I'm not a neurologist. I'm just a journalist. And I'm not a sufferer, I'm a carer. But I see a therapist myself who has some expertise in PTSD, because it helps me do my half of keeping my marriage as healthy as possible. We've been discussing exactly this issue a lot.
I've talked with my therapist a lot about that question, because she refers to it as "curable," and the concept bothers me a little. I think that, at least in her case and probably those of other medical professionals, they use the word "curable" to mean that a PTSD sufferers symptoms can get better. But the degree to which they can get better, how long it takes, and how much ongoing treatment is necessary to keep them that way....well, it is different for everyone, and we don't really know all that much about it.
There have apparently been fairly recent studies showing that the brain of a PTSD sufferer is actually different than the brain of a non-sufferer. The hippocampus, which plays a role in memory formation and in processing stress, can be as much as 20% smaller in a PTSD sufferer than a non-sufferer. If you laid two brains on a table in front of some neurologists, they could pick out the PTSD sufferer from the brain of the non-sufferer.
The challenge is different, even, for those exposed as children and those exposed as adults. Some people can remember themselves pre-PTSD and say "I'm thinking differently now," which alters the treatment and, often, what they believe is possible for them. Some people can't.
Think about that one -- my brain and my wife's brain are different. So it's not as if she can just decide to think like I do. We have different types of thinking machines.
In a relationship, it's not fair to say one is a good brain and the other one a flawed brain. Keeping score could be harmful. It's just important to keep in mind that you're approaching everything with different thinking equipment, so a LOT of communication is necessary to ensure everyone gets their needs met.
In my own marriage, we have an ongoing issue with trust, which may be our biggest conflict -- she has a hard time trusting me. She has a hard time trusting anything. It took me a long time, and a lot of therapy, to learn that it's not about me. I can't earn her trust -- her truster is just broke, so to speak. The best we can do is get to a place where she can think to herself "I may not be right to be scared of this right now. It might be PTSD." We actually seem better sometimes when I stop working so hard to try to get her to trust me. That isn't up to me, anyway.
Now, apparently, my therapist tells me, there have been studies in rats showing that damage to the hippocampus can be partially repaired, but never fully repaired, and only over a long time. A rat exposed to extreme stress when they are young develops a smaller hippocampus as it grows. But if the stress is removed, it can actually grow some of it back...but that hippocampus will never be as large as it would have been if they hadn't been exposed to that stress. At least, that's how it's been explained to me, and again, I'm not a scientist.
So I can live with therapists who call it "curable" because I think they mean that, compared to some severe brain diseases like Schizophrenia where no recovery is really possible, PTSD has a pretty good prognosis. Sufferers can reduce their symptoms. But it's a lot of work, there's no proven method that works for everyone, and really, the science of this is very young...hopefully we'll know a lot more in ten or twenty years (god knows, the wars of the last few years have tragically given us a lot of cases for medical science to observe), we'll have therapy techniques that always work and maybe even a drug that helps the therapy along.
But right now, sufferers have to work like hell to get better and carers have to do what they can to help that along while staying physically and emotionally safe. We're all in the dark ages of PTSD treatment.
That's why I'm so amazed by all of the sufferers here working to get better. To me, it looks like every one of you has been asked to move Mt. Everest with their bare hands -- and some days, I see you slide it. Sometimes a few feet, sometimes an eighth of an inch...it doesn't matter. Every day you even put your shoulder into it and try, and I'm just in awe of that. You guys are all incredible.
