PTSD and Physical Symptoms

The link between trauma in the mind and effects on the body is an interesting one. Perhaps the most widely studied mental disorder related to trauma is PTSD (posttraumatic stress disorder). PTSD can be comorbid with a variety of other psychological disorders and physical health risks, such as depression, obesity, and chronic pain.

In particular, I am most interested in the connection between PTSD and weight gain. Often times, individuals who binge eat are said to be “eating away the pain” or “trying to fill the emptiness inside”. Binge eating can of course lead to obesity, which then puts the individual at greater risk for other psychological and physical health risks, and creates somewhat of a vicious cycle in their health outcomes. It seems to be similar for individuals who experience PTSD in that their traumatic experiences may lead to binge eating as a coping mechanism, and this maladaptive coping pattern can result in further issues. Hall and colleagues (2014) describe that PTSD-diagnosed individuals are much more likely than non-diagnosed individuals to become obese over time. This is both because of binge eating and because there may be an avoidance of physical activity. The avoidance of physical activity makes sense as sensations such as sweating and faster heartbeat could be feared by an individual who has experienced these same bodily arousal sensations during a traumatic experience. Hall and colleagues also highlight that individuals who were overweight and obese prior to the onset of PTSD are more likely to gain weight faster. Although they do not provide a potential explanation for this pattern, this makes sense as individuals who already have an established coping mechanism for dealing with life’s issues may continue to use what they have already established. However, for individuals who have just been diagnosed, they may be a bit slower to find binge eating as a way of working through their trauma.

After reading through Hall et al.’s (2014) review, I wondered what would happen if we were able to treat the PTSD effectively. After all, it seems like the core of the issue is PTSD, and it is leading to all of the other possible physical symptoms. Therefore, one would think that by treating the main issue, the other problems would simply go away. However, Schnurr (2015) addressed this problem in a review of examining pathways between trauma and physical health. As it turns out, even when PTSD is treated through cognitive behavioral therapy and medication, it does not necessarily mean that the physical symptoms will be mitigated. There are a few exceptions that have been cited, such as chronic whiplash disorder (Schnurr, 2015). For more chronic diseases, such as cardiovascular disease, diabetes, or obesity, there is a lack of research and the effectiveness of treating such disorders during or after PTSD treatment seems to be largely unknown. However, from previous readings (see previous blog posts), it would seem that the development of long term diseases cannot simply be reversed, even if PTSD is treated. Because the initial steps that lead to cardiovascular disease are a process that occurs over time, and could even be triggered by other comorbid factors (such as life event stress, or depression), it seems unlikely that cardiovascular disease would be reversed. Even with obesity and weight gain, it would not be enough to simply treat PTSD, but rather all of the physical activity and binge eating patterns that had developed over time. Behaviors that had been established over time after the onset of PTSD would need to be reversed. Therefore, it seems unlikely that just because someone may learn to work through the trauma they experienced, and learn how to avoid responding to potential triggers for traumatic responses, that their other physical risks would simply dissipate.

 

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