Attrition: How Stress Gets You High Before You Die

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July 26, 2010: Israeli PTSD (post-traumatic stress disorder) researchers have made an interesting discovery. By monitoring troops in a combat zone, they discovered that stress (the major cause of PTSD) made troops less vigilant, not, as conventional wisdom long held, more vigilant. A lot of stress tended to make troops zone out, as a way to cope. Some troops did buckle down and become more alert under stress, but not the majority. Lack of vigilance in a combat zone is a major source of death, injury and getting yelled at.

Since World War II, several other factors for PTSD have been discovered. Israel noted, after the 1982 war in Lebanon, that reservists were more sensitive to the aftereffects of combat. The Lebanon conflict used a larger (than previous wars)  number  of older reserve troops, who tended to be more prone to coming down with stress disorders. This was probably due to the fact the full time soldiers are constantly conditioned to deal with stress. While this is often referred, often derisively, as "military discipline," it has been known for thousands of years that such practices reduce stress and panic during combat. Apparently it reduces the chances of coming down with stress problems as well. Thus the new programs to spot stress related problems, as early as possible, and also develop new treatments. The stress angle has been more intensively studied in Iraq than in any previous war. Naturally, the more you look, the more you find.

More recently, Israeli researchers also found markers in the blood that indicate someone has PTSD. Other researchers found that patients suffering from PTSD, along with other forms of mental distress (substance abuse, depression, chronic pain) had different brain images (provided by CT scans) than those with just PTSD.  Research is also showing that PTSD is a distinct form of mental distress. For example, research turned up the fact those who had killed someone in combat, were 40 percent more likely to show symptoms of PTSD, or similar symptoms found in those who suffered concussions from roadside bombs.

Many troops, because of exposure to roadside bombs, and battlefield explosions in general, have developed minor concussions that, like sports injuries, that can turn into long term medical problems. Often these concussions were accompanied by some PTSD. Further research documented the connection between concussions, and other brain trauma, and PTSD conditions.

There is a PTSD epidemic right now, created by the unprecedented exposure of so many troops, to so much combat, in so short a time. But what is actually happening is the discovery that much of what is thought to be PTSD, is actually physical injuries (to the brain) that can now be detected (with more precise instruments like MRI), and often treated. Thus it is becoming clear that there are several different conditions here, all with similar PTSD symptoms, but not with similar effects on the brain. Each strain of PTSD will require a different type of cure. Finding these cures is increasingly important, since better diagnostic capabilities has made it possible to more frequently, and accurately, diagnose PTSD.

None of these discoveries is going to cure PTSD, but they are examples of how new technology (how to easily measure neurosteroids in the brain and cheaper and easier brain scans) has made it possible to isolate the physical factors operating in PTSD patients. That kind of incremental success, results in better treatments for PTSD.