Mike Rosmann: Survival mechanisms go awry in PTSD casesIn many ways, post- traumatic stress disorder is a normal response that has gone haywire. The initial trigger situation might be: the explosion of a bomb alongside an Afghanistan road; severe farm financial pressures, such as loan foreclosure; getting hit on a highway by a drunken driver whose vehicle swerved into your lane; or any severe traumatic event.
In many ways, post- traumatic stress disorder is a normal response that has gone haywire.
The initial trigger situation might be: the explosion of a bomb alongside an Afghanistan road; severe farm financial pressures, such as loan foreclosure; getting hit on a highway by a drunken driver whose vehicle swerved into your lane; or any severe traumatic event.
Traumatic events are dangerous to our physical or emotional well-being and elicit distress.
In 1915, Dr. Walter Cannon, a Harvard University physiology professor, demonstrated how we deal with threatening situations by avoiding the threat or confronting it. He called this the “Flight or Fight Response.”
Later, Dr. Martin Seligman, a University of Pennsylvania psychologist, added a third response – “Freeze.” Also called learned helplessness, to freeze is to become emotionally paralyzed and unable to do anything.
Stimuli that remind us of the threatening event (e.g., loud noises that remind the soldier of a roadside bomb exploding, a friendly chance encounter with a bank official that reinstates foreclosure fears or becoming upset when you are driving down the same highway where the drunken driver wrecked your vehicle and injured you) trigger alarm reactions.
Becoming alarmed is meant to protect us. But when we overreact and become alarmed unnecessarily by non-threatening events only because they remind us of the initial stressor, we have developed PTSD.
Even bad dreams can trigger distress.
Our physiological and psychological reactions to stress comprise what is called the Arousal-Depletion Cycle. Also called the General Adaptation Syndrome, the phases of the cycle include:
- We appraise a situation as threatening because it can harm us in some way.
- Our nervous system becomes aroused by a flood of neurotransmitter chemicals (chiefly adrenaline), which prepare us to take flight from the threat, fight the threat or to freeze.
- Our muscles tense, our heart speeds up, blood pressure increases and our senses sharpen, such as our pupils dilate to take in visual information. In short, we are alert and alarmed.
- Our nervous system tries to resume a state of normalcy after the threat dissipates, or because we appraise the situation as no longer threatening, have taken flight, fought the threat or became emotionally helpless and froze, afterwards. Our adrenal gland secretes cortisol. This helps us recuperate and prepare for the next threat.
It allows muscles and pupils to relax, our heart to slow down and makes us feel tired. It encourages the accumulation of fat reserves for future emergencies.
If no additional threats occur, our nervous system is able to produce serotonin and norepinepherine. These are essential transmitter chemicals that give us a sense of well-being, increase our tolerance of pain and help us to relax.
Each time another threat triggers our alarm, the connection between the stimulus events and our reaction of flight, fight or freeze strengthens.
Sometimes the threats are real, such as repeated deployments to war zones and further exposures to intermittent explosive devices. We might endure further legal actions stemming from bankruptcy or we might encounter another erratic driver.
But when we can’t stop ourselves from reacting unnecessarily to triggers that aren’t really dangerous, we have acquired a learned bad habit. Essentially, PTSD is habitual but unnecessary repetition of the arousal-depletion cycle.
Just like multiple stressors wear down our ability to cope physiologically and psychologically, repeated exposures to triggers – whether real or learned bad habits – result in fatigue and chronic depletion of serotonin and norepinepherine. We become exhausted and depressed.
Even our immune system can become compromised in its ability to ward off disease. PTSD, with its accompanying depression, contributes to an increased risk of suicide.
We can grow so weary of the repeated cycles that we want only to escape what seems like endless torment.
What can we do when we have developed PTSD?
PTSD seldom goes away on its own. The most effective treatments include relearning how to manage ourselves, usually with the assistance of a trained and experienced professional caregiver, so we don’t incorrectly interpret every reminder of the initial threat as dangerous.
Anti-anxiety medications often are needed to gain control over our physiological reactions. Relearning works best when we feel safe, understood by those who are assisting us and have others to coach us through rough times.
Next week, I will follow up with more information about resources for farm people dealing with PTSD, including returning soldiers, who originated from farm and rural backgrounds.
As you may know, soldiers who trace their origins to farm and rural life are disproportionately represented among our militia.
Dr. Rosmann is a clinical psychologist and farmer; he lives near Harlan, Iowa. For previously published columns and his recent book, “Excellent Joy: Fishing, Farming, Hunting and Psychology,” see the website www.agbehavioralhealth.com.