Post-Traumatic Stress Disorder, Complex PTSD, and Epilepsy.

By: Natalie L. Boehm, MBA, RBLP-T

What is Post-Traumatic Stress Disorder?

The American Psychiatric Association (APA) defines Post Traumatic Stress Disorder (PTSD) as a psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event. Examples can be a serious accident, war/combat, rape/sexual assault, or who have been threatened with death, sexual violence, or serious injury.

PTSD can affect anyone in their lifetime. One in eleven people will be diagnosed in their lifetime, a statistic that many are not aware of. When we think of the stigma that is connected to mental illness, it is alarming to see how many are affected, yet many are most likely not receiving the help they need. Women are twice as likely to be diagnosed, and minorities such as African Americans, Latinos, and Native Americans are at a higher risk for developing PTSD (APA, 2020).

Signs and Symptoms

1. Intrusion: Intrusive thoughts such as repeated, involuntary memories, distressing dreams, or flashbacks of the traumatic event. Can be vivid, as if they are reliving or reseeing the event.

2. Avoidance: Avoid people, places, activities, objects, and situations that may trigger distressing memories. May avoid trying to think about the traumatic event or may not be willing to talk about the event.

3. Alterations in cognition and mood: cannot remember important aspects of the event, negative thoughts, feelings, and distorted beliefs about oneself and/or others, ongoing fear, horror, anger, rage, guilt, or shame. Disinterest in activities they once liked, feeling detached/estranged from others, being unable to experience positive emotions (void of happiness or satisfaction).

4. Alterations in arousal and reactivity: arousal and reactive symptoms may include being irritable and having angry outbursts; behave recklessly or self-destructive, suspiciousness, easily startled, problems concentrating or sleeping.

(APA, 2020)

What is Complex Post-Traumatic Stress Disorder?

Individuals who are battling PTSD may be diagnosed with Complex PTSD. Situations such an early life trauma, child abuse, ongoing trauma, and still being in contact with an abuser can fall under the guidelines of CPTSD.

Symptoms are similar to those who are battling PSTD but may include:

  • Feelings of shame or guilt
  • Difficulty controlling your emotions
  • Periods of losing attention and concentration (dissociation)
  • Physical symptoms, such as headaches, dizziness, chest pains, and stomach aches
  • Cutting yourself off from friends and family
  • Relationship difficulties
  • Destructive or risky behavior, such as self-harm, alcohol misuse, or drug abuse
  • Suicidal thoughts

(NHS.UK, 2018)

How does Post-Traumatic Stress Disorder affect Epilepsy?

Post-Traumatic Stress Disorder can affect individuals with epilepsy in many ways. Just having a seizure can be a traumatic event for someone who is battling epilepsy. In the article, Postepileptic seizure PTSD: A very rare psychiatric condition in patients with epilepsy, fifty one percent of patients with epilepsy were reported to have a PTSD cause by a traumatic seizure (Labudda et. al., 2018).

Individuals who battle anxiety and depression are at higher risk to develop Post-Traumatic Stress Disorder. Anxiety and depression are common side effects for people battling epilepsy. Due to the stigma and discrimination that many with epilepsy face, many who develop Post-Traumatic Stress Disorder are very likely to be hypersensitive. Hormones such as adrenaline and cortisol can be above normal levels due to the ‘fight, flight, or freeze” reaction that many with Post-Traumatic Stress Disorder have. Post-Traumatic Stress Disorder has a negative effect on the brain. Many who are diagnosed with Post-Traumatic Stress Disorder have shrinkage of the hippocampus, which can result in cognitive impairment. Flashbacks and nightmares are a result of the damage to the hippocampus from Post-Traumatic Stress Disorder (NHS, 2018).

Treatments

According to Mayo Clinic, there are two main treatments that can be used to help treat Post-Traumatic Stress Disorder:

Psychotherapy

Cognitive therapy: a type of talk therapy that helps to recognize a person’s way of thinking. Helps to alleviate negative thoughts about oneself and prevent reoccurring trauma. Cognitive therapy can be used with exposure therapy.

Exposure therapy: Helps someone battling PTSD to face situations and memories that they find frightening so that they can cope with them. Effective treatment in helping to reduce flashbacks and night terrors.

Eye movement desensitization and reprocessing (EMDR): EMDR combines exposure therapy with a series of guided eye movements that help you process traumatic memories and change how you react to them.

Medication

Antidepressants: Can help with symptoms of depression and anxiety. Can help to reduce insomnia and improve concentration. Selective serotonin reuptake inhibitor (SSRI) such as sertraline (Zoloft) and paroxetine (Paxil) are approved by the Food and Drug Administration (FDA) for PTSD treatment.

Anti-anxiety medications: Can help to relieve severe anxiety and related problems. Are used for a short time due to the potential of people abusing them. 

Conclusion

Post-Traumatic Stress Disorder is a psychiatric disorder that may occur in people who have experienced or witnessed a traumatic event. Examples can be a serious accident, war/combat, rape/sexual assault, or who have been threatened with death, sexual violence, or serious injury.

People with epilepsy can develop Post-Traumatic Stress Disorder due to anxiety and depression. For some, having a seizure can be traumatic enough for them to develop Post-Traumatic Stress Disorder.

The signs and symptoms of Post-Traumatic Stress Disorder should not be ignored. If battling Post-Traumatic Stress Disorder, there are different options for therapy that can be arranged by your physician. Most importantly, do not judge those who are battling Post-Traumatic Stress Disorder. Support them and help them to heal.

Resources:

American Psychiatric Association (2020). What is Posttraumatic Stress Disorder? American Psychiatric Association. Retrieved from: https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd

Brenner, L., Köllner, V., & Bachem, R. (2019). Symptom burden and work-related impairment among patients with PTSD and complex PTSD. European Journal of Psychotraumatology10(1), 1694766–1694766. https://doi.org/10.1080/20008198.2019.1694766.

Labudda, K., Illies, D., Bien, C.G., Neuner, F. (2018). Postepileptic seizure PTSD: A very rare psychiatric condition in patients with epilepsy. Epilepsy Behavior, 2018 Jan;78:219-225. doi:10.1016/j.yebeh.2017.08.043.Epub2017Nov.7PMID:29122493.

Mayo Clinic (2021). Post-traumatic stress disorder. Mayo Clinic. Retrieved from: mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/diagnosis-treatment/drc-20355973

National Health Service (2018). Causes-Post-traumatic stress disorder. National Health Services, United Kingdom. Retrieved from: www.nhs.uk/mental-health/conditions/post-traumatic-stress-disorder-ptsd/causes/

National Health Service (2018). Complex PTSD- Post-traumatic stress disorder. National Health Services, United Kingdom. Retrieved from: https://www.nhs.uk/mental-health/conditions/post-traumatic-stress-disorder-ptsd/complex/

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