WEBVTT - How PTSD Works 0:00:01.200 --> 0:00:04.640 Welcome to Stuff you should Know front House Stuff Works 0:00:04.680 --> 0:00:13.160 dot Com. Hey, and welcome to the podcast. I'm Josh Clark. 0:00:13.160 --> 0:00:16.400 Getting across from me as always is Charles W. Chuck Bryant. 0:00:16.440 --> 0:00:19.680 And that makes this say you again, howdy, this is 0:00:19.680 --> 0:00:23.200 stuff you should know. Let jump the gun there. That's okay, awkward, 0:00:23.360 --> 0:00:26.200 I was talking a little fast. It's a little weird. 0:00:27.240 --> 0:00:30.479 How's it going, It's going good, good. This is a 0:00:30.480 --> 0:00:33.559 long awaited podcast. It is. We've been putting this off 0:00:33.600 --> 0:00:37.400 for like a year at least, maybe even two or so. Um. 0:00:37.440 --> 0:00:40.559 There is a guy, um who we need to give 0:00:40.600 --> 0:00:43.000 a huge shout out to. His name is Will Sovey. 0:00:43.280 --> 0:00:46.120 Is that who wrote us? Initially? Yeah, initially. He is 0:00:46.280 --> 0:00:51.519 a clinician who studies PTSD, started out at Walter Read Hospital. 0:00:51.680 --> 0:00:53.920 From the hospital. Basically he's like right there on the 0:00:53.960 --> 0:00:58.200 front lines, not just treating, but like learning about PTSD 0:00:59.080 --> 0:01:00.960 and uh no, no, only do we have to thank 0:01:01.000 --> 0:01:05.120 Will for Basically we handed him this document, this article 0:01:05.160 --> 0:01:07.480 and said, hey, how up to date is this? And 0:01:07.520 --> 0:01:11.360 he sent back this great like annotated copy with all 0:01:11.360 --> 0:01:13.880 this new stuff and basically said this is don't say this, 0:01:13.880 --> 0:01:17.399 don't be stupid. That kind of stuff. Um, so we 0:01:17.440 --> 0:01:18.920 have to thank not only Will, but we have to 0:01:18.959 --> 0:01:21.959 thank his wife, Meg, who was the one who originally 0:01:21.959 --> 0:01:24.800 turned Will onto stuff. You should know. So without Meg, 0:01:25.240 --> 0:01:27.640 we would have no Will, and without Will, we would 0:01:27.680 --> 0:01:31.160 probably have a grossly out of date and laughable PTSD 0:01:31.560 --> 0:01:33.880 article to work from that would have haunted us. We 0:01:33.920 --> 0:01:36.399 probably would have released a podcast and just pissed us off. 0:01:36.400 --> 0:01:40.680 Still exactly. Yeah, So you have now taken his information 0:01:41.280 --> 0:01:45.000 and redid your original article and now we are pretty 0:01:45.040 --> 0:01:46.920 much up to date. Yeah, and I need to go 0:01:47.000 --> 0:01:49.760 onto the site and like update the actual article, which 0:01:49.760 --> 0:01:52.880 is harder than the rounds, you know, but to just 0:01:52.960 --> 0:01:56.000 listen to this podcast for the time being, Okay, uh, 0:01:56.040 --> 0:01:58.440 And this is really good timing, Chuck, because I found 0:01:58.440 --> 0:02:02.280 out after we decided to do that, June is PTSD 0:02:02.480 --> 0:02:07.320 awareness month. Yeah, and specifically June is PTSD Awareness Day. 0:02:07.360 --> 0:02:10.119 So if you have a friend or a loved winn 0:02:10.160 --> 0:02:13.880 or a coworker who suffers from post traumatic stress disorder, 0:02:14.360 --> 0:02:18.120 be extranized to him on jun So we're talking about PTSD, 0:02:18.720 --> 0:02:22.880 which is of course um abbreviation for post traumatic stress disorder, 0:02:23.600 --> 0:02:27.760 and um, it's not a new disorder. I don't I 0:02:28.080 --> 0:02:31.519 can't imagine like when it really first came about, although 0:02:31.520 --> 0:02:35.600 it was first described in the Civil War. My guess 0:02:35.680 --> 0:02:38.560 is that it came about the first time people started 0:02:38.639 --> 0:02:42.840 encountering big time stresses, traumatic events. Yeah, they just didn't 0:02:42.840 --> 0:02:45.160 know what the heck they call it exactly, you know. Um, 0:02:45.240 --> 0:02:47.519 But it wasn't I guess until about the Civil War 0:02:48.000 --> 0:02:52.919 that we saw casualties on such a colossal level that somebody, 0:02:53.200 --> 0:02:58.280 a doctor named Jacob Mendi's Da Costa um described what 0:02:58.320 --> 0:03:01.240 he called soldier's Heart. Yeah, before that, they were just like, 0:03:01.280 --> 0:03:05.080 what's wrong with Goody Johnson? Exactly? It's just always freaking 0:03:05.080 --> 0:03:09.720 out whenever, like he hears us play this song, right, well, 0:03:09.720 --> 0:03:11.919 Goody short for good wife, So there's there's a lot 0:03:11.960 --> 0:03:18.120 going on with Goody Johnson. Um that he she um, 0:03:18.639 --> 0:03:22.440 So Da Costa is he he calls his things soldier heart, 0:03:22.639 --> 0:03:26.240 soldier's heart, and it basically is like you you seem 0:03:26.320 --> 0:03:30.679 to have some sort of heart failures techniccardia. Um, You're 0:03:30.760 --> 0:03:35.160 you're very much stressed out. And Da Costa said, this 0:03:35.200 --> 0:03:39.600 is probably a result of some sort of uh trauma 0:03:39.720 --> 0:03:42.280 from the war. Right, But they initially, like you said, 0:03:42.280 --> 0:03:44.680 thought it was cardiac based, because I'm sure dudes were like, 0:03:45.120 --> 0:03:48.680 you know, my heart's racing exactly, you know, I'm freaking 0:03:48.680 --> 0:03:51.640 out right, it's your heart. Then it can't possibly have 0:03:51.640 --> 0:03:53.520 anything to do with your mind, which we know pretty 0:03:53.600 --> 0:03:57.120 much nothing about. Right. That came about during World War 0:03:57.200 --> 0:04:01.040 One when it was famously called shell shock. Charles Myers 0:04:01.040 --> 0:04:05.240 in nineteen fifteen described it as and he was actually 0:04:05.240 --> 0:04:08.600 onto something here that it could have been a resulting 0:04:08.680 --> 0:04:13.040 from pressure from you know, artillery shells exploding nearby, and 0:04:13.080 --> 0:04:16.000 how it affects the brain, like physically affected the brain, right, 0:04:16.080 --> 0:04:18.880 And that's actually what he's talking about. Is called today 0:04:19.360 --> 0:04:23.800 mild traumatic brain injury, yeah, which is UM with the 0:04:23.839 --> 0:04:26.800 symptoms of which kind of overlap with PTSD. Yeah. I 0:04:26.800 --> 0:04:28.760 think we covered that in Concussion. Some didn't we I 0:04:28.800 --> 0:04:31.200 think we probably did too, because you know, some NFL 0:04:31.240 --> 0:04:34.960 guys are, uh, former NFL players are like committing suicide 0:04:35.040 --> 0:04:37.680 now here and there. Probably the same thing that was 0:04:37.720 --> 0:04:40.440 an interesting episode was in the shell shock Yeah, so yeah, 0:04:40.520 --> 0:04:45.560 so um, Charles Myers describes mild traumatic brain injuries and 0:04:45.600 --> 0:04:48.560 calls them shell shock. So if you just go slightly 0:04:48.600 --> 0:04:52.599 further afield and and um and kind of get a 0:04:52.600 --> 0:04:56.400 little more into the psychology behind it, you arrive finally 0:04:56.440 --> 0:04:59.719 at PTSD, the modern diagnosis of which first came about 0:04:59.720 --> 0:05:03.800 in nine teen eight. Yeah, thanks to UM they really 0:05:03.839 --> 0:05:07.280 started doing a lot of studying post Vietnam and UH 0:05:07.320 --> 0:05:10.040 in nineteen eight three, Uh, they did a case study 0:05:10.080 --> 0:05:13.360 that really just like opened up a wealth of information 0:05:13.400 --> 0:05:15.840 to kind of get the ball rolling. And since then 0:05:15.880 --> 0:05:18.640 we studied a lot, and we continue to because we're 0:05:18.680 --> 0:05:22.600 still not exactly sure the best way to treat it. Uh. 0:05:22.640 --> 0:05:28.320 And we've learned many many things since nineteen eighty about it, like, oh, well, 0:05:28.640 --> 0:05:31.599 there's the part of the brain that stores memories of 0:05:31.640 --> 0:05:36.400 fearful incidents. I think that's a venturo medial prefrontal cortex. 0:05:37.160 --> 0:05:39.760 The size of that can have an effect on whether 0:05:39.839 --> 0:05:42.680 or not you're at risk for PTSD. Some folks are 0:05:42.680 --> 0:05:45.039 more prone than others. Uh. We'll get to all this 0:05:45.120 --> 0:05:47.599 and more detail, of course, UM, Like women may not 0:05:47.640 --> 0:05:51.839 get out as much then as men. Uh, how how 0:05:51.920 --> 0:05:55.080 much danger you perceived yourself to be in, how intense 0:05:55.160 --> 0:05:58.000 the danger was, how long the danger went on for 0:05:58.400 --> 0:06:01.839 All of those are contributing factor to the development of PTSD. Yeah, 0:06:01.839 --> 0:06:03.760 and it's and like you said, perception is the key 0:06:03.839 --> 0:06:08.080 because it's your perceived reaction to it. It's not necessarily 0:06:08.600 --> 0:06:11.640 the guy next to you might not have had any reaction, 0:06:12.600 --> 0:06:15.040 you know, and gone through the same incident. Maybe two 0:06:15.040 --> 0:06:17.440 people are in the same car accident, one person can 0:06:17.480 --> 0:06:19.560 have that one person might not right, and it can 0:06:19.600 --> 0:06:22.560 be that can be exclusively based on the perception of 0:06:22.560 --> 0:06:24.920 the event. Yeah, um, you were saying, we're still learning 0:06:24.920 --> 0:06:28.279 about it. It's true. We don't have even numbers on 0:06:28.320 --> 0:06:32.080 the number of people with PTSD. That's shocking. I think 0:06:32.120 --> 0:06:34.839 the v Yeah, I think the v A estimated UM 0:06:34.880 --> 0:06:40.039 as many as eight hundred thousand veterans alone have PTSD. Well, 0:06:40.080 --> 0:06:42.640 I think. I say it's shocking, but it is. It 0:06:42.720 --> 0:06:45.840 can also be confused with things like depression and just 0:06:45.920 --> 0:06:50.000 generalized anxiety, So it's very specific PTSD, So I sort 0:06:50.000 --> 0:06:52.560 of get that right. But it has a huge effect 0:06:52.640 --> 0:06:56.960 on people like depression and anxiety disorders in general. Do UM. 0:06:57.000 --> 0:07:02.760 PTSD specifically is known to um increase unemployment, failed marriages, 0:07:02.839 --> 0:07:07.640 domestic violence, and homelessness. In suicion, Yeah, suicide is a 0:07:07.680 --> 0:07:10.440 big one too. Um, we have no idea how many 0:07:10.520 --> 0:07:15.000 PTSD suffers commit suicide. But in two ten, I believe 0:07:15.080 --> 0:07:21.520 Chuck UM twenty two veterans a day active and UM 0:07:22.120 --> 0:07:27.640 former military a day twenty two we're committing suicide. And 0:07:27.680 --> 0:07:30.120 I believe to two thousand ten not all of those 0:07:30.120 --> 0:07:33.560 are necessarily PTSD related. But once we have a better 0:07:33.640 --> 0:07:36.840 idea of how many people have PTSD, how many people 0:07:37.120 --> 0:07:39.480 who have PTSD commit suicide, I have a feeling the 0:07:39.560 --> 0:07:41.640 numbers are just gonna get bigger and bigger. I think 0:07:41.680 --> 0:07:44.440 you're right, because we're still I mean, we're only like 0:07:44.480 --> 0:07:47.239 a few generations removed from the concept of shell shock, 0:07:47.880 --> 0:07:52.120 you know, and then even more from soldier's heart and 0:07:52.200 --> 0:07:55.520 even more from what's wrong with Diddy Johnson were in 0:07:55.560 --> 0:08:00.040 the lake swims? Okay, so I guess let's get on 0:08:00.120 --> 0:08:04.200 the brass tacks. UM. Simply defined, it is a set 0:08:04.200 --> 0:08:07.840 of symptoms that result from a trauma. UM. We hear 0:08:07.840 --> 0:08:11.000 about a lot in military, obviously because they experience very 0:08:11.040 --> 0:08:14.680 intense trauma more than most folks do. But it can 0:08:14.680 --> 0:08:21.080 come about from accident, an assault, UM, natural disaster, anything 0:08:21.120 --> 0:08:24.240 that you perceive as traumatic. It can come about. Yeah, 0:08:24.280 --> 0:08:26.080 it can. It can the death of a loved one. 0:08:26.200 --> 0:08:29.160 It doesn't even necessarily have to be ama a trauma 0:08:29.200 --> 0:08:31.960 that happens directly to you. It can indirectly affect you, 0:08:32.000 --> 0:08:35.520 and you can still develop PTSD from it. Um. But 0:08:35.640 --> 0:08:40.120 the thing is that there's uh, if if somebody experiences 0:08:40.120 --> 0:08:43.240 a trauma, I'm not going to develop PTSD. They normally 0:08:43.240 --> 0:08:47.120 shake it off. Right. There's actually some some criteria for 0:08:47.320 --> 0:08:52.599 an actual PTSD diagnosis. UM, So you have to the 0:08:52.920 --> 0:08:56.600 symptoms basically have to present themselves over a certain period 0:08:56.640 --> 0:08:59.960 of time for certain length of time, and certain symptoms 0:09:00.040 --> 0:09:03.600 have to appear in the cornerstone of what's called the 0:09:03.640 --> 0:09:06.839 symptom cluster of PTSD. All the symptoms you put together 0:09:06.880 --> 0:09:11.800 to form a diagnosis. The cornerstone of those is re experience. Yeah, 0:09:11.840 --> 0:09:14.920 and some of that can happen. But the thing I 0:09:15.000 --> 0:09:17.160 kept coming across in these studies is what they called 0:09:17.200 --> 0:09:20.960 excessive retrieval. So just like you know, it's one thing 0:09:21.000 --> 0:09:24.120 to get an accident and be a little weird next 0:09:24.120 --> 0:09:26.880 time you drive in the rain, or more careful or whatever, 0:09:27.360 --> 0:09:31.720 but excessive retrieval means that it's like consuming your life. Nightmares, 0:09:32.240 --> 0:09:35.640 day terrors, I mean, you name it, like a song 0:09:35.720 --> 0:09:38.480 can spark it and you're just re experienced this thing 0:09:38.520 --> 0:09:40.680 over and over in your mind. Yeah, And it doesn't 0:09:40.679 --> 0:09:43.679 even necessarily have to be from something like a song 0:09:43.920 --> 0:09:45.679 like the song that was playing on the radio when 0:09:45.720 --> 0:09:49.080 your car you crashed your car um to trigger. It 0:09:49.080 --> 0:09:52.480 can just come without any apparent trigger whatsoever. And the 0:09:52.480 --> 0:09:54.680 big problem with this is not just like, oh man, 0:09:54.720 --> 0:09:56.880 that was such a bummer that that happened to me. 0:09:57.240 --> 0:10:01.960 It's your brain is remembering this in such a way 0:10:02.000 --> 0:10:06.199 that the the same chemical cascade takes place as it 0:10:06.280 --> 0:10:08.840 did when you were initially going through it. So for 0:10:08.880 --> 0:10:12.320 all intents and purposes, at that moment, you're fully going 0:10:12.360 --> 0:10:16.480 through that same experience again. And this happens again and 0:10:16.559 --> 0:10:20.320 again and again and again. And that's the re experience 0:10:20.480 --> 0:10:24.600 of the trauma. And that's the cornerstone symptom of PTSD. Yeah, 0:10:24.600 --> 0:10:28.280 that's what of UH, one of what they call symptom clusters, 0:10:28.320 --> 0:10:31.920 one of four. The other three are avoidance, which is 0:10:32.880 --> 0:10:35.520 obviously speaks for itself. You're gonna avoid thinking about it. 0:10:35.559 --> 0:10:38.319 Avoid you know, let's say you're in the military, might 0:10:38.360 --> 0:10:41.240 not go to Fourth of July celebrations or other places 0:10:41.240 --> 0:10:46.440 where they're big booms, um, numbness um. Doing anything you 0:10:46.480 --> 0:10:49.360 can to numb it withdrawing alcohol and drugs. Yeah, that 0:10:49.440 --> 0:10:52.319 can be a big problem with PTSD, going into it 0:10:52.480 --> 0:10:55.640 and afterward, right right, And if you already had a 0:10:55.760 --> 0:10:59.439 Drugger alcohol problem and you you develop PTSD, that can 0:10:59.480 --> 0:11:03.400 be a really hard thing to treat and separate. And 0:11:03.400 --> 0:11:07.160 the last one there is hyper arousal, which basically UM, 0:11:07.280 --> 0:11:09.640 when you see movies, they'll portray this way movies A 0:11:09.679 --> 0:11:13.840 lot is a soldier that's just jumpy and irritable and 0:11:14.040 --> 0:11:17.720 I can't sleep. They feel unsafe, sort of paranoid, always 0:11:17.720 --> 0:11:20.960 on guard. It's like your fight or flight response is 0:11:21.000 --> 0:11:24.000 always on and it's gonna be exhausting. Yeah. Well, we 0:11:24.080 --> 0:11:26.199 talked about like you can die from that kind of thing, 0:11:26.280 --> 0:11:31.040 from prolonged stress, heightened stress, like it depletes your immune system, 0:11:31.160 --> 0:11:34.320 and um, you can die as a result. And that's 0:11:34.480 --> 0:11:37.720 one of the hallmarks of PTSD is you're just constantly 0:11:37.880 --> 0:11:40.880 on guard. Yeah. Yeah, I can't imagine how tired you 0:11:40.960 --> 0:11:43.880 must be. Plus you can't sleep on top of that, exactly. Yeah, 0:11:44.400 --> 0:11:48.520 So it's a pretty awful condition to to have. UM. 0:11:49.160 --> 0:11:52.640 And uh, one of the one of the criteria for 0:11:52.760 --> 0:11:56.199 diagnosing this is that it's it's not short this can 0:11:56.240 --> 0:11:59.559 go on a very long time. Um, there's three three 0:11:59.600 --> 0:12:04.240 different types. There's acute, which is um acute PTSD the 0:12:04.320 --> 0:12:09.280 symptoms come on uh and last about three months, right, Yeah, 0:12:09.280 --> 0:12:11.200 it has to to be PFC. It has to go 0:12:11.240 --> 0:12:13.719 beyond the one month period right after that. It's kind 0:12:13.720 --> 0:12:17.120 of most people, I guess shake off a trauma within 0:12:17.120 --> 0:12:19.440 a within a month. Yeah, if it keeps going on 0:12:19.480 --> 0:12:22.360 after that, then you're in PTSD territory. If at lasts 0:12:22.400 --> 0:12:25.400 three months, that was a cute PTSD, and you probably 0:12:25.640 --> 0:12:29.000 should consider yourself lucky that that's all it was. Yeah, 0:12:29.040 --> 0:12:32.320 that's true. You could also develop chronic PTSD UM where 0:12:32.320 --> 0:12:36.280 the symptoms last more than three months and possibly a lifetime. UM. 0:12:36.400 --> 0:12:38.839 And then there's delayed onset where the symptoms don't show 0:12:38.920 --> 0:12:40.480 up for at least six months. And then I guess 0:12:40.520 --> 0:12:42.840 it could be acute delayed on set or chronic delayed 0:12:42.880 --> 0:12:45.120 on set. Yeah. And you point out here that kids 0:12:45.120 --> 0:12:46.760 can get it too. It's not you know, we talk 0:12:46.840 --> 0:12:52.240 about adults oftentimes, but uh, kids can present differently. Um. 0:12:52.280 --> 0:12:56.400 You know, really poor behavior, really needy behavior, drawing things out. 0:12:56.920 --> 0:12:58.880 And that's something you always see in movies too, Like 0:12:58.920 --> 0:13:01.960 the kid drawing the plane car right and stuff like um, 0:13:02.080 --> 0:13:05.400 or acting it out with dolls. That's another one too. 0:13:05.840 --> 0:13:07.959 But as they grow up, they become a little more 0:13:08.040 --> 0:13:12.120 just regular adult symptoms if they haven't you know, gotten 0:13:12.120 --> 0:13:14.880 over by then, which is super sad. Yeah. So for 0:13:15.000 --> 0:13:18.400 a very long time, Chuck researchers thought that everyone is 0:13:18.440 --> 0:13:21.520 at equal risk of developing PTSD after going through trauma. 0:13:22.320 --> 0:13:26.000 But they found, UM, I guess from studying really hardcore 0:13:26.080 --> 0:13:31.400 since that Vietnam study, UM that there's actually risk factors 0:13:31.440 --> 0:13:35.280 and protective factors that can keep people from developing PTSD 0:13:35.480 --> 0:13:38.320 or can make you more likely to develop PTSD. Yeah. 0:13:38.360 --> 0:13:41.840 One of the big ones is, um, if you've already 0:13:41.920 --> 0:13:45.760 experienced a prior trauma, Yeah, because um, it's additive. So 0:13:45.920 --> 0:13:49.440 it can actually mount up these things over the years, 0:13:49.960 --> 0:13:52.720 and then there could be one final trauma that finally 0:13:52.720 --> 0:13:55.679 triggers the PTSD. And you're more likely too if you've 0:13:55.679 --> 0:13:58.000 experienced these things exactly. And you were saying, like, the 0:13:58.000 --> 0:14:01.600 military's at greater risk than the average person because there 0:14:01.760 --> 0:14:08.000 they are experienced a prolonged, intense trauma, and um, it 0:14:08.080 --> 0:14:11.440 seems to me that PTSD is moving very quickly toward 0:14:11.520 --> 0:14:15.640 it almost entirely brain based model UM. And one of 0:14:15.640 --> 0:14:17.920 the reasons why is it finding like all these chemicals 0:14:17.960 --> 0:14:24.280 and and UM genetic markers that are responsible for different aspects, 0:14:24.280 --> 0:14:26.920 and it's like this clear pictures emerging. One of the 0:14:26.920 --> 0:14:31.360 big ones is a gluco corticoid. Yeah, that's right, I 0:14:31.400 --> 0:14:35.720 got it. It's a class of brain hormones and they 0:14:35.760 --> 0:14:39.400 help control our stress response. So we were talking about 0:14:39.480 --> 0:14:43.960 how UM, if you experience one trauma, you you're gluco 0:14:44.120 --> 0:14:47.920 corticoid UM levels are depleted, because it's like, come on, 0:14:48.000 --> 0:14:50.240 let's just hang in there. We'll hang in there if 0:14:50.240 --> 0:14:54.040 you get another. If you experience another trauma and those 0:14:54.080 --> 0:14:57.560 hormones are depleted already, then you're going to experience the 0:14:57.640 --> 0:15:01.680 fear and stress of that far more acutely then you 0:15:01.720 --> 0:15:06.360 would have had your glucocorticoid levels been normal. Yeah, that's 0:15:06.360 --> 0:15:09.280 why it's compounding and additive. Well, and they also have 0:15:09.360 --> 0:15:14.600 found that UM cortisol, which is a glucocorticoid, Elevated levels 0:15:14.640 --> 0:15:19.600 of this can affect your memory in a negative way, 0:15:19.960 --> 0:15:23.160 which can be positive if you have PTSD. So they 0:15:23.160 --> 0:15:26.960 did a study in two thousand eight three month blind 0:15:27.040 --> 0:15:30.720 double blind placebo controlled study, our favorite kind that sounds 0:15:30.720 --> 0:15:33.800 like a real deal, where they gave these three soldiers 0:15:34.280 --> 0:15:39.240 low low doses of cortisol or hydrocortisone, and um, they 0:15:39.280 --> 0:15:44.160 found significant effects with no side effects and even evidence 0:15:44.200 --> 0:15:47.800 of prolonged effect. So, um, I know later on in 0:15:47.840 --> 0:15:49.840 the article you talk about one of the things they're 0:15:49.840 --> 0:15:52.680 doing now is injecting people with hydrocortisone and like the 0:15:53.000 --> 0:15:55.600 er Yeah, like immediately after an event, and it's it's 0:15:55.640 --> 0:15:58.000 basically shown to decrease your memory, like you just don't 0:15:58.000 --> 0:16:00.480 remember that stuff as well. Yeah, and it lowers the 0:16:00.520 --> 0:16:03.200 stress response. I mean think about this, you're you're the 0:16:03.200 --> 0:16:05.440 stress response is part of your immune system right where 0:16:05.440 --> 0:16:11.120 it's at least connected in some really close way. Hydrocortizone 0:16:11.280 --> 0:16:17.240 is like an anti dampens your immune response, So they 0:16:17.280 --> 0:16:21.680 think that PTSD is like maybe a heightened stress response 0:16:21.760 --> 0:16:25.400 or a heightened immune system response, and just giving somebody 0:16:25.400 --> 0:16:29.520 like a regular shot of hydrocortizone, it's it's working. Yeah, 0:16:29.680 --> 0:16:32.080 it's so weird. Well, because as to do with memory, 0:16:32.120 --> 0:16:35.440 if you're if you're decreasing your ability to remember something, 0:16:35.640 --> 0:16:38.200 you're going to increase the likelihood that you won't suffer 0:16:38.240 --> 0:16:42.600 from bad memories, you know. Um, so some other risk 0:16:42.640 --> 0:16:46.880 factors and protective factors. Uh, like what type of personality 0:16:46.920 --> 0:16:49.920 you have factors? And this makes sense. If you're an 0:16:49.960 --> 0:16:53.280 optimistic type, you're probably going to be less likely to 0:16:53.280 --> 0:16:56.280 suffer PTSD. Yeah, you haven't here belief that there's order 0:16:56.320 --> 0:16:58.440 to the umerg Does that is that specific to like 0:16:59.120 --> 0:17:01.600 a belief in God. I think that that's one of 0:17:01.640 --> 0:17:05.840 the accepted definitions of optimism or the optimistic personality. It's 0:17:05.880 --> 0:17:10.200 interesting somebody who believes, yeah, not that it's not chaotic, 0:17:10.240 --> 0:17:13.080 that there's reasons for things. Things happen for a reason. 0:17:13.359 --> 0:17:15.119 So I wonder if an atheist is more likely to 0:17:15.119 --> 0:17:19.800 get PTSD. I could see that interesting. Um, But it's 0:17:19.800 --> 0:17:22.720 also that other people are generally good is another It's 0:17:22.800 --> 0:17:25.760 like the second part of that definition. Uh, if you 0:17:25.840 --> 0:17:29.400 are someone who tackles things head on and don't put 0:17:29.440 --> 0:17:34.119 your problems on the back burners, obviously this is gonna wait. 0:17:34.160 --> 0:17:36.560 If you're not putting it on the backburner, that means 0:17:36.560 --> 0:17:39.960 you're going to have a less likelihood. Yeah, I got 0:17:39.960 --> 0:17:43.560 all confused there. Yeah, because avoidance is one of the deal. 0:17:44.320 --> 0:17:48.320 And if you have problem avoidance behavior avoidance behavior UM, 0:17:48.480 --> 0:17:50.360 or you just like don't like to talk about problems 0:17:50.440 --> 0:17:52.840 or don't like to think about things, You just rather 0:17:52.960 --> 0:17:54.680 just kind of push it. It's probably true for any 0:17:54.760 --> 0:17:57.040 mental disorder. If you're not prone to tackle it head on, 0:17:57.119 --> 0:17:59.440 then it's just gonna get worse. Yeah, you know, yeah, 0:17:59.480 --> 0:18:01.879 well that's one of the things about PTSD is like 0:18:01.920 --> 0:18:06.760 your memories become exaggerated and bloated and way worse even 0:18:06.840 --> 0:18:12.840 than the actual experience. If you are college graduate or 0:18:12.960 --> 0:18:15.920 maybe even just went to college, then um, you're gonna 0:18:15.920 --> 0:18:18.320 be less likely to have it. And we also pointed 0:18:18.359 --> 0:18:21.679 out earlier that women are less likely to experience it 0:18:21.720 --> 0:18:26.719 than men. Yeah, they're not entirely certain why. I don't know, 0:18:26.840 --> 0:18:30.240 but that's strictly from the Vietnam study. I think, um, 0:18:30.359 --> 0:18:34.320 it was something like thirty six percent of Vietnam veterans 0:18:34.320 --> 0:18:37.000 who experienced hardcore combat. I don't know if that's the 0:18:37.080 --> 0:18:38.600 term that you use, but you know what, I'm sorry 0:18:38.600 --> 0:18:41.199 to work combat. Yeah, thirty six percent of males in 0:18:41.200 --> 0:18:44.840 that situation had PTSD and eighteen percent of females did. 0:18:45.640 --> 0:18:47.760 So what that's like twice as likely if you're male, 0:18:48.000 --> 0:18:51.679 then a female UM. They think genes may have something 0:18:51.680 --> 0:18:54.560 to do with it. They're looking to a gene called 0:18:54.560 --> 0:18:58.520 the serotonin transporter gene. And there is a paper out 0:18:58.520 --> 0:19:01.560 there that indicates that if you have a mutated gene 0:19:01.840 --> 0:19:06.320 serotonin transporter gene, than it could impact your attention to 0:19:06.480 --> 0:19:10.080 environmental threats, which could impact whether or not you get 0:19:10.119 --> 0:19:15.480 PSD PTSD. Geez. So you remember we did that episode 0:19:15.520 --> 0:19:20.800 Can my grandfather's diet shortened my life? About epigenetics? Well, 0:19:21.080 --> 0:19:26.520 epigenetics possibly factor into UM PTSD as well. So epigenetics 0:19:26.520 --> 0:19:31.240 is basically where the function of a gene is um 0:19:31.280 --> 0:19:35.080 affected within somebody's lifetime changes basically right, So it's like 0:19:35.160 --> 0:19:39.159 evolution on the basis of years rather than you know, 0:19:39.280 --> 0:19:42.919 generations and generations UM. And there was a study in 0:19:43.320 --> 0:19:47.160 Detroit of a hundred people who fit the criteria for 0:19:47.359 --> 0:19:52.840 PTSD diagnoses, and they found that they had six or 0:19:52.880 --> 0:19:56.800 seven times the epigenetic changes of the control group, and 0:19:56.840 --> 0:19:59.480 that a lot of those epigenetic changes, most of them 0:19:59.800 --> 0:20:02.919 UM had to do with genes that that were responsible 0:20:02.960 --> 0:20:06.159 for keeping up the immune system. Interesting, did they factor 0:20:06.160 --> 0:20:08.760 in the fact that they've lived in Detroit? Well, that 0:20:08.920 --> 0:20:12.320 was funny. I guess, in some horribly dark comic goal 0:20:12.400 --> 0:20:15.600 way is that the researchers were from New York City 0:20:16.000 --> 0:20:18.280 and they traveled to Detroit to find a hundred people 0:20:18.320 --> 0:20:20.880 with PTSD. I'm sure they could have found that New York. 0:20:21.080 --> 0:20:24.719 I guess they cast their lot in Detroit for some reason. 0:20:24.920 --> 0:20:26.639 We love Detroit. By the way, We've been getting a 0:20:26.680 --> 0:20:29.320 lot more emails lately because I think people pick up 0:20:29.400 --> 0:20:32.480 newly and hear us dashing Detroit and they don't realize 0:20:32.520 --> 0:20:35.040 it's been a running joke now for five years, as 0:20:35.440 --> 0:20:41.960 almost six years. We love Detroit. Who doesn't exactly um. 0:20:42.080 --> 0:20:44.679 And then, of course, the most important factor with this 0:20:44.840 --> 0:20:48.760 or any other mental disorder is what they called a 0:20:48.800 --> 0:20:52.520 trauma membrane, which is that support network your friends and 0:20:52.560 --> 0:20:55.680 your family if you've got a strong one, and it's 0:20:55.800 --> 0:20:58.600 a strong one in the right way. Like you point out, 0:20:58.880 --> 0:21:02.640 they can be well meaning, but the person receiving that 0:21:02.960 --> 0:21:06.120 membrane and that protection it has to do do right 0:21:06.160 --> 0:21:08.600 by them. Yeah, and then they can't just be like, well, 0:21:08.680 --> 0:21:11.960 you know, just just on the bright side, you know, 0:21:12.080 --> 0:21:16.040 don't worry about that. Like, however, you're you're experiencing this 0:21:16.119 --> 0:21:18.479 and getting over it. You're doing it wrong. Do it 0:21:18.520 --> 0:21:21.240 this way. That's not gonna help, right. But basically the 0:21:21.280 --> 0:21:28.240 point is if you are single alcoholic veteran that is 0:21:28.320 --> 0:21:30.639 a loner living by yourself, it doesn't like to think 0:21:30.680 --> 0:21:33.440 about your problem. Yeah, and like your tiny little apartment. 0:21:33.520 --> 0:21:38.560 Then that's like the worst case scenario for PTSD. Yes. Yeah, 0:21:38.720 --> 0:21:43.040 Like we said, the military is at a greater UM 0:21:43.359 --> 0:21:46.920 risk just from being exposed to these situations and being 0:21:46.960 --> 0:21:50.200 exposed to him over and over and over again. UM. 0:21:50.280 --> 0:21:53.800 And but one of the other reasons that the military, 0:21:53.880 --> 0:21:59.840 especially the military of late UM is at risk is 0:21:59.880 --> 0:22:03.919 be because brain injuries where the quote signature wound of 0:22:03.960 --> 0:22:08.240 the Iraq War I don't remember thanks to UM roadside 0:22:08.240 --> 0:22:12.719 bombs I e. D. S UM, there are a significant 0:22:12.720 --> 0:22:16.720 amount of head injuries. Are treatment of head injuries advanced 0:22:16.800 --> 0:22:18.919 enough so that we could save lives where they wouldn't 0:22:18.920 --> 0:22:21.800 have been before, Like people were exposed to head injuries 0:22:21.840 --> 0:22:25.680 like in countless other wars. But now we've gotten to 0:22:25.680 --> 0:22:28.080 the point where we can save those people's lives. The 0:22:28.119 --> 0:22:32.040 problem is that their brains are changed. They've undergone what 0:22:33.040 --> 0:22:37.600 Charles Myers called shell shock mild traumatic brain injury, which 0:22:37.640 --> 0:22:42.120 again is almost indistinguishable and possibly one and the same 0:22:42.160 --> 0:22:47.480 in some cases as PTSD. Yeah, and imagine the uncertainty 0:22:47.560 --> 0:22:53.040 of guerrilla warfare and things like roadside bombs. Um, Like, 0:22:53.080 --> 0:22:55.920 you can be prepped somewhat for for battle and we'll 0:22:55.960 --> 0:22:57.400 get to that here in a little bit. What they're 0:22:57.400 --> 0:22:58.840 trying to do the more and more of these days 0:22:58.880 --> 0:23:02.400 with that, but with these guerrilla tactics that are going 0:23:02.440 --> 0:23:04.719 on in the Middle East, with with suicide bombers and 0:23:05.040 --> 0:23:07.879 car bombs and things like that, it's like kind of 0:23:07.880 --> 0:23:13.359 the perfect prescription for eventual ps PTSD. Yeah. I'm trying 0:23:13.359 --> 0:23:17.560 to trick to take the trauma out of it. Yeah. 0:23:17.880 --> 0:23:21.680 Um yeah, we mentioned earlier, remember the optimistic personalities less 0:23:21.720 --> 0:23:24.320 likely in the optimist believes in order in the universe. Well, 0:23:24.520 --> 0:23:27.360 guerrilla warfare is like the opposite of order in the universe. 0:23:28.920 --> 0:23:31.520 Are you starting to see like this pattern, Like all 0:23:31.640 --> 0:23:34.600 this stuff is on the table. Yeah, it's just now 0:23:34.640 --> 0:23:38.159 a matter of connecting it. And it seems like neurology 0:23:38.240 --> 0:23:40.360 is going to be the field that does that, I think, so, 0:23:40.560 --> 0:23:45.080 you know, so counseling obviously is step one. Um, and 0:23:45.240 --> 0:23:47.080