Where to start on this one? I think before I dive into the research and outline each of the bodies systems impacted by PTSD I will give you a brief summary of my physical journey with PTSD.
As many of you will know I have had Complex PTSD from early childhood (first major trauma that I can consciously process was at 2 years of age, but prior to that there was significant trauma and abuse). When we are reminded of our trauma(s) without treatment our brains and bodies flip us to the emotional and physical age we were at our first trauma. A traumatized infant skips the stages of stress and alarm, going straight to the last: comatose. My physical payments as a result have been significant and at 48 years of age, I am frankly living on borrowed time.
To understand how our BODIES KEEP SCORE, please purchase Bessel van der Klerk’s book with this name. It is a MUST READ for anybody with PTSD or who anybody loves somebody with it. Otherwise google the stages of ALERT or ALARM and look at the hormones that are released by the body before, during and after trauma (they are the same as a PTSD survivor releases when triggered, each and everytime without much hope of ever controlling that body reaction to be honest, building resilience and ability to withstand more is all we can do). The cop websites are good for this information as they give the stages of stress on the job and the adrenalin dump when they are off: particularly significant in cops on a 4 on/4 off schedule. Cops when they retire suffer from a gamut of heart, auto-immune and gastro issues, if you love one show them this post.
The first physical symptoms of PTSD that I can remember are: stomach pain, severe migraines, visual disturbances (upwards of hours without the ability to see anything but hazy white light), fainting, inability to breath, numbness in hands and legs, severe cold and inability to warm up.
In my 20’s these developed in severity but then started to include more neuropathic pain.
In my 30’s the wheels fell off the cart. I was determined to have children, in my first pregnancy I developed blood clots (DVT) and diagnosed with anti-phospholipid syndrome with lupus markers. Suspected diabetic but nothing ever proved that, just the symptoms of it. In my second successful pregnancy I was in labour at 22 weeks, hospitalized and I literally ran the gamut of “how to die in pregnancy”. So severe was my case that no doctor in Singapore would take my case, my rheumatologist had to go to the Board of Medicine in Singapore and no less than the Chairwoman became my obstetrician and lead doctor. I don’t blame them, none of them wanted my corpse on their hands and all indications were that I had very little hope of making it. My Gypsy was born sub-30weeks and I died three times on the delivery table. That wasn’t the end of it, unable after both pregnancies to sit once standing (the thing about DVT they don’t tell you is that the veins rewrite themselves around the buggared ones, it’s excruciating). There’s no need to go into the details except to say that in my 30’s I became Patient A for rheumatologists, cardiologists, neurologists, hematologists, obstetrics and I became a lab rat from then to now. I am immune to Warfarin (proving no doubt that I was a rat in my past life), one cardiologist was so infuriated having doubled the recommended dose to see no movement in my coagulation numbers that he hospitalized me thinking I wasn’t following the regimen he’d prescribed. I was. Neurologists looked for tumours in my head. None found. But other things were found like strangely large areas of my brain that one described as being the opposite of an autistic brain. Rheumatologists and hematologists found strange vanishing markers, here one minute, gone the next.
In my 40’s now with more answers than most have, I can tell you that I suffer from:
- heart complications when triggered, my heart rate dips severely, blood pressure goes to zero (I was lucky on this one because it is temporary it was discovered by a paramedic who was quicker than most to get me hooked up), I am aware that my heart isn’t the greatest and am careful to not waste beats (smiling)
- core temperature is low but when triggered blood leaves my extremities, pulled into my core, if in an exposed situation this can be life threatening as I literally can’t get warm
- hemiplegic migraines – a recent discovery and one that I am grateful for – it appears to be a stroke with paralysis of the right side which can last upwards of an hour. Google the hemiplegic society for more on this.
- immune disease markers including lupus, antiphospholipid syndrome (lupus is a disease that can be helped with sleep and rest, which I take seriously, and it works)
- neuropathic and other pain is a fairly constant in my life, because I’ve lived with pain since I was tiny I’ve found a way to push it back, it becomes a noise for the most part that I can ignore and get on with life, it does however wear me down
- rheumatoid arthitis in my hands sadly, but so far I have it under control
- hernia – my own doing, another story another time
So, when I say I understand the physical side of PTSD… I’m not kidding.
I wrote a post this week in which I said that if you have PTSD you MUST get a cardiologist, a neurologist, a rheumatologist, etc as well as the psychologist. This is why.
From no less than Volume 49, Number 5, 2012 from the US Department of Veteran Affairs:
“… it is crucial that clinicians and researchers develop more integrated treatment programs and strategies to meet the needs of Veterans with PTSD…”
Entire tranches of research in these tomes are dedicated to the research that states that for PTSD to be treated successfully the US VA must integrate its medical and psychological treatments ACROSS the board. Yet, this remains in 2018 a surprising thought? Judging by the messages I received after posting this week nobody out there is aware of the CAUSAL RELATIONSHIP between PTSD and physical issues. Let’s start with Heart Disease.
In a study of 8,000 Veterans living in Hawaii and the Pacific Islands those with PTSD were 50% more likely to develop heart failure. Heart failure is where the heart grows weaker and can’t pump enough blood to adequately supply the body’s needs. Those with this (wait for it) feel tired with physical activity, like their muscles aren’t getting enough blood (sound a tad familiar when you’re triggered?). Dr Alyssa Mansfield was one of the authors of the study stated that the results provide further potent evidence of the nexus between mental and physical health. The practical upshot of the findings she said is that veterans with PTSD should realize that by treating their PTSD they may be helping to prevent heart disease later on.
The connection between PAIN and PTSD has been well known for sometime, so much so that there are four theoretical models for studying that connection. I will write about PAIN and PTSD in another post as it is quite complicated with an outline of these models used (Shared Vulnerability, Mutual Maintenance, Fear-Avoidance and Triple Vulnerability models). The most common PAIN experienced by those with PTSD are as follows:
- Back pain, a leading cause of long-term disability
- Headache & Migraine: the first is a pressing or tightening of the front of your head, the second is a chronic disabling neurological pain syndrome
- Neuropathic pain, these include Allodynia, Hyperalgesia, Dysaesthesia and Parasthesia. Trust me if you have these you will know what these lovely terms mean, otherwise, just know that you don’t want it.
Auto-immune Disorders are and have been proved to have a CAUSAL relationship with PTSD, yet we find that nobody with PTSD is automatically referred to an rheumatologist. Sigh. 2013 US Medicine released a paper “PTSD lined to Greater Risk of Autoimmune Disorders” in which they detail the findings and the relationships. This is but one out there of which there are dozens of scholarly articles on this issue. That ache in your hands? Don’t ignore it if you have PTSD it is likely the first signals of rheumatoid arthritis, don’t panic it’s manageable but knowledge is power.
These are two informative articles on the research done, print it out and bring them with you to your next appointment.
Gastrointestinal disorders? Same deal. Why do so many veterans have gut issues? There’s literally tons of research out there showing how PTSD is a factor.
Now, this wouldn’t be a balanced post if I didn’t also point out that living with these chronic diseases and pain can cause PTSD.
Yup. There’s papers on that too, one particularly informative one in the US Department of Veteran Affairs research centre. I suggest you go there if this is you or email me and I will send you the links I’ve found to be most useful on this.
In summary, if you have PTSD it is not simply a psychiatric injury it is a physical one too: the impact on your health is immense. Please connect with me if you have any questions, if my journey can help you then maybe some of the pain over the years has been worthwhile.