As our knowledge of both physical and mental health has grown, it seems that we have become increasingly focused on identifying specific conditions and finding the best treatment to address them. Rather than simply labeling someone as sick, we are able to identify whether they are suffering from the flu, a sinus infection, or an autoimmune disease, and each of these conditions calls for a different treatment. While this specificity has done wonders to extend our life expectancy and decrease unnecessary loss of life, the more we learn about a specific condition, the more we realize that both its causes and consequences can be far broader than what originally meets the eye. Gaining a more complex understanding of how our bodies operate and how different health issues may interact with each other is crucial to ascertaining both effective treatments and preventative options.
One condition that is still quite early in this process of holistic understanding is post-traumatic stress disorder (PTSD). PTSD is a psychological condition in which individuals experience a traumatic event and fail to adequately recover from it. As a result, they re-experience the physiological symptoms of distress that were present during the original incident, attempt to avoid thoughts and reminders of the incident, and experience hyperarousal symptoms such as hypervigilance and insomnia (Yehuda & LeDoux, 2007). These symptoms result in impaired social, occupational, or interpersonal functioning, and are often comorbid with substance abuse disorders and depression (Yehuda & LeDoux, 2007). For example, a veteran returning from war may have been traumatized by a life-threatening situation in combat and experience severe distress when hearing fireworks go off because the sound reminds them of their traumatic experience. As a result, their heart may start racing or they may desperately try to get everyone around them to take cover, thus disrupting their social life (e.g., at a New Years party). While it is unclear what causes one individual to develop PTSD in the wake of a traumatic incident while another simply resumes a normal lifestyle, research suggests that individual differences in genetics and epigenetics play a huge role in determining whether people are resistant to stress, how well they recover from it, and who actually becomes more resilient after the traumatic stressor (Yehuda & LeDoux, 2007).
In order to address these symptoms, mental health professionals are often the primary source of treatment for individuals with PTSD. However, we are beginning to see that the effects of PTSD are not simply limited to psychological symptoms. Although evidence is not completely clear yet, a review of 15 studies conducted between 1980-2014 suggested that PTSD was negatively associated with physical activity and positively associated with binge eating behavior (Hall, Hoerster, & Yancy, 2015). It is not surprising, then, that a large-sample (n=54,224) prospective study also found that PTSD was associated with faster weight gain and increased risk of obesity among female nurses (Kubzansky et al., 2014). Furthermore, PTSD has been shown to be associated with chronic diseases such as cardiovascular, metabolic, and neurological conditions as well as cancer (Schnurr, 2015). Interestingly, these conditions are not a direct result of trauma, but rather, they originate alongside severe and persistent distress (Schnurr, 2015).
Before reading these articles, I had no idea so many physical health conditions were associated with PTSD. Some, such as cardiovascular disease, are somewhat logical because of their link to the physiological symptoms of PTSD such as increased heart rate when re-experiencing trauma. However, others, such as weight gain and unhealthy eating, are less predictable. Given the seriousness of many of these chronic diseases it seems critical that we increase awareness of their connection with psychological conditions such as PTSD. Individuals with PTSD should not only see mental health professionals but should also receive guidance from medical doctors to monitor and attempt to prevent the onset of medical conditions such as obesity or cancer. Furthermore, future studies should continue to examine PTSD as holistically as possible, including looking at health consequences that at first glance may not seem connected. Our bodies work in complex ways that we are only just beginning to understand, and sometimes we need to remind ourselves that the physical and mental cannot be compartmentalized, but rather, are intimately connected within one body.
Hall, K. S., Hoerster, K. D., & Yancy Jr, W. S. (2015). Post-traumatic stress disorder, physical activity, and eating behaviors. Epidemiologic reviews, 37(1), 103-115.
Kubzansky, L. D., Bordelois, P., Jun, H. J., Roberts, A. L., Cerda, M., Bluestone, N., & Koenen, K. C. (2014). The weight of traumatic stress: a prospective study of posttraumatic stress disorder symptoms and weight status in women. JAMA psychiatry, 71(1), 44-51.
Schnurr, P. P. (2015). Understanding pathways from traumatic exposure to physical health. In Evidence Based Treatments for Trauma-Related Psychological Disorders (pp. 87-103). Springer International Publishing.
Yehuda, R., & LeDoux, J. (2007). Response variation following trauma: a translational neuroscience approach to understanding PTSD. Neuron, 56(1), 19-32.