Health and Post Traumatic Stress Disorder

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Physical Health and Post Traumatic Stress Disorder

The presence of trauma in post traumatic stress disorder overly stimulates the activity of the sympathetic nervous system (Shalev, 2000), resulting in abnormal levels of the neurotransmitters norepinephrine, epinephrine, and dopamine (Yehuda & others, 1992), not only in the brain, but also within the body, as evidenced by the presence of noradrenaline in urine samples of people with PTSD (Davidson & Baum, 1986). Over activation of the sympathetic nervous system in post traumatic stress disorder is also related to increased heart rate and high blood pressure. Thus, people with post traumatic stress disorder are at risk of several heart problems, including heart attack and heart failure. Furthermore, these measures are also easily induced. In one study, combat veterans with PTSD were played war tapes, and they reported increased subjective distress, and showed higher heart rate, blood pressure, and epinephrine levels (McFall, Murburg, Ko & others, 1990). [See also: How Does Stress Affect Health?]

Mental Health and Post Traumatic Stress Disorder

Patients with post traumatic stress disorder exhibit a pattern of psychological deterioration, especially those who received severe physical and mental abuse (Siegel, 1984). First, they attempt to fight the stressor, but the defensive reactions are mostly weak, inappropriate, and may even be exaggerated. Then, they become desperate. Coupled with altered brain metabolism, they may experience hallucinations and delusions. If the stressor persists, they may become violent, and then become apathetic, that is, a feeling of desensitization over the stressor.

Nightmares are also profoundly affected in PTSD. Post traumatic stress disorder caused by traumatic events that are related to physical harm, such as natural disasters, accidents and violence tend to result in nightmares revolving around the theme of the trauma. For example, college students who experienced the 1989 Loma Prieta earthquake in San Francisco significantly had more nightmares (and these nightmares are often about earthquakes) than did a control sample (Wood & others, 1992). Martin (not his real name), who survived a jet crash, also reported dreams closely related to the accident (Perlberg, 1979).

PTSD can also precipitate the development of other disorders, such as clinical depression and substance abuse (Brown, Stout & Mueller, 1999). Around 16 percent of people with PTSD have a comorbid disorder, and around 54 percent have three or more other comorbid disorders (Kessler & others, 1995). This is because the trauma in PTSD can serve as a predisposition to further stress (Mazure, 1998; Metalsky & others, 1982). Indeed, people with PTSD are characteristically irritable and short-tempered (Marks, Yule & De Silva, 1999). This low tolerance for stress can precipitate alcohol abuse in people with PTSD (Rutledge & Sher, 2001).

The Trauma in PTSD

Other health effects of post traumatic stress disorder are specific to the type of trauma experienced. Common traumatic events that precipitate PTSD are death of a loved one, rape, and war and military combat.

Post traumatic stress disorder resulting from the sudden and unexpected death of a loved one (Kim & Jacobs, 1995) is often associated with negative health effects, such as eating problems (loss of or increased appetite) and suicidal thoughts (Prigerson, Bierhals, Kasl, Reynolds & others, 1997). The fact that the stressor is irreversible, that is, one cannot bring back the dead, could mean that the only way to cope is to let the time pass away. For some people, time is enough to heal, as with cases of unipolar depression resulting from PTSD (Monroe & Hadjiyannakis, 2002) that lasts for at least a year; but for some, depression can last for even 5 years (Boland & Keller, 2002).

Post traumatic stress disorder in rape victims, particularly women, showed marked deficits across a range of functioning (McCann & others, 1988). Rape victims are often physically disturbed, and report feeling anxious for most of the day. They also tend to be emotionally unstable, are often depressed, and tend to exhibit low self-esteem. Their cognitive ability is also diminished; most report an inability to concentrate due to intrusive thoughts stemming from the attack. They are also more likely to view themselves and others negatively, or more aptly, helplessly, thinking that anyone is susceptible to rape. Antisocial behaviors, such as shows of aggression and hostility, and substance abuse, are also common. Lastly, rape victims are also prone to having relationship problems, especially concerning sex and power distribution.

Combat-related post traumatic stress disorder varies according to the level (or type) of exposure in war. Civilians living in war zones can also develop PTSD, and the most common symptom associated with it is anxiety (Zeidner, 1993; Schwarzwald & others, 1993; Weizman & others, 1994). Post traumatic symptoms associated with exposure to combat violence include intrusive thoughts, anxiety, apathy, and cognitive problems, such as concentration and memory difficulties; and these symptoms, including depression, are present in those who were not only exposed to violence, but also participated in it (Laufer, Brett & Gallops, 1985). Soldiers who handled corpses, on the other hand, tend be more angry, anxious, and complain of physical problems (McCarroll, Ursano & Fullerton, 1995). Prisoners of war are at higher risk for developing severe post traumatic stress symptoms. Besides the symptoms associated with war, POWs typically sustain severe damage in both physical and psychological functioning, including headaches (mostly due to head injuries), sexual impotency (as a result of contracting infectious diseases, diarrhea (mostly caused by malnutrition), suppressed immunity, and severe adjustment problems, such as low tolerance to stress, substance abuse, and inability to control anger (Barrett, Resnik, Foy & Dansky, 1996; Chambers, 1952; Goldsmith & Cretekos, 1969; Hunter, 1978; Sigal & others, 1973; Strange & Brown, 1970; Warnes, 1973; Wilbur, 1973). POWs are also nine times more likely to die from tuberculosis, four times more likely to die from gastrointestinal problems, and two times more likely to die from cancer, heart disease, and suicide, in the first six years after release, compared to typical civilians (Wolff, 1960).

PTSD Treatment

There are several treatment methods for PTSD (or stress in general) that are currently available. In short-term crisis therapy, the potential PTSD client is given emotional support and encouraged to talk about the experiences during the crisis. The therapy is brief and focuses only on the crisis as the stressor. Research shows that short-term crisis therapy can open the gates for easier stress adjustment (Butcher & Hatcher, 1988).

Post disaster debriefing sessions are usually for delayed PTSD clients. The results of these sessions are still immeasurable and controversial because most are supervised or facilitated with people who do not have sufficient mental health background, although some reported that the sessions were helpful.

Direct-exposure therapy is beneficial for people with established PTSD. In this process, the client is forced to face the object of fear, a stimulus associated with the traumatic incident (McIvor & Turner, 1995). Telephone hotlines serve as a means to an end. They aim to convince the caller to seek professional help. The good thing about telephone hotlines is that they provide the anonymity that people with PTSD need, as they tend not to seek any sort of treatment for their problem (Weisaeth, 2001). Lastly, antidepressants may be prescribed to relieve such symptoms of PTSD as depression, intrusive thoughts and nightmares, and social avoidance (Marshall & Klein, 1995; Shaley, Bonne & Eth, 1996).


  1. Barrett, D. H., Resnick, H., Foy, D. W., & Dansky, B. S. (1996). Combat exposure and adult psychosocial adjustment among U.S. Army veterans serving in Vietnam, 1965-1971. Journal of Abnormal Psychology, 105(4), 575-81.
  2. Boland, R. J., & Keller, M. B. (2002). Course and outcome of depression. In I. H. Gottlib & C. L. Hammen (Eds.), Handbook of depression (pp. 43-57). NY: Guilford.
  3. Brown, P. J., Stout, R. L., Mueller, T. (1999). Substance use disorder and posttraumatic stress disorder: Comorbidity, addiction, and psychiatric treatment rates. Psychology of Addictive Behaviors, 13, 115-22.
  4. Butcher, J. N., & Hatcher, C. (1988). The neglected entity in air disaster planning: Psychological services. American Psychologist, 43, 724-29.
  5. Chambers, R. E. (1952). Discussion of “Survival factors…” American Journal of Psychiatry, 109, 247-48.
  6. Davidson, L. M. & Baum, A. (1986). Chronic stress and posttraumatic stress disorders. Journal of Consulting and Clinical Psychology, 54, 303-8.
  7. Goldsmith, W., & Cretekos, C. (1969). Unhappy odyseys: Psychiatric hospitalization among Vietnam returnees. American Journal of Psychiatry, 20, 78-83.
  8. Hunter, E. J. (1978). The Vietnam POW veteran: Immediate and long-term effects. In C. R. Figley (Ed.), Stress disorders among Vietnam veterans. NY: Brunner/Mazel.
  9. Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. B. (1995). Posttraumatic stress disorder in the National Comorbidity Study. Archives of General Psychiatry, 52, 1048-60.
  10. Kim, K., & Jacobs, S. (1995). Stress bereavement and consequent psychiatric illness. In C. M. Mazure (Ed.), Does stress cause psychiatric illness? Washington, DC: American Psychiatric Association.
  11. Laufer, R. S., Brett, E., & Gallops, M. S. (1985). Dimensions of posttraumatic stress disorder among Vietnam veterans. Journal of Nervous and Mental Diseases, 173(9), 538-45.
  12. Marks, M., Yule, W., & De Silva, P. (1999). Post-traumatic stress disorder in airplane cabin crew attendants. Human Performance in Extreme Environments, 4(1), 128-32.
  13. Marshall, R. D., & Klein, D. F. (1995). Pharmacotherapy in the treatment of posttraumatic stress disorder. Psychiatric Annals, 23(10), 588-89.
  14. Mazure, C. M. (1998). Life stressors as risk factors in depression. Clinical Psychology: Science and Practice, 5(3), 291-313.
  15. McCann, I. L., Sakheim, D. K., & Abrahamson, D. J. (1988). Trauma and victimization: A model of psychological adaptation. Counseling Psychology, 16, 531-94.
  16. McCarroll, J. E., Ursano, R. J., & Fullerton, C. S. (1995). Symptoms of PTSD following recovery of war dead: 13-15 month follow-up. American Journal of Psychiatry, 152(6), 939-41.
  17. McFall, M. E., Murburg, M. M., Ko, G. N., & Veith, R. C. (1990). Autonomic responses to stress in Vietnam combat veterans with posttraumatic stress disorder. Biological Psychiatry, 27(1), 1165-75.
  18. McIvor, R. J., & Turner, S. W. (1995). Assessment and treatment approaches for survivors of torture. British Journal of Psychiatry, 166, 705-11.
  19. Metalsky, G. I., Abrason, L. Y., Seligman, M. E. P., Semmel, A., Peterson, C. R. (1982). Attributional styles and life events in the classroom: Vulnerability and invulnerability to depressive mood reactions. Journal of Personality and Social Psychology, 43, 612-17.
  20. Monroe, S. M., & Hadjiyannakis, K. (2002). The social environment and depression: Focusing on severe life stress. In I. H. Gottlib & C. L. Hammen (Eds.), Handbook of depression (pp. 314-40). NY: Guilford.
  21. Perlberg, M. (1979). Trauma at Tenerife: The psychic aftershocks of a jet disaster. Human Behavior, 49-50.
  22. Prigerson, H., Bierhals, A. J., Kasl, S. V., Reynolds, C. F., et al. (1997). Traumatic grief as a risk factor for mental and physical morbidity. American Journal of Psychiatry, 154(5), 616-23.
  23. Rutledge, P. C., & Sher, K. J. (2001). Heavy drinking from the freshman year into early young adulthood: The roles of stress, tension-reduction drinking motives, gender and personality. Journal of Studies on Alcohol, 62(4), 457-66.
  24. Schwarzwald, J., Weisenberg, M., Waysman, M., Soloman, Z., & Klingman, A. (1993). Stress reaction of school-age children to bombardment by SCUD missiles. Journal of Abnormal Psychology, 102, 404-10.
  25. Shalev, A. Y. (2000). Biological responses to disasters. Psychiatric Quarterly, 71(3), 277-88.
  26. Shaley, A. Y., Bonne, O., & Eth, S. (1996). Treatment of posttraumatic stress disorder: A review. Psychosomatic Medicine, 58, 165-82.
  27. Siegel, R. K. (1984). Hostage hallucinations: Visual imagery induced by isolation and life-threatening stress. Journal of Nervous and Mental Disorders, 172(5), 264-72
  28. Sigal, J. J., Silver, D., Rakoff, V., & Ellin, B. (1973). Some second-generation effects of survival of the Nazi persecution. American Journal of Orthopsychiatry, 43(3), 320-27.
  29. Strange, R. E., & Brown, D. E., Jr. (1970). Home from the wars. American Journal of Psychiatry, 127(4), 488-92.
  30. Warnes, H. (1973). The traumatic syndrome. Mental Health Digest, 5(3), 33-34.
  31. Weisaeth, L. (2001). Acute posttraumatic stress: Nonacceptance of early intervention. Journal of Clinical Psychiatry, 62, 35-40.
  32. Weizman, R., Laor, N., Barber, Y., Selman, A., Schujovizky, A., Wolmer, A., Laron, Z., & Gild-Ad, I. (1994). Impact of the Gulf war on the anxiety, cortisol, and growth hormone levels of Israeli civilians. American Journal of Psychiatry, 151, 71-75.
  33. Wilbur, R. S. (1973). In S. Auerbach (Ed.), POWs found to be much sicker than they looked upon release. Los Angeles Times, Part I, p. 4.
  34. Wolff, H. G. (1960). Stressors as a cause of disease in man. In J. M. Tanner (Ed.), Stress and psychiatric disorder. London: Oxford University Press.
  35. Wood, J. M., Bootzin, R. R., Rosenhan, D., Nolen-Hocksema, S., & Jourden, F. (1992). Effects of the 1989 San Francisco earthquake on frequency and content of nightmares. Journal of Abnormal Psychology, 101, 219-24.
  36. Yehuda, R., Southwick, S. M., Giller, E. L., et al. (1992). Urinary catecholamine excretion and severity of PTSD symptoms in Vietnam combat veterans. Journal of Nervous and Mental Diseases, 180, 321-25.
  37. Zeidner, M. (1993). Coping with disaster: The case of Israeli adolescents under threat of missile attack. Journal of Youth and Adolescence, 22, 89-108.