On Facebook recently, I was tagged to comment on a thread in
which someone remarked in passing that "PTSD caused [unnamed relative] to
do [inappropriate act]."
Clearly I am highly abridging the text for the person's
privacy, but I was tagged in to comment on the idea that PTSD caused the
behavior. This is a common tendency in
popular culture – from the movie "Rambo" in which PTSD 'caused' the
character John Rambo to commit violent acts, to the dangerous medical tendency
to consider PTSD as a 'mental disorder' as an excuse to deny fundamental
rights. Given that PTSD is of
considerable research interest to me, I have adapted my comments to the current
blog and installment of The Lab Rats' Guide to the Brain:
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PTSD is a disorder with strong physiological basis that
result in effects generally revealed through personality. It is characterized by memory disorder
(flashbacks or triggered memory with a strong emotional content), generalized
anxiety, hypersensitivity to certain audiovisual or sensory stimuli reminiscent
of the traumatic stress event, depression (sometimes bipolar), attention
deficit, etc. Further, there is an alteration
in how brain and body react (physiologically) to future stressful
incidents.
We now know that PTSD in particular, and stress in general,
result in a change in the normal balance of neurotransmitter and receptor
subtypes. There are 7 primary
neurotransmitters and about a dozen secondary neurotransmitters, and as many as
15 distinct receptor subtypes for each neurotransmitter - thus the balance
of neurotransmitter synthesis and release, as well as the ratios of receptors
and their regulation are important to brain function.
It is no more accurate to state that PTSD caused a
person to commit rape than it is to say that depression caused a person
to suicide or that schizophrenia caused a person to commit murder. Rather, imbalances of mental state alter the
"censor" that each of us has regarding actions that are or are not
socially acceptable. We all have random
thoughts and urges that we (usually) immediately set aside because we know that
such urges are inappropriate. However,
when the "censor" is affected, the urge is not immediately
suppressed.
Virtually everyone has had the urge - when wronged by
someone - to take revenge. The
schizophrenic, literally being of "split mind." does not apply the
social norm and commits some act of violence.
We get temporarily depressed and think "What if I weren't
here? So-and-so would really
regret it then!" The normal person
gets a cup of coffee or a cigarette and moves on to other things, but the
depressed person acts on the impulse and commits suicide. The PTSD reaction is much more likely to
manifest in the realm of anxiety and stress (especially
"over-reaction"). A sleeping
person rolls over and touches his/her companion, startling them awake and
triggering a violent PTSD-related response resulting in an ER visit for broken
nose and concussion. A non-sensitized
person simply rolls over and goes back to sleep, but for the PTSD sufferer, the
"filter" that says "home" & "safe" never
really engages, and all sudden events are perceived as possible threats.
Now, it is possible for a person to have more than one
disorder, such as anger disorder plus PTSD or schizophrenia plus PTSD. With such combinations we do speak of
the disorder 'causing' the behavior,
but again, it is not the PTSD, but the underlying condition that 'allows' (not causes) the person
to act on impulses that they would ordinarily ignore or suppress. The terms "psychopath" and
"sociopath" have fallen out of favor among psychologists and
psychiatrists – favoring instead the catch-all term "personality
disorder." However, the older term
both refer in common to individuals that do not understand or care about social
norms – or at least care whether their actions violate those norms.
The choice to commit an act of exhibitionism or violence was
not itself caused by the PTSD.
Having PTSD may have allowed the person to act on the
impulses. Having another type of
psychological or personality disorder would certainly compound the
problem.
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The reason researchers and psych types stress these issues
is that it is very important to understand all of the contributing
effects (and consequences) of an action.
Successful treatment of a mental disorder requires that medical
professionals accurately describe which symptoms and actions are due to which
disease – that way, as treatment progresses, they know which effects and side
effects are appropriate.
On the other hand, a diagnosis of PTSD is often a stigma,
often resulting in loss of respect, jobs, family and even certain rights as a
citizen. Partly this is because of
misdiagnoses, and part due to the tendency to attribute any and all
"bad" behavior to PTSD. We owe
it to our soldiers and fellows not to abuse the term!
Yes, we DO owe it to our vets not to treat PTSD as a stigma. But in Realityville, people will, because it's a simple solution to use that label: heck, you need but be labeled as a VETERAN in many situations, and you'll immediately lose status and opportunities. I know I've experienced that. . .
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