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News Hippocampal Volume And Resilience In Posttramatic Stress Disorder

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PTSD isn't the result of a single area of the brain, just like it isn't due to a single neurotransmitter (which is why only some people with PTSD will get any relief with SSRI or SNRI therapy. Also, the human brain has a tremendous range over what is normal - think of human faces, how amny different looking ones there are and the relative size of noses, eyes, ears, and such. Such is hippocampal volume. Treating PTSD however has been shown to increase the size from baseline to 6 months of targeted therapy.

New research looking at PET are designed to look at receptors that you can't see any other way except by PET. They use healthy controls matched against the PTSD patients. The way brain fields light up is quite different between controls and PTSD patients. I've actually participated in a PET study looking at CB1 receptors. There are two experimental drugs currently only for animal use that selectively attach CB1 receptors - when those become available, I'll sign up. It has only been a year since I received a proper diagnosis. I've been treated for ulcers, depression, irritable bowel, migraines, fibromyalgia, hypertension, seasonal affective disorder, premenstrual dysphoric disorder, social anxiety disorder, generalized anxiety disorder, panic attack disorder. It is all just PTSD.

Because I'm an anesthesiologist, I know it is important for people to participate in research - that is how we make strides in medicine. Things I learned in medical school in the 80's have since been shown to be wrong. But it takes research. Usually studies have to start small because of funding issues. I used to teach at a major university and did research in anesthesia. It was hard to get subjects at all, let alone people who were diverse. The media blow things out of proportion constantly because they make money off of stories. Researchers get funding based on either the likelihood of a drug company getting a patent or the government looking at likelihood of public benefit. Finally - not every study is good science either from emthodology flaws to bias issues. Early studies tend to be flawed because often not all the science is known.

<Please insert full line spaces between paragraphs. Thanks Amethist>
 
PTSD isn't the result of a single area of the brain, just like it isn't due to a single neurotransmitter (which is why only some people with PTSD will get any relief with SSRI or SNRI therapy.
It seems more current research data in relation to SSRI's / SNRI's is actually not to do with where or what PTSD affects in the brain, but more that the depression caused due to PTSD as a symptom, is mood based, not physically chemical based, ie. serotonin or such, but purely mood due to anxiety.

With a little playing in this area myself, I tested this theory, and you could add me to the majority that seems to fit this new data, as a small dose of valium to treat the residual anxiety, also removed my depression completely. I had never been treated with a pure anxiety based approach before... so it seems current trending data and analysis is more correct than the past Pax Medica model.

You likely know more about this than I as an anaesthesiologist. Seems the experts are on the mark though with their latest research data...

New research looking at PET are designed to look at receptors that you can't see any other way except by PET.
Are you referring to [DLMURL="http://medgadget.com/2010/01/magnetoencephalography_as_an_objective_test_for_ptsd.html"]Magnetoencephalography[/DLMURL] study, finding a 90% accuracy for PTSD diagnosis?
 
I remember getting myself off them many years ago, because I wanted to just constantly kill myself... whilst I still had anxiety and depression after removing SSRI's, I never had the awful suicidal ideation that the meds caused, thus I now believe based on current data, literally made me chemically depressed, when as a PTSD sufferer, suffered mood based depression, being one of the different types, or more known as A-Typical depression.

They just shouldn't be treating A-Typical depression with anti-depressants, as a majority, they do more harm than good. I'm sooooooo glad that slowly physicians are shifting away from them. Not good for pharma companies or kickbacks, but better for patients who as they do more research themselves, demand off the things and onto something that is actually going to help them, not hinder them / maintain a chemical dependency and state of depression.

Even the doctor who came to see Nicolette on the weekend at home, he ended up stripping all these meds away from her that other doctors kept prescribing, trying to treat her pain and the symptoms, and instead went outside the box, back to basics, and looked at ways to treat the cause with ease, and less medication, and he got it right by doing it, as she quickly improved, which everyone tossing medication has so far failed. Vitamin C powder which creates a lining within the bladder so infection simply cannot stick to it and create further issues, as well as plain old penicillin to kill the antibacterial infection now caused... and it worked the best out of everything so far done.

There is simply to much dependency, laziness even, from medical professionals and prescribing medications based on pharmaceutical companies information, which so far has proven wrong in many cases. There is a lot of good life saving drugs now available, there is also a lot of over-prescribing and misuse occurring.

The medical industry have lost touch with a balanced approach IMHO.
 
No - the Magnetoencephalography is different in method - but is looking at similar concepts: that the PTSD brain is a very different animal than other brains, beyond just sizes of things. The PET study I participated in is looking at over 200 brains with many different types of PTSD patients - so more generalizability to all populations. CB1 receptors bloom in PTSD brains - and coupled with results of fMRI, they are getting a better idea of precisely how a PTSD brain is different than other brains. (Notice I didn't say normal brains.)

Studies have a hard time recruiting in the very damaged CPTSD because we don't like to come out of our comfort zone and being studied can act like a trigger. But the more I participate - the more I realize that I can conquer so much of this. I get such an uplift after each study - even though I have to come off all meds and supplements.
 
I agree you can't take the published research at face value, but I don't think you should wait for science to reach a consensus before taking actions. I am taking tianeptine (Stablon) for my ptsd and it has made a significant impact in terms of reducing reactivity and anxiety. They are finding many things they thought they knew about depression and neurotransmitters were flat out wrong.

The current working hypothesis for how Stablon helps with ptsd and anxiety is by regulating glutamate receptors in various regions of the brain. This makes sense to me in that ptsd can cause disregulation of metabolism by causing high circulating glucose and insulin resistance due to high circulating levels of glucocorticoids. This may only be true for the subset of PTSD sufferers who also carry genetics for metabolic syndrome.

There has been research done showing that the body craves sweets in high stress situations - which makes sense because we just released a lot of glucose from the liver and it's gonna want to refill that. However, the research (on mice) shows that the sugar is somehow calming to the system. I wonder if it wakes up the "digest and rest" cycle.

I agree patients need to be informed and assertive. I had a psych who after 5 minutes of seeing me decided I was bipolar. In spite of the fact that I told her I hadn't slept in 8 days because of my husband's suicide attempt and all the attendant problems. I refused the medication which had potential to damage my liver and later was diagnosed with PTSD.

NutritionNerd
 
No - the Magnetoencephalography is different in method - but is looking at similar concepts: that the PTSD brain is a very different animal than other brains, beyond just sizes of things.
Interesting... thanks.

I do know that neurology is focusing near all efforts towards the prefrontal cortex now with PTSD, as it seems more is being found within that region than past efforts of limited technology trying to equate sizes, which was just useless. Exciting at the time, but really useless overall when compared against non-PTSD brains showing similar things.

I think technology in neuroscience is the key to continuously getting closer to finding what PTSD is, and exactly what part of the brain causes it. I would not be surprised to see something with conclusive efficacy within the next 5 - 10 years on exactly what PTSD is.
 
Yes I agree Anthony - the technology will be the key for the most part. Over the past 30 years I have been treated based on history and symptoms for so many different things, when in fact what I have is PTSD. The PET study showed I have a very traumatized/stressed brain that doesn't look anythink like a normal brain under the same study conditions. I hope to be part of the reason technology can advance. Being willing to participate requires a lot of committment and many times inconvenience, as well as blood draws, etc. But the science cannot advance without test subjects in numbers that allow robust data. Twelve people in a study might hint at something, but doesn't provide rigorous data for proof of concept.

Many studies don't prescreen for other disorders as rigorously either. So who knows if the researchers were really looking at PTSD or things with overlapping symptoms. The science is getting better because it is getting more competitive.

But all pure science aside, I think compassionate therapists still make a tremendous contribution and always will.
 
I think "PTSD" brain ought to be a bit more defined. If you define everyone who has PTSD as looking a certain way in a MRI scan or use it as a diagnostic you may be missing people.

I believe in neurogenesis, genetic differences, and alterations in the brain as well as other endocrine systems as being the source of PTSD. Just because some PTSD sufferers don't have shrinkage doesn't mean that they won't evenually. The papers I have read posit elevated glucocorticoids inhibit neurogenesis in some parts of the brain.

People who have been traumatized early in life or have a trauma filled life might be more likely to have brain shrinkage than someone who has a single incident PTSD. And amongst that population others will have genetic variations that make them more or less resistant to inhibition of neurogenesis. (for example exercise causes the release of chemicals that assist neurogenesis)

Same for studies showing elevated vs lowered glucocorticoids. Genes and time make the difference.
 
Nutriotionnerd - I think the problem is that people do not understand what is ptsd.
Ptsd in my opinon has to be an event (it does not matter , if it happend once, or couple of times ) that a person felt a phisical threat to his life. It is not about amotional abouse , or trauma of all kinds, it is about a situation that a peron felt a threat to his phisical existence. In some people ,in that kind of situation the brain (or the body) produces unreversible response that alter the brain both chemically, and physiologicly.

It does not have to early in life or a trauma filled life - like you said - even the objective severity of the trauma is not a key factor here - the only factor is the occurrence of this chemical and physical changes a short pereod after the traumtic event.
 
Define "Event" - a soldiers entire tour of duty in a hostile environment could be considered an Event.

Physical threat to life means something different to a very young child who is dependent upon others for it's life.

I see PTSD as being an overload of the HPA system. It goes over the tipping point and can no longer reach homeostasis and runs haywire.

I don't say you have to have lead a trauma filled life to get PTSD but that the brain and chemistry of those PTSD sufferers who have lead trauma filled lives may be very different than those who have not. PTSD is a failure of the stress response system.

There is also evidence that genetics predisposes certain people to depression if they experience a certain amount of stress. And this same difference may account for PTSD.

I disagree that the disorder is irreversible. There is no way to know that and it is a product of a science that is still very young and only recently discovered neurogenesis. Sufferers who are misdiagnosed and misunderstood wind up with treatments that reinforce the changes rather than altering them. Their experience is akin to stroke victims who were not given any therapy because it was believed their brain couldn't regenerate.
 
in a case of a soldiers , i . think , it is hard to say what exactly and when exacly they got the ptsd.
but in some point of the tour this figh or fligh responce occurred in such strong and abnormal way , making permanent (?) changes in the lymbic system .
 
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