Trauma and PTSD - Am I Going Crazy?
You might have seen a previous article I wrote about depression. However, depression’s cousin when it comes to serious medical illness is often trauma-induced PTSD. Per the CDC,1“Most everyone has been through a stressful event in his or her life. When the event, or series of events, causes a lot of stress, it is called a traumatic event. Traumatic events are marked by a sense of horror, helplessness, serious injury, or the threat of serious injury or death.”
What is trauma?
For me, it took some time to realize that what I had been through can be considered trauma. For those of you who have been through a serious, life-threatening event such as a STEMI heart attack, cardiac code(s), or an extended stay in a cardiac ICU, then you are able to relate. If you know what a Swans Ganz catheter is, or an Impella Device, you likely are a part of this tribe.
PTSD often presents after witnessing an extremely stressful event. Those with PTSD often report feeling anxious or scared even in the absence of danger. Think of it as hypervigilance and/or hyperarousal.2
Per the CDC, symptoms of PTSD fall into three broad categories:1
- Re-living includes flashbacks, nightmares, and extreme emotional and physical reactions to reminders of the event.
- Avoidance includes staying away from activities, places, thoughts, or feelings related to the trauma or feeling detached or estranged from others.
- Increased arousal includes being overly alert or easily startled, difficulty sleeping, irritability or outbursts of anger, and lack of concentration.
It is helpful to understand what is happening in the brain to understand why people with PTSD respond the way they do. As I often write, I am not a doctor, so all of this is from my own reading and understanding.
The amygdala handles fears and emotions. It is good to have this part of your brain triggered when you experience a disturbing or potentially dangerous event. However, in those with PTSD this part of the brain is overactive leading to a fight or flight response when you’re not actually in danger. When it’s overactive it’s hard to think rationally.3
The prefrontal cortex handles our executive decision making and higher-level cognitive processes like self-control, decision making, problem-solving, etc. In people with PTSD, this area of the brain doesn’t do its job properly.3
Unfortunately, the combination of an overactive amygdala and a malfunctioning prefrontal cortex can cause tremendous suffering for the affected person.
You deserve healing
While this post is merely scratching the surface of PTSD, I think it is important that we are aware of this experience. Personally, I noticed some strange things when I left the hospital after my second heart attack, and I wish I had realized this was likely all related to PTSD. For example,
I would forget what I was going to say midsentence, simple word recall could be challenging, and it was a struggle to concentrate for prolonged periods. The first time this happened at a therapist’s office I forgot what I was about to say mid-sentence. This had never happened before to me. I was 35 and had held a high performing job. I was terrified and earnestly asked if I was going crazy. My doctor said no, this is trauma and anxiety.
So, if this speaks to you talk to your doctor and get some help. You survived something traumatic and need some additional support to heal. If you are at a large academic institution your heart failure clinic might have a social worker or therapist, you can speak to you. You deserve it.
What type of heart failure have you been diagnosed with?