Globeadvisor.com: Emotional pain: the silent killer of spirit

From globeadvisor.com:
SUSAN PINKERspinker@globeandmail.com

Dear Susan,
I have worked in broadcasting for 20 years and the past five years have been very painful, as I lost two brothers to suicide and suffer from severe posttraumatic stress syndrome as a result. In your last column you asked how illness has affected one's career, and, although I realize that this is not a physical illness, it has affected my morale, interests and made each day feel like torture. Do you have any ideas about how to move forward?
Michele

Dear Michele,
When I was about 10, I impressed my parents with the observation that injured feelings hurt more than cuts, scrapes and broken bones. I no longer remember what prompted that piece of juvenilia, but I still hold to it, even if the boundary between psychological and physical illnesses is no longer that meaningful. The best evidence we have now points to anxiety disorders - including posttraumatic stress disorder (PTSD) - as heritable illnesses with biochemical and genetic roots.

Like its cousin, major depression, susceptibility to PTSD runs in families, is far more common among women, and has mortal risks. The trigger is a disaster, or a devastating assault on one's psyche but the groundwork that makes a person vulnerable is laid down by their genes and the subtle flow of neurotransmitters that regulate their emotions. A biochemical stew gone awry is what makes them lose interest in activities they used to love (your work comes to mind), and those suffering from PTSD relive a trauma over and over through flashbacks and panic. Both mimic life-threatening fear reactions that put one on high alert.

With their hearts racing and often unable to sleep or to concentrate, people with PTSD are at increased risk of suicide and substance abuse. They can pass these susceptibilities on to their children, not just through their genes but via their unusual emotional responses - which, amazingly, can alter the genetic capacities of the next generation to handle its own stresses.
It all sounds ethereal and psychological, but the nuts and bolts are biological. People with PTSD secrete smaller amounts of cortisol, a chemical that helps the body deal with life-threatening events, and they have smaller hippocampi, a seahorse-shaped organ deep in the brain that is one of its most ancient switching stations for facing down fear.

So what should you do?

First, as a physical illness, take PTSD as seriously as you would a cancer diagnosis, starting with a visit to your physician and a referral to an expert. If you live in a major urban centre, it should be easier to see a specialist: the Homewood Health Centre in Guelph, Ont., and Toronto's Centre for Addiction and Mental Health are two world-renowned centres of expertise. As with any health problem, living in a rural region makes access to help trickier, but a treatment plan should include medication, cognitive behavioural therapy and regular follow up visits.

As a workplace veteran, your health and disability plan should cover your absences and treatment, but almost as important is finding renewed purpose in your job and meaningful connections to other people. Therein likes recovery, and the source can be volunteering, involvement in community or church, and research shows, even online support groups. You may feel like the lone survivor of a major catastrophe but if you scratch just a little, you'll find others much like you - PTSD is an unusually common Canadian story, with more than 9 per cent of the population having experienced the disorder, compared with 8 per cent of Americans and less than 2 per cent of Europeans.

Canadians may seem outwardly peaceful but many, like you, have roiling inner lives.

Posted in: globe advisor,ptsd,susan pinker