A possible root for some cases of PTSD?

The term 'post-traumatic stress disorder' has become something of a cliché these days.  I think it's greatly over-diagnosed by doctors and other medical professionals who have no personal experience of it, and therefore treat it as a 'catch-all' category in which to lump those with a military or security background who have psychological or psychiatric issues for which they have no other explanation.  Nevertheless, it is real.  I've experienced it to some extent myself, during and after eighteen years' exposure to conflict in southern Africa.

One possible cause of at least some sorts of PTSD has come to light.  The Telegraph reports:

Shockwaves from explosions may scar the brains of soldiers in areas linked to post-traumatic stress disorder (PTSD), suggesting a possible physical cause for the condition.

Scientists found distinctive injuries in the brains of eight military personnel who survived bomb blasts but died between four days and nine years after the trauma.

. . .

“Blast-related brain injuries are the signature injury of modern military conflicts”, said senior author Dr Daniel Perl from the Uniformed Services University of the Health Sciences, Maryland, USA.

“Although routine imaging for blast-related traumatic brain injury often shows no brain abnormalities, soldiers frequently report debilitating neuropsychiatric symptoms such as headaches, sleep disturbance, memory problems, erratic behaviour and depression suggesting structural damage to the brain.

“Because the underlying pathophysiology is unknown, we have difficulty diagnosing and treating these ‘invisible wounds’.”

The authors conclude: “This presents the possibility that the scarring, particularly that in the neuroanatomical areas associated with PTSD ... may increase the probability of PTSD symptom expression in people exposed to blasts.”

In five male soldiers who survived more than six months after blast exposure, the scientists found a ‘distinctive, consistent, and unique pattern’ of prominent scarring in parts of the brain that are crucial for thinking, memory, sleep and other important functions.

. . .

The scarring was different to injuries seen in soldiers who had suffered other types of brain injury such as through car accidents or contact sports.

“In these controls we did not see similar scarring to the blast cases, which increases the likelihood that the pattern is linked with high-explosive exposure,” added Dr Perl.

“Although little is known about the effect of blast shockwave on the human brain, the unique pattern of damage that we found is consistent with known shockwave effects on the human body.”

There's more at the link.

I'm intrigued by this discovery.  I've been exposed to high explosive blasts (artillery shells, grenades, etc.) at close range (sometimes very close).  I can well recall the effect;  it was as if my brain had suddenly been clogged with excessive quantities of cotton wool.  I could think, but only very slowly, struggling to form coherent thoughts and finding it difficult, if not impossible, to act on them with any speed.  I can only describe it as the mental equivalent of a sprinter having to run through thigh-deep molasses.  He'd be straining every muscle and sinew, but unable to move at more than a snail's pace.  That's pretty much what it felt like (although, fortunately, the symptoms disappeared after a few minutes or hours, depending on the severity of the exposure).

Interestingly, I haven't experienced (or, at least, I don't think I've experienced) the physical PTSD consequences described in the article.  My PTSD was more psychological in nature, the result of losing 27 friends (including my fiancée) in the 18 years of near-civil-war that South Africa experienced between 1976 and 1994.  I've written about some of those experiences - see here for one example.  They affected me very profoundly.  I was fortunate to be able to make a fresh start by coming to the USA in the late 1990's, and to find a therapist here who'd had to deal with his own PTSD after serving in Vietnam.  He was able to help me find ways to accept and deal with the bad memories, then put them away and move on with my life.

I guess my PTSD (if that's what it was) was transient in nature.  This research appears to have uncovered a more permanent form of PTSD, one that doesn't go away after therapy, and perhaps is physically incapable of going away.  I hope this line of inquiry is pursued further.  If it can help those who suffer from PTSD to find balance and get on with their lives, it'll be invaluable - and, heaven knows, after fifteen years of the War on Terror, we have far too many of them in our midst.

Peter