Is Ptsd Really A Disease?

[mohsen]

Today as always I was walking in the street. After some time, I heard a loud sound, it was like someone was setting off firecrackers. Then I saw people running away in all directions. That was the time I realized what is really going on: an Armed robbery. Two gold dealers were shot in front of my eye: A father and a son. The son didn't make it, and the father was screamed in agony. I was lucky; I could have been killed by a bullet in my head if I wasn't more careful.

What's the chance that I'll survive next time? and after that? The more I expose myself to such incidents the more chances are to be killed.

I want you to imagine that you are an engineer. Your job is to create or design some psychological mechanism in order to increase my chance of survival. What would you do?

The plan could be like this:

First, I have to identify what really hinder the survival. Second I need to collect the important information that ultimately led to the incident. My subject only needs to remember those clues not the incident itself. Third I need some mechanism to be active when these conditions are met. These mechanisms should act fast; any delay can put the organism at great risk, and they should be cost effective.

Now I want to implement the plan.

The first problem: Historically, I know there are circumstances in which many people have been killed. Like war, Assault, Rape, flood and ....My case certainly is the assault one. So after realizing that, I can immediately active the fight-or-flight response to save the organism.

The second problem: Only after rescue I will deactivate the fight-or-flight response and start to process the information that led to the incident things like shot sounds (the next time you hear this sound you will act faster) the time of robbery (if it was night or day? Maybe thieves prefers the night over the day) the place of robbery (maybe it is an attractive place for thieves, so it can happen again) and.... so as you can see I'm not randomly or aimlessly choosing the clue.

The third problem: After Estimating the situation and gathering clue, I need to correct the information, but first I need the organism to stay away from gun shot when he or she hears the crackle of gun fire. It is the high priority because it can lead to injury, then I need the organism to stay away from that street, if the police was present, I will active the mechanism with less power than the time the police is absent.

There is a technique some psychologist called exposure therapy. I think that could help me correct my data. If subject can go to that street, for example, 100 times I would not deactivate the mechanism because the robbery can take place in 101 visits.

The only way that I will deactivate the mechanism is when the subject show me the evidence that he or she is safe. For example, example more police in area and that is exactly what would happen to someone who has experienced the trauma.

The things some phycologist called symptoms, I would call function, for example:

• Reliving" the event, which disturbs day-to-day activity.
• Flashback episodes, where the event seems to be happening again and again.
• Repeated upsetting memories of the event
• Repeated nightmares of the event
• Strong, uncomfortable reactions to situations that remind you of the event.

They are magnificent mechanism because they can active fight-or-flight response even before the accident occurs.

They don't need to be accurate or work every time they could be false alarm, but what if one of them be true?? The cost of losing life is much higher than having some Flashback episodes.

or

• Avoidance
• Emotional "numbing," or feeling as though you don't care about anything.
• Feeling detached
• Being unable to remember important aspects of the trauma
• Having a lack of interest in normal activities
• Showing less of your moods
• Avoiding places, people, or thoughts that remind you of the event.
• Feeling like you have no future.

Most of them is part of a fight-or-flight response.

So back to first question

Is PTSD really a disease??

How could that be? Sorry I can't accept that. In my opinion, what you call PTSD is just an evolved mechanism to solve the adaptive problems of survival.

and sorry for my bad english .

 

[therapybankrupt]

I am not sure what you are asking about? Are you questioning your own issues for self diagnosis or are you questioning the professional diagnosis of PTSD? PTSD is a diagnosis not a disease. Read the Wiki it has lots of info about PTSD.

 

[Rumors]

PTSD stands for Post Traumatic Stress Disorder not disease. The two, although similar, are not alike.

 

[Abstract]

Leaving the word "disease" out of the equation I think I can see what you are saying but there are certain big problems with your reasoning. If PTSD really helped us be safer and function better then that would be marvellous. Some aspects of it can help I believe but mostly it is debilitating and wears down the body and makes us waste masses of physical and psychological energy reacting to normal harmless situations as if they are a true threat.

To an extent PTSD is a normal reaction to abnormal situations and we deserve no shame for having it. But it is not an helpful condition.

 

[Hashi]

.
Most of them is part of a fight-or-flight response.


So back to first question

Is PTSD really a disease??

How could that be? Sorry I can't accept that. In my opinion, what you call PTSD is just an evolved mechanism to solve the adaptive problems of survival.

I agree with some of what you say. Fight or flight is a survival response to threat. If I understand correctly, you think the threat of an armed robbery is still there when you walk down the street, so it makes sense for your survival responses to activate. If the risk seems reduced enough - for example, more police - then it's OK for your survival responses to relax.

The issue is whether reacting with full fight or flight response is appropriate. Is it really a situation where that survival mechanism is needed? If not, it would actually weaken our chances of survival overall, because of the stress on the organism of going into fight or flight response, and because we're not judging danger accurately.

Taking your example, it makes sense for your survival responses to activate if there's an actual armed robbery again, or if there's good reason to think an actual armed robbery is about to happen again at that moment. I don't think it make sense for full survival responses to activate if there's only a possibility of another armed robbery at some time. In that case, vigilance would be an appropriate reaction but hyper-vigilance wouldn't. Alertness would be an appropriate reaction but full fight or flight response wouldn't.

I think the question is whether there's a real threat to survival, or whether you're over-responding to the situation. If the threat is real, then the fight or flight response is a healthy survival mechanism. If you're over-responding to the actual level of threat, which happens with PTSD, then to go into fight or flight response is not a healthy survival mechanism.

The organism is not designed to react with a full survival response "just in case" something happens, only when the danger is high and real. It's not appropriate, it's unhealthy for the organism, it confuses our sense of real danger, so it's a disorder.

 

[InHell11]

Well if I could control some of the PTSD symptoms such as the fight of flight response and turn off the numbness when I wanted ect, then it would be much more useful. But it doesn't do me much good to feel like there is impending danger or doom when there isn't its unpleasant and makes me act quite weird from the perspective of others which can be an issue. I see some benefits since it would be much harder for me to miss something if there was actually impending danger. However, its too out of control to really be much use in most situations in my opinion so I see it as more of a disorder.

I wouldn't use the term disease since thats not very specific, mental disorder seems more specific not to mention most people associate disease with physical sickness.

 

[saffy]

Hi Mohsen

I would more likely ask myself what was the chance of this happening again.

Flight and fight mechanisms are for survival but they are out of your control, you cannot switch on or off which one you will do, you might even freeze, that is also a survival mode.

I am not entirely certain what you are asking?

Dis-ease can be a label for it.

I would like to comment though on the symptoms you have listed. I would not call these a function of survival because they can affect you deeply at times when you should feel the safest. This is very debilitating on a daily basis for the sufferer and therefore they cannot function properly.

Your next list is based on avoidance, trying everyday to live without the above comment, therefore, trying to function normally.

What has happened might also make you more alert, this is also a symptom of PTSD, making you very edgy and tense; over reactive to your surroundings. This is not a survival mode because it is based on irrational thinking based on what I have already said.

Living with this daily really does affect your whole life, health and happiness so we are holistically in dis-ease.

best wishes
Saffy :)

 

[mohsen]

I read all of your comments, and I can see your concern. I too believe that pain and suffering are not good things at all. However, I believe that we are not here on earth just to be happy and celebrate our existence. The main purpose of our existence is to be alive and reproduce. And honestly being alive is not as important as producing offspring.

The main function of PTSD is to make sure you, and the people close to you are alive and can reproduce. One prediction is that PTSD can affect more women under age 50 (or around the time when they reach Menopause) because after that age chance of getting pregnant significantly drops and subsequently, the chance of getting raped. Because it was very costly for a woman to raise a child without the aid and resource provided by a man. In the past, this child could be easy dead. So PTSD not only cares about you but also the people who have a copy of your gene in their body. Like mother, father, sister, brother, and... specially your child, because she or he inherited 50% of your gene and she, or he has more chances to transfer your gene to the next generation.

So we can make two prediction:1- seeing the death of a close family member makes you more susceptible to PTSD than seeing the death of a stranger 2- the death of your child can affect you more than the death of your parents.

And I want to comment on some of your remarkable answers.

Some aspects of it can help I believe but mostly it is debilitating and wears down the body and makes us waste masses of physical and psychological energy reacting to normal harmless situations as if they are a true threat.

You are right. Your brain is like a super computer. It has to calculate thousands of possibilities. And it takes a great deal of mental and physical energy to do that. And only after considering all possibilities it will decide which situation is harmless and, which is a true threat.

I don't think it make sense for full survival responses to activate if there's only a possibility of another armed robbery at some time. In that case, vigilance would be an appropriate reaction but hyper-vigilance wouldn't. Alertness would be an appropriate reaction but full fight or flight response wouldn't.

I'm not so sure what you mean by full survival responses, but I suspect it will be active when you see a snake or tiger or whatever that pose a great threat to your survival. However, in the most case you are just on alert. And I think even 1% possibility of another armed robbery worth considering.

According to a new approach called error management theory it would be exceedingly unlikely that the cost-benefit consequences of the two types of errors would be identical across their many occurrences. We intuitively understand this in the context of smoke alarms, which are typically set to be hypersensitive to any hint of smoke. The costs of occasional false alarms are minor in comparison with the catastrophic costs of failing to detect a real house fire. Error management theory extends this logic to cost-benefit consequences in evolutionary fitness.

Actually, it would be more beneficial to produce more false positives than false negatives. In another word, 100 false alarm is less costly than missing true one.

Consider this:
there is only 1 percent chance that another robbery will take place in that street which means if I walk down the street every day, for 100 days, one day I would witness another robbery. It is unknown if it is day 1 or 2 or 7 or 45 or 90.

Now If I give you two options, which one would you chose?

1- I can give you a phycological mechanism that alerts you every time you walk along that street.

Pros: if you listen to it, and avoid that street, after three months, there is a very good chance that you still be alive.

cons: it is nasty, it is inaccurate, From 100 alert, 99 is false. , it consumes your energy. It makes you feeling detached,Flashback episodes, Repeated upsetting memories of the event, Having a lack of interest in normal activities and..

2-I can make you forget all things ,You can happily walk down the street without any upsetting memories of the event.

Pros :it doesn't contains any of above cons. You save your energy for whatever you like to do. You sleep well and....

cons:you could be dead or injured in the next 100 days.

You may choose option 1 or 2. However, nature already made its choice.
And same rule is true about hyper-vigilance. Imagine a Gazelle. She remains hyper-vigilance most the time. In 99% cases it is just crackling of trees but one could be a real threat. That's exactly why hunting a Gazella is much difficult than a sheep.

Well if I could control some of the PTSD symptoms such as the fight of flight response and turn off the numbness when I wanted ect, then it would be much more useful

You can't . They are much more like breathing or blinking. Suppose I attack you with a knife from behind, and you just have a second to react and save yourself. What do you do? Actually rational thinking here can get you killed.

I see some benefits since it would be much harder for me to miss something if there was actually impending danger

Good point. Actually, you do most things because you feel they are right not because you think they are right. If I offer you a rotten apple, for example, you don't go to search the internet or read a book for Signs of food spoilage you just throw it away. You don't think what your body needs. You just get hungry and eat something. If I ask you would you commit incest, you say no, it is disgusting,you don't say wait until I'll go and check with a biologist to see what he has to say or let's think about it ... and many other things. So intelligence is not equal to rational thinking.

[DLMURL="https://www.ptsdforum.org/c/members/saffy.16807/"]I would not call these a function of survival because they can affect you deeply at times when you should feel the safest. This is very debilitating on a daily basis for the sufferer and therefore they cannot function properly.[/DLMURL]

True. It is very unfortunate that we must go through all this pain. However, compare to other mechanisms, what you call PTSD work best, otherwise it wasn't here today.

The Psychiatrist may help you to manipulate these symptoms, or something like that or prescribe Prazosin for you to feel better but feeling better is different from being safer.

So my conclusion is that although PTSD can bring you some pain, but compare to other strategies it can save more life.

How many women would become the victim of rape again if they didn't have PTSD?

And if you really know the real threat, and you know the ways to avoid it, so why in first place, you got PTSD?

If I had more times, I could research about all functions of PTSD. However, as I said in my first post, if I was responsible for creating some phycological mechanism to save the organism(not to make it happy or joyful) I would definitely go along with PTSD.

 

[Abstract]

How many women would become the victim of rape again if they didn't have PTSD?

I actually think that having been exposed to trauma and just negative environments made me very vulnerable to being re traumatised. I consider myself lucky that I did not end up in very bad situations. I could easily have done so and I think I am far from alone.

For many chronic dissociation, freeze responses, learned helplessness as well as risk of flashbacks at inopportune times are all part of their PTSD. And much much more on top. All can leave one vulnerable to being victimised. Not only that but PTSD makes us physically weaker which is a negative both self protection and reproduction wise. We could also overreact to a non threatening situation which can put us in direct danger. Suicide is a significant risk too.

The body and brain means well and means to ensure our survival and some aspects of this works but all in all it backfires badly.

 

[The Albatross]

Well then we flunked in our family (ability to reproduce). Nice hypothesis, get a life.

 

[InHell11]

You can't . They are much more like breathing or blinking. Suppose I attack you with a knife from behind, and you just have a second to react and save yourself. What do you do? Actually rational thinking here can get you killed.

Well yes it kind of is I've tried explaining to people that if I overreact when startled for instance it happens before I think like about it like breathing and blinking. However I should not constantly feel in danger of being attacked as it's more exhausting and confusing than useful and that's what PTSD does. Its hard to tell when its for real and when something that reminds me of a traumatic experiance without me realizing it triggering it when its not nessisary...its good if I am in an area I need to be cautious in but its not so great if I'm in a relaxed environment trying to enjoy the company of others or even just time by myself.

 

[msqualia]

I can say with all certainty that there's a far distance between the normal fight or fight response and PTSD symptoms.

When I am yelling at my (wonderful) partner because he reminds me of my ex by pure coincidence, that's not helpful to my survival
When I have intrusive thoughts when I am safe, that's not helpful to my survival.
When I cry uncontrollably when I should be doing something else, that's not helpful to my survival.
When I spend all day physiologically aroused when there is NO danger-- when I do that for a week-- that is not helpful to my survival.
When I cannot sleep (and I have not slept unaided for 20+ years), that doesn't help my survival.

I'm not looking to deaden helpful or unpleasant things in my life. I'm looking to function. The end. I have no objection to being fearful of frightening things, or having physiological reactions to normal things. But this is, at its worst, all consuming and exhausting. And I hope you will be kind in recognizing that there is a line where it is not controlled and abnormal.