. It is crucial to differentiate PTSD from other psychiatric conditions with similar symptoms, such as acute stress disorder, depression, and anxiety disorders. I have had PTSD since 17, which sucks - but I believe that in some ways it has made me a more thoughtful and diligent human being.

Treatment options for PTSD include

  1. psychotherapy and medications.

  2. Cognitive-behavioral therapy (CBT), particularly trauma-focused CBT, is highly effective in helping individuals process the traumatic event and develop coping strategies.

  3. Medications such as selective serotonin reuptake inhibitors (SSRIs) can also be prescribed to alleviate associated symptoms.

My life is both defined by, and not defined by my mental illness. I understand just how irrational, violent, superstitious and insular human beings can be. I understand how the brain can err in judgement - it is NOT a perfect machine! PTSD has made me a more reflective and thoughtful human being because I am always striving to be as rational as I can. In this manner, mental illness has developed a meta-cognitive life-perspective in me. For this I am grateful.

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