Post Traumatic Stress Disorder: Making a Difference Tomorrow

Although PTSD treatment options — and their effectiveness — have increased, the condition still cripples millions each year. And more than a third with the condition fail to completely recover. At the same time, incidence of PTSD may be increasing due to the ongoing conflicts in Iraq and Afghanistan; these veterans have PTSD at nearly twice the rate of the general population.

PTSD doubled among adults living within several miles of the World Trade Center after Sept. 11, 2001. Similar jumps in PTSD rates occur after major natural disasters, such as the Dec. 26, 2004 tsunami in Asia and the 2010 earthquake in Haiti.

Adapted from The New England Journal of Medicine, 346: 982-987; 2002.

But with continued funding from the National Institutes of Health, the U.S. military, and other organizations, researchers hope to find ways to diagnosis PTSD before symptoms appear, better methods for reducing vulnerability to PTSD, and superior therapy and drug treatment options for resistant cases.

Research Brings Hope for the Future

Much work focuses around discovering why certain people have a greater risk of developing PTSD. The risk of PTSD after a traumatic event is only around 9.2 percent, even though most people suffer from a trauma at some point in their lives. Such information may allow military commanders to reassign vulnerable soldiers to less stressful positions.

Studies of twins indicate that genetic factors play a substantial role in PTSD susceptibility, and brain researchers are attempting to identify those genes and their functions. An altered stress-related gene may increase susceptibility to PTSD in children with a stressful childhood, for instance. Environmental factors also are important. Children who were sexually abused are more susceptible, and studies show that if parents have PTSD-like symptoms, their children’s risk of mental illness increases.

Other studies are looking at ways of preventing PTSD from occurring entirely. Although antidepressants have not shown such a preventive effect, scientists are looking at whether drugs known as beta-adrenegic blockers might achieve this. Another line of work involves disrupting memory consolidation, in which short-term memories are transferred into long-term storage, to reduce the intensity of stressful memories.

Neuroscientists also are studying brain-scanning methods and biochemical tests for detecting people vulnerable to PTSD or about to develop it. By identifying the characteristic brain changes of PTSD, doctors could make easier, quicker diagnoses and start treatment earlier, when it is more effective.

Neuroscientists are looking at new, more powerful treatment options for PTSD. For instance, targeting corticotropin-releasing factor or other stress hormones might offer an effective means of controlling symptoms. Many other classes of drugs, such as opiates, anticonvulsants, and tranquilizers, also have shown some effectiveness in treating PTSD and are being tested more rigorously.

Other treatment methods aim to reverse PTSD-associated brain changes. One approach is memory manipulation, which involves drugs and other methods for altering or removing an existing memory to eliminate symptoms.

Hope for Other Diseases

PTSD is part of a cluster of common diseases that often occur together, strike the same people repeatedly, and have overlapping symptoms. Continued funding for PTSD research could offer new diagnostic and treatment options for the millions suffering from these related conditions, which include depression, anxiety disorders, phobias, and bipolar disorder.