Wednesday, July 28, 2010

Cure for Post Traumatic Stress Disorder?

Post Traumatic Stress Disorder is defined in the DSM-IV-TR (468) as being a disorder linked to having experienced a traumatic event, and characterized by symptoms such as hyper vigilance, flashbacks, emotional numbness, avoidance of stimuli associated with the trauma, difficulty sleeping, concentrating, persistent anxiety, etc. (American Psychiatric Association, 2000, /Diagnostic and statistical manual of mental disorders/, pp. 467-468).

PTSD essentially involves a person ingesting a trauma memory that is so emotionally overwhelming  it cannot be processed and grieved normally and instead is just avoided as best as can be managed. The trauma memory does not degrade as normal memories do, but instead stays fresh and intrudes into the traumatized person's awareness in an unwanted, unbidden and very frightening manner.

"Unlike other forms of psychological disorders, the core issue in trauma is reality: 'It is indeed the truth of the traumatic experience that forms the center of its psychopathology; it is not a pathology of falsehood or displacement of meaning, but of history itself" (Caruth, 1995, p. 5).

deVries (1996, p. 409) notes: "The age at which trauma occurs, the social context, and the support and resources available will all influence the outcome."

As reported by J. Kelly, M.A. Birthmother research Project:
That relinquishing a child is a traumatic experience is alluded to over and over again throughout the literature (Barton, 1996; Carlini, 1992; Jones, 1993; Lauderdale & Boyle, 1994; Lifton, 1994; Verrier, 1997). Unresolved grief, guilt, and shame are signatory of many birthmothers (Gediman & Brown, 1991; Lauderdale & Boyle, 1994; Logan, 1996; Stiffler cited in Davidson, 1994)....Van Kepple, Midford and Cicchini (1987, cited in Arthur & Jacobs, 1999) compare the loss of a child by death to the loss of a child through relinquishment and contend that both are significantly traumatic. However, in the former case, there are established outlets for grief reactions; and in the latter, the birthmother "suffers in silence" (p. 17).... Jones (1993) has identified the following traits: unresolved grief, symptoms of PTSD, diminished self-esteem, dual identities, arrested emotional development, self-punishment, unexplained secondary infertility, and living at extremes. Carlini (1992) has defined a set of "core issues of relinquishment" which include: low self-esteem, grieving the loss of the child, forgiving oneself and others, being out of touch with one's feelings, difficulty giving and receiving love, codependency, self-hatred, and dysfunctional sexual problems.

Additionally, Holli Ann Askren MSN, Kathleen C. Bloom, PhD, CNM, “Postadoptive Reactions of the Relinquishing Mother: A Review” Jr. of Obstetric,  Gynecologic, & Neonatal Nursing, Vol. 28 Issue 4 Pp. 395-400, July 1999:
“The relinquishing mother is at risk for long-term physical, psychological, and social repercussions…. Relinquishing mothers have more grief symptoms than women who have lost a child to death, including more denial; despair, atypical responses; and disturbances in sleep, appetite, and vigor.”   
Some of the effects of loss of a child to adoption found by Dr. Geoff Rickarby, Member of the Faculty of Child Psychiatry, New South Wales, include: 
•  Pathological Grief
•  Post Traumatic Stress Disorder
•  Dysthymia and Major Depression
•  Dissociative Disorder
•  Panic Disorder (and other anxiety disorders including situation stress
•  Alcohol and Prescription Drug Dependent Disorder 
•  Disorder and incapacity in human relationships

A Cure?

Doctors have treated the symptoms of PTSD with anti-depressant and anti-anxiety medications. In 2006 Craig Powell, a professor of neurology and psychiatry at UT Southwestern reported: "Corticosterone appears to enhance new memories that compete with the fearful memory thereby decreasing its negative emotional significance,"

A study in the journal Pain Practice reports that Stellate Ganglion Block (SGB), a ten-minute procedure that applies local anesthetic to a bundle of nerves in the neck, proved an effective remedy for this anxiety disorder, potentially offering an alternative to the pharmaceuticals traditionally used to treat the flashbacks, anger, anxiety, and sleep disturbances caused by PTSD. The block has been used for years for pain. when injected into the neck releives nightmares and flashbacks associated with PTSD in soldiers. The effects last six months to a year.

"The way I look at PTSD, it's a biological problem. It's no different than a broken arm," said Dr. Eugene Lipov, medical director at Advanced Pain Center.

The way these injections work is to block the memory of the trauma. This works well for soldiers who have witnessed violence.

Would you trade your PTSD symtoms for loss of memory of the event that caused it? Perhaps forgetting that you relinquished a child? Or that that child even exists?


Von said...

These doctors are great aren't they?It's all so easy with a few drugs!
Adoptees also suffer PTSD although I believe some have 'recurrent memories' rather than flashbacks.

Anonymous said...

Here is another cure for PTSD, MDMA known on the street as Ecstasy. Doubt either erases memory, just makes the patient not as upset about it.

halforphan56 said...

Adoptees have PTSD also. No, blocking the memory of traumatic events is altering one's life. Not a good idea. Facing the trauma and learning to cope are acceptable.

Great post!

Anonymous said...

Blocking the memory of the trauma is not the same as blocking recollection of the event itself.
I have read about this treatment before and although I don't know what kind of success rate it has had, it seems cruel to cock a snook at something that could help people who suffer acutely as a result of terrible life-threatening experiences.
My interpretation is that this treatment was developed to help reduce the intensity of emotional pain triggered by memories of the event, so that those memories can be dealt with in a way that is healthier and less destructive to people's lives. It is not about the "eternal sunshine of the spotless mind".

Mirah Riben said...

I siad soecifically that it would seem to work well for soldiers. I QUESTIONED whether mothers who lost children to adoption would want it. Period.

Does that qualify for "cocking a snook" whatever that is?

Anonymous said...

"Does that qualify for "cocking a snook" whatever that is?"

Well, it sounds dismissive to me. Almost like you're saying it's OK for vets who have lost their peace of mind only as a result of serving their country, but not for mothers who have surrendered, because their pain is a precious reminder of their greater (by implication) personal loss.
Of course, I could be wrong.

"Would you trade your PTSD symtoms for loss of memory of the event that caused it?"

No, because as I interpret it, I don't believe I'd be trading in recall for the "eternal sunshine of the spotless mind".
Your question above implies that the treatment obliterates the memory of the event itself. There is no indication that that's what it is supposed to do.
In fact (Dr. Eugene Lipov, medical director at Advanced Pain Center said "The way I look at PTSD, it's a biological problem. It's no different than a broken arm"), PTSD appears to be a damaging overactive adrenaline response to an extreme situation, and it's that aspect of it - and only that - that the treatment is intended to influence and control.
It sounds to me that what the medication does is block the receptors that are linked to such negative and life-damaging physical reactions such as flashbacks, hyper-vigilance, insomnia, nightmares and panic attacks. What's so bad about that, if it enables a person to process their emotions more effectively - and consequently with less damage to themselves and others?

I think I might have been grateful for such help, especially immediately after reunion when it might have helped me process my thoughts and emotions in such a way that my judgment wouldn't have been impaired and I could have had more thought and consideration for the other people involved.
The trouble with being a loose cannon is that it can cause collateral damage.

Mirah Riben said...

I in no way dismissed anyone's pain or PTSD...war vets or mothers.

Th question I posed was: would you trade loss of memory of the event. I did not claim that any of the treatments do that, it was a hypothetical question.

I recently heard a very intersting quote that applies to many mothers who lost children to adoption:

"Delay is the deadliest form of denial."
C. Northcote Parkinson

And that is shared, too, with no agenda.

Anonymous said...

"Th question I posed was: would you trade loss of memory of the event."
One can only assume you mean trade loss of memory for relief from the symptoms of PTSD, which is what the treatment is intended to do. And then only even temporarily.

If that's not what you meant, why even bother to bring up the treatment, unless as a pretext to frame your agenda?

'I recently heard a very intersting quote that applies to many mothers who lost children to adoption:
"Delay is the deadliest form of denial."
C. Northcote Parkinson '

Fine. But as Hofstadter said "It always takes longer than you expect, even when you take into account Hofstadter's Law."

Anonymous said...

If I were in the kind of pain I have read that PTSD causes, nightmares. flashbacks, inability to function on the job and in relationships, yes, I think I would be interested in any treatment that helped make those symptoms better or even less severe. That would be no matter what caused the PTSD, combat or relinquishment.

Some loss of memory would be a small price to pay for relief from crippling symptoms, but since there is no treatment that can create total loss of memory of a specific targeted event, why even speculate about that? And why in the context of this treatment that does not wipe out the actual memory, just makes it easier to deal with?

Anonymous said...

I highly doubt that no matter what medications or treatments I was given that it would erases the memories of all the traumatic events in my life as there have been a great many spanned over my life. Some relief after suffering from this disorder for over 20 years would be nice

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