My Two Cents
February 12, 2017
This week on My Two Cents:
“It’s All In Your Head. Is PTSD the New Fibromyalgia? Where Do We Go From Here?”
DISCLAIMER: This piece is merely my opinion, based on my limited experience and research. This document should not be used as a replacement for proper medical advice and is for entertainment purposes only.
It is early 2017 and already the buzzword PTSD is at the forefront of the news and television. Just weeks ago a former soldier on the East Coast of Canada kills his entire family, and then himself. Later we discover he was desperately seeking help for PTSD. But, what does that mean to us? Does PTSD excuse murder? In a society today where everyone seems to have a diagnosis of something, where does PTSD fit in?
Before PTSD had a name, soldiers began coming home from war and were different people. Vietnam War veterans came home and could not cope with life back in America. They became violent. They abused substances. They killed themselves. But, no one could explain why they had come back such changed men. As the years past, more and more soldiers came back from wars with a mysterious, psychological ailment. Now, we have found examples of PTSD in not only soldiers, but in people of all walks of life, adults and children alike, and we have to discover why has this insidious disease taken hold of so many people worldwide? In actuality, “the focus on the military’s struggle with Post-Traumatic Stress Disorder (PTSD) obscures a simple reality: PTSD hits more civilians than soldiers, and more women than men. And it manifests with a dizzying range of symptoms, from flashbacks, nightmares and aggression to depression, numbness and avoidance” (Suzuki, 2017).
Due to my limited experience and knowledge of PTSD, I am going to speak using myself as a subject. I have suffered fibromyalgia for over 30 years, and possibly since I was about 3 years old, when the pain started for me. It is suspected that I suffer from PTSD as a result of trauma in life and the loss of function from failed surgeries. The medical research field has proven that the brains of patients with PTSD physically change. The memory centres in the PTSD brain becomes hyper active and interacts with other regions of the brain much more highly than the “normal” brain. Special imaging that monitors the brain in real time, rather than the still slices that one sees in an MRI, have found that the brain acts in a heightened state nearly all of the time, which explains why the PTSD sufferer seems to continuously suffer from flashbacks, nightmares, and avoidance due to overwhelming brain activity.
The Fibromyalgia Connection?
So, the question remains, why? Like fibromyalgia, which is a chronic illness that causes the sufferer to experience nearly constant pain, sleep disorders, and a multitude of other symptoms, PTSD seems to set the brain on fire, figuratively. In fibromyalgia, the brain becomes “obsessed,” if you will, with pain. It begins to register pain where no pain should exist. What happens in the brain with fibromyalgia is still a mystery, but in effect, the brain becomes hyper sensitive to stimuli and it records all this stimuli as pain. This causes the patient to suffer mild to severe pain, intestinal complaints, sleep disorders, depression, fatigue, and other symptoms. The causes of fibromyalgia are varied, complex, and unable to prove, but often physical trauma, emotional trauma, or serious illness are believed to be causes. And, because fibromyalgia cannot be definitively identified with any diagnostic testing, doctors have been sceptical when diagnosing. It is much more prevalent in women and many in the medical field believe that it is a disease of the mind (psychological illness) and not a disease of the body.
PTSD, in much the same way, seems to be a disease of “pain” located in the brain. Because the brain itself has no nerve endings, it cannot feel physical pain. PTSD causes the brain to re-wire its synapses, which allows the brain to “hyper” interact with the frontal cortices of the brain and the memory centres of the brain (Suzuki, 2017). Victims are continuously suffering flashbacks when external stimuli trigger a severe reaction to traumatic memories from the person’s past. This in turn causes the sufferer to re-live the trauma over and over while awake and dreaming. Aggression, depression, suicidal ideation, violent outbursts, withdrawal, substance abuse, and suicide are the results of this super sensitive brain and the sufferer is often left destroyed, just an empty shell of their former self.
What I am interested in is the ties between PTSD, fibromyalgia, and mental illness. Due to the severe stigma of mental illness, incidents of PTSD and other forms of mental illness are still unreported as the victims do not seek out treatment. Those that do are often told that it is all in their head and to “deal with it” or “get over it.” Soldiers, who are predominantly male, are trained and encouraged never to discuss their feelings, never cry, and to be strong when faced with their demons (Suzuki, 2017). Many soldiers are only diagnosed upon their deaths from suicide or substance abuse. Men bury their feelings and suffer in silence. Women are told that they are too emotional and as such their symptoms of fibromyalgia or PTSD come as a result of being unable to deal with their emotional lives. Their conditions are downplayed. Mental and physical pain become debilitating, which destroys lives, families, and dreams.
Or, is PTSD the new ADD/ADHD? Is it the new over diagnosed illness that gives every man, woman and child a new syndrome, a new excuse to be off work or school? We have seen the insurgence of ADD and ADHD diagnoses in the past years, giving a name to every child that does not pay attention every second of the day and needs to be told twice what to do. My opinion? We belittle the truly ill by lumping them into this mundane argument of “everyone has it or no one has it.” Some kids do have ADHD. Some just don’t like to listen. Some people have PTSD. And I am sure that some, luckily, just need some help to cope.
As a fibromyalgia sufferer, it is believed I may have a PTSD link. It has become known that not only do the victims of trauma suffer from PTSD, but those who are around the sufferer or their situation can show symptoms of Pre-PTSD or PTSD. Family members who are close to the patient often show symptoms congruent with PTSD (Tremonti, 2017). Growing up in a Northern Canadian community, I was, as a teenager, exposed to significant vicarious trauma due to the severe and persistent abuse of a close friend. My own trauma during that time, things that I have explored in the safety of my therapist’s office, led to bouts of insomnia, depression, severe nightmares and night terrors when I started university. At the time I was unclear that there may be a connection. Today, I still am not sure my youth was a catalyst to my life today. Sleep loss was accompanied by the ever growing presence of pain in my body. As an elite athlete, the pain was always explained away by medical doctors as nagging sports injuries mixed with over training.
Poor coping skills of youth and questionable life choices only exacerbated my pain and sleeplessness. Doctors began to suspect that I had a sleep disorder, maybe depression, or I was not getting enough attention and was making it up. Prozac was administered, finally, after a psychiatrist could squeeze me in for a consult. It caused nearly as many problems as it cured. Specialist after specialist eventually diagnosed me with insomnia and possibly fibromyalgia, or some form of arthritis. Away I was sent with sleeping pills and a patronizing smile. One doctor over the years told me if I was more religious that I would not have pain because women do not get cope with stress or emotions properly. They hang onto them and carry them around with them, and a good religious or spiritual life will help “hysterical” women (my term) cope with life. In reality, many of my PTSD pathways in my brain, if there are any, could have been created by the years of emotional abuse from doctors who did not think I had anything wrong with me. Despite the severe pain and the problems with my gastrointestinal system, I was left to cope with the issue on my own over and over again. My career in law enforcement I never felt was a contributing factor to my possible PTSD, but my therapist disagrees. Perhaps a part of me has absorbed the horrible crimes of my caseloads after years and years of reading and interacting with the worst people in the country. One thing that has been consistent over time has been my terrible relationship with sleep. When I sleep, I am plagued by nightmares. Some nights they are terrors and my body awakens with my brain truly believing the trauma has happened to me overnight. I have never had a good dream that I recall. My bad dreams are pervasive. They are realistic. They are in full colour. I feel pain and anxiety during and after them. 95% of them are violent. The rest involve severe psychological stress. I remember nearly all of my dreams vividly. Some fade over weeks or months. Many I remember in detail decades after having them. My neurologist was deeply concerned by my dream patterns. I was sent to a sleep specialist (the 3rd or 4th, I have lost count) and a sleep psychologist. She promised to send me the information I needed to start to deal with these awful dreams. That was fourteen months ago. I’ve never heard from her again and she has never returned any of my dozens of calls. Navigating the pain/PTSD landscape can be an excruciatingly painful process in itself.
There is hope. Going Forward.
There have been some breakthroughs in treating pain in people with fibromyalgia. Medications that treat nerve pain coupled with diets that help with digestive problems, focus on treatment of insomnia and cognitive behavioural therapy all can give the patient some measure of relief. Similarly, certain medications have shown promise with PTSD sufferers. One doctor uses beta blockers coupled with intense therapy to lessen the symptoms and move the patient past traumatizing memories of PTSD to simply bad memories that can be coped with in a healthy way (Suzuki, 2017). Other doctors are using psychedelic medications such as MDMA and ketamine to help the patient’s brain learn new memories to replace the old memories that are responsible for the symptoms. The hope is for the brain to change its pathways again, back to normal memory and frontal cortex interaction (Tremonti, 2017).
Another promising breakthrough in treatment of fibromyalgia and PTSD is cannabis. In the right strains and doses, medical marijuana seems to allow the brain to calm down and begin to forget the wrongs associated with it. Or, at the very least, dull the noise in the mind so that with new clarity, sufferers can focus on something other than their mental and/or physical pain again (Suzuki, 2017). I have tried this method, unsuccessfully the first time. I plan to try again under the close advisement of a new pain specialist, one that can ensure that my medication regime is helpful. Perhaps, if I have both afflictions, the pain control offered by the pain clinic and the THC will help with both afflictions.
The world has become a very different place. Psychological pressures on the human race are higher than they have ever been before. We are overworked. We are overbooked. We’re too busy. Too stressed. We spend all of our time looking for external affirmation of our life through social media. The same social media makes access to horrors worldwide just a mouse click or finger tap away. The world thrives on violence and pain and violence and pain are easy to find. The suffering of people has become centre stage 24 hours a day, 365 days a year. Terrorism is rampant and has caused mass PTSD in itself. Soldiers continue to fight their battles long after they come home. Children suffer PTSD before their teenage years if they grow up in poverty, war, or abuse. They grow up and pass the PTSD onto their children through their behaviour. And, the cycle continues.
I hope that the new treatments provide relief from the hundreds of thousands of PTSD sufferers in North America. Millions more suffer from fibromyalgia. Add other mental illness and the numbers are astounding. At least we are stepping in the right direction. We are beginning to believe that these people are truly sick. And they need our help.
Suzuki, D. (Producer). 2017. The Nature of Things PTSD: Beyond Trauma. Canada: CBC.
Tremonti, J. (Producer). 2017. The Current with Anna Maria Tremonti. Lost on Arrival: Me, the Mounties & PTSD. Canada: CBC.