May 23, 2013 • 39 mins
With Post-traumatic Stress Disorder the sufferer relives, over and over again, the worst moment of his life. What's worse is medicine still doesn't know how to treat it. Learn about this condition and how it's leading to an understanding of memory.
Learn more about your ad-choices at https://www.iheartpodcastnetwork.com
See omnystudio.com/listener for privacy information.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:01):
Welcome to Stuff you should Know front House Stuff Works
dot Com. Hey, and welcome to the podcast. I'm Josh Clark.
Getting across from me as always is Charles W. Chuck Bryant.
And that makes this say you again, howdy, this is
stuff you should know. Let jump the gun there. That's okay, awkward,
(00:23):
I was talking a little fast. It's a little weird.
How's it going, It's going good, good. This is a
long awaited podcast. It is. We've been putting this off
for like a year at least, maybe even two or so. Um.
There is a guy, um who we need to give
a huge shout out to. His name is Will Sovey.
Is that who wrote us? Initially? Yeah, initially. He is
(00:46):
a clinician who studies PTSD, started out at Walter Read Hospital.
From the hospital. Basically he's like right there on the
front lines, not just treating, but like learning about PTSD
and uh no, no, only do we have to thank
Will for Basically we handed him this document, this article
and said, hey, how up to date is this? And
(01:07):
he sent back this great like annotated copy with all
this new stuff and basically said this is don't say this,
don't be stupid. That kind of stuff. Um, so we
have to thank not only Will, but we have to
thank his wife, Meg, who was the one who originally
turned Will onto stuff. You should know. So without Meg,
we would have no Will, and without Will, we would
(01:27):
probably have a grossly out of date and laughable PTSD
article to work from that would have haunted us. We
probably would have released a podcast and just pissed us off.
Still exactly. Yeah, So you have now taken his information
and redid your original article and now we are pretty
much up to date. Yeah, and I need to go
onto the site and like update the actual article, which
(01:49):
is harder than the rounds, you know, but to just
listen to this podcast for the time being, Okay, uh,
And this is really good timing, Chuck, because I found
out after we decided to do that, June is PTSD
awareness month. Yeah, and specifically June is PTSD Awareness Day.
So if you have a friend or a loved winn
(02:10):
or a coworker who suffers from post traumatic stress disorder,
be extranized to him on jun So we're talking about PTSD,
which is of course um abbreviation for post traumatic stress disorder,
and um, it's not a new disorder. I don't I
can't imagine like when it really first came about, although
(02:31):
it was first described in the Civil War. My guess
is that it came about the first time people started
encountering big time stresses, traumatic events. Yeah, they just didn't
know what the heck they call it exactly, you know. Um,
But it wasn't I guess until about the Civil War
that we saw casualties on such a colossal level that somebody,
(02:53):
a doctor named Jacob Mendi's Da Costa um described what
he called soldier's Heart. Yeah, before that, they were just like,
what's wrong with Goody Johnson? Exactly? It's just always freaking
out whenever, like he hears us play this song, right, well,
Goody short for good wife, So there's there's a lot
going on with Goody Johnson. Um that he she um,
(03:18):
So Da Costa is he he calls his things soldier heart,
soldier's heart, and it basically is like you you seem
to have some sort of heart failures techniccardia. Um, You're
you're very much stressed out. And Da Costa said, this
is probably a result of some sort of uh trauma
(03:39):
from the war. Right, But they initially, like you said,
thought it was cardiac based, because I'm sure dudes were like,
you know, my heart's racing exactly, you know, I'm freaking
out right, it's your heart. Then it can't possibly have
anything to do with your mind, which we know pretty
much nothing about. Right. That came about during World War
One when it was famously called shell shock. Charles Myers
(04:01):
in nineteen fifteen described it as and he was actually
onto something here that it could have been a resulting
from pressure from you know, artillery shells exploding nearby, and
how it affects the brain, like physically affected the brain, right,
And that's actually what he's talking about. Is called today
mild traumatic brain injury, yeah, which is UM with the
(04:23):
symptoms of which kind of overlap with PTSD. Yeah. I
think we covered that in Concussion. Some didn't we I
think we probably did too, because you know, some NFL
guys are, uh, former NFL players are like committing suicide
now here and there. Probably the same thing that was
an interesting episode was in the shell shock Yeah, so yeah,
so um, Charles Myers describes mild traumatic brain injuries and
(04:45):
calls them shell shock. So if you just go slightly
further afield and and um and kind of get a
little more into the psychology behind it, you arrive finally
at PTSD, the modern diagnosis of which first came about
in nine teen eight. Yeah, thanks to UM they really
started doing a lot of studying post Vietnam and UH
(05:07):
in nineteen eight three, Uh, they did a case study
that really just like opened up a wealth of information
to kind of get the ball rolling. And since then
we studied a lot, and we continue to because we're
still not exactly sure the best way to treat it. Uh.
And we've learned many many things since nineteen eighty about it, like, oh, well,
(05:28):
there's the part of the brain that stores memories of
fearful incidents. I think that's a venturo medial prefrontal cortex.
The size of that can have an effect on whether
or not you're at risk for PTSD. Some folks are
more prone than others. Uh. We'll get to all this
and more detail, of course, UM, Like women may not
get out as much then as men. Uh, how how
(05:51):
much danger you perceived yourself to be in, how intense
the danger was, how long the danger went on for
All of those are contributing factor to the development of PTSD. Yeah,
and it's and like you said, perception is the key
because it's your perceived reaction to it. It's not necessarily
the guy next to you might not have had any reaction,
(06:12):
you know, and gone through the same incident. Maybe two
people are in the same car accident, one person can
have that one person might not right, and it can
be that can be exclusively based on the perception of
the event. Yeah, um, you were saying, we're still learning
about it. It's true. We don't have even numbers on
the number of people with PTSD. That's shocking. I think
the v Yeah, I think the v A estimated UM
(06:34):
as many as eight hundred thousand veterans alone have PTSD. Well,
I think. I say it's shocking, but it is. It
can also be confused with things like depression and just
generalized anxiety, So it's very specific PTSD, So I sort
of get that right. But it has a huge effect
on people like depression and anxiety disorders in general. Do UM.
(06:57):
PTSD specifically is known to um increase unemployment, failed marriages,
domestic violence, and homelessness. In suicion, Yeah, suicide is a
big one too. Um, we have no idea how many
PTSD suffers commit suicide. But in two ten, I believe
Chuck UM twenty two veterans a day active and UM
(07:22):
former military a day twenty two we're committing suicide. And
I believe to two thousand ten not all of those
are necessarily PTSD related. But once we have a better
idea of how many people have PTSD, how many people
who have PTSD commit suicide, I have a feeling the
numbers are just gonna get bigger and bigger. I think
you're right, because we're still I mean, we're only like
(07:44):
a few generations removed from the concept of shell shock,
you know, and then even more from soldier's heart and
even more from what's wrong with Diddy Johnson were in
the lake swims? Okay, so I guess let's get on
the brass tacks. UM. Simply defined, it is a set
of symptoms that result from a trauma. UM. We hear
(08:07):
about a lot in military, obviously because they experience very
intense trauma more than most folks do. But it can
come about from accident, an assault, UM, natural disaster, anything
that you perceive as traumatic. It can come about. Yeah,
it can. It can the death of a loved one.
It doesn't even necessarily have to be ama a trauma
(08:29):
that happens directly to you. It can indirectly affect you,
and you can still develop PTSD from it. Um. But
the thing is that there's uh, if if somebody experiences
a trauma, I'm not going to develop PTSD. They normally
shake it off. Right. There's actually some some criteria for
an actual PTSD diagnosis. UM, So you have to the
(08:52):
symptoms basically have to present themselves over a certain period
of time for certain length of time, and certain symptoms
have to appear in the cornerstone of what's called the
symptom cluster of PTSD. All the symptoms you put together
to form a diagnosis. The cornerstone of those is re experience. Yeah,
and some of that can happen. But the thing I
(09:15):
kept coming across in these studies is what they called
excessive retrieval. So just like you know, it's one thing
to get an accident and be a little weird next
time you drive in the rain, or more careful or whatever,
but excessive retrieval means that it's like consuming your life. Nightmares,
day terrors, I mean, you name it, like a song
(09:35):
can spark it and you're just re experienced this thing
over and over in your mind. Yeah, And it doesn't
even necessarily have to be from something like a song
like the song that was playing on the radio when
your car you crashed your car um to trigger. It
can just come without any apparent trigger whatsoever. And the
big problem with this is not just like, oh man,
that was such a bummer that that happened to me.
(09:57):
It's your brain is remembering this in such a way
that the the same chemical cascade takes place as it
did when you were initially going through it. So for
all intents and purposes, at that moment, you're fully going
through that same experience again. And this happens again and
again and again and again. And that's the re experience
(10:20):
of the trauma. And that's the cornerstone symptom of PTSD. Yeah,
that's what of UH, one of what they call symptom clusters,
one of four. The other three are avoidance, which is
obviously speaks for itself. You're gonna avoid thinking about it.
Avoid you know, let's say you're in the military, might
not go to Fourth of July celebrations or other places
(10:41):
where they're big booms, um, numbness um. Doing anything you
can to numb it withdrawing alcohol and drugs. Yeah, that
can be a big problem with PTSD, going into it
and afterward, right right, And if you already had a
Drugger alcohol problem and you you develop PTSD, that can
be a really hard thing to treat and separate. And
(11:03):
the last one there is hyper arousal, which basically UM,
when you see movies, they'll portray this way movies A
lot is a soldier that's just jumpy and irritable and
I can't sleep. They feel unsafe, sort of paranoid, always
on guard. It's like your fight or flight response is
always on and it's gonna be exhausting. Yeah. Well, we
(11:24):
talked about like you can die from that kind of thing,
from prolonged stress, heightened stress, like it depletes your immune system,
and um, you can die as a result. And that's
one of the hallmarks of PTSD is you're just constantly
on guard. Yeah. Yeah, I can't imagine how tired you
must be. Plus you can't sleep on top of that, exactly. Yeah,
(11:44):
So it's a pretty awful condition to to have. UM.
And uh, one of the one of the criteria for
diagnosing this is that it's it's not short this can
go on a very long time. Um, there's three three
different types. There's acute, which is um acute PTSD the
symptoms come on uh and last about three months, right, Yeah,
(12:09):
it has to to be PFC. It has to go
beyond the one month period right after that. It's kind
of most people, I guess shake off a trauma within
a within a month. Yeah, if it keeps going on
after that, then you're in PTSD territory. If at lasts
three months, that was a cute PTSD, and you probably
should consider yourself lucky that that's all it was. Yeah,
that's true. You could also develop chronic PTSD UM where
(12:32):
the symptoms last more than three months and possibly a lifetime. UM.
And then there's delayed onset where the symptoms don't show
up for at least six months. And then I guess
it could be acute delayed on set or chronic delayed
on set. Yeah. And you point out here that kids
can get it too. It's not you know, we talk
about adults oftentimes, but uh, kids can present differently. Um.
You know, really poor behavior, really needy behavior, drawing things out.
(12:56):
And that's something you always see in movies too, Like
the kid drawing the plane car right and stuff like um,
or acting it out with dolls. That's another one too.
But as they grow up, they become a little more
just regular adult symptoms if they haven't you know, gotten
over by then, which is super sad. Yeah. So for
a very long time, Chuck researchers thought that everyone is
(13:18):
at equal risk of developing PTSD after going through trauma.
But they found, UM, I guess from studying really hardcore
since that Vietnam study, UM that there's actually risk factors
and protective factors that can keep people from developing PTSD
or can make you more likely to develop PTSD. Yeah.
One of the big ones is, um, if you've already
(13:41):
experienced a prior trauma, Yeah, because um, it's additive. So
it can actually mount up these things over the years,
and then there could be one final trauma that finally
triggers the PTSD. And you're more likely too if you've
experienced these things exactly. And you were saying, like, the
military's at greater risk than the average person because there
they are experienced a prolonged, intense trauma, and um, it
(14:08):
seems to me that PTSD is moving very quickly toward
it almost entirely brain based model UM. And one of
the reasons why is it finding like all these chemicals
and and UM genetic markers that are responsible for different aspects,
and it's like this clear pictures emerging. One of the
big ones is a gluco corticoid. Yeah, that's right, I
(14:31):
got it. It's a class of brain hormones and they
help control our stress response. So we were talking about
how UM, if you experience one trauma, you you're gluco
corticoid UM levels are depleted, because it's like, come on,
let's just hang in there. We'll hang in there if
you get another. If you experience another trauma and those
(14:54):
hormones are depleted already, then you're going to experience the
fear and stress of that far more acutely then you
would have had your glucocorticoid levels been normal. Yeah, that's
why it's compounding and additive. Well, and they also have
found that UM cortisol, which is a glucocorticoid, Elevated levels
(15:14):
of this can affect your memory in a negative way,
which can be positive if you have PTSD. So they
did a study in two thousand eight three month blind
double blind placebo controlled study, our favorite kind that sounds
like a real deal, where they gave these three soldiers
low low doses of cortisol or hydrocortisone, and um, they
(15:39):
found significant effects with no side effects and even evidence
of prolonged effect. So, um, I know later on in
the article you talk about one of the things they're
doing now is injecting people with hydrocortisone and like the
er Yeah, like immediately after an event, and it's it's
basically shown to decrease your memory, like you just don't
remember that stuff as well. Yeah, and it lowers the
(16:00):
stress response. I mean think about this, you're you're the
stress response is part of your immune system right where
it's at least connected in some really close way. Hydrocortizone
is like an anti dampens your immune response, So they
think that PTSD is like maybe a heightened stress response
(16:21):
or a heightened immune system response, and just giving somebody
like a regular shot of hydrocortizone, it's it's working. Yeah,
it's so weird. Well, because as to do with memory,
if you're if you're decreasing your ability to remember something,
you're going to increase the likelihood that you won't suffer
from bad memories, you know. Um, so some other risk
(16:42):
factors and protective factors. Uh, like what type of personality
you have factors? And this makes sense. If you're an
optimistic type, you're probably going to be less likely to
suffer PTSD. Yeah, you haven't here belief that there's order
to the umerg Does that is that specific to like
a belief in God. I think that that's one of
the accepted definitions of optimism or the optimistic personality. It's
(17:05):
interesting somebody who believes, yeah, not that it's not chaotic,
that there's reasons for things. Things happen for a reason.
So I wonder if an atheist is more likely to
get PTSD. I could see that interesting. Um, But it's
also that other people are generally good is another It's
like the second part of that definition. Uh, if you
are someone who tackles things head on and don't put
(17:29):
your problems on the back burners, obviously this is gonna wait.
If you're not putting it on the backburner, that means
you're going to have a less likelihood. Yeah, I got
all confused there. Yeah, because avoidance is one of the deal.
And if you have problem avoidance behavior avoidance behavior UM,
or you just like don't like to talk about problems
(17:50):
or don't like to think about things, You just rather
just kind of push it. It's probably true for any
mental disorder. If you're not prone to tackle it head on,
then it's just gonna get worse. Yeah, you know, yeah,
well that's one of the things about PTSD is like
your memories become exaggerated and bloated and way worse even
than the actual experience. If you are college graduate or
(18:12):
maybe even just went to college, then um, you're gonna
be less likely to have it. And we also pointed
out earlier that women are less likely to experience it
than men. Yeah, they're not entirely certain why. I don't know,
but that's strictly from the Vietnam study. I think, um,
it was something like thirty six percent of Vietnam veterans
(18:34):
who experienced hardcore combat. I don't know if that's the
term that you use, but you know what, I'm sorry
to work combat. Yeah, thirty six percent of males in
that situation had PTSD and eighteen percent of females did.
So what that's like twice as likely if you're male,
then a female UM. They think genes may have something
to do with it. They're looking to a gene called
(18:54):
the serotonin transporter gene. And there is a paper out
there that indicates that if you have a mutated gene
serotonin transporter gene, than it could impact your attention to
environmental threats, which could impact whether or not you get
PSD PTSD. Geez. So you remember we did that episode
(19:15):
Can my grandfather's diet shortened my life? About epigenetics? Well,
epigenetics possibly factor into UM PTSD as well. So epigenetics
is basically where the function of a gene is um
affected within somebody's lifetime changes basically right, So it's like
evolution on the basis of years rather than you know,
(19:39):
generations and generations UM. And there was a study in
Detroit of a hundred people who fit the criteria for
PTSD diagnoses, and they found that they had six or
seven times the epigenetic changes of the control group, and
that a lot of those epigenetic changes, most of them
(19:59):
UM had to do with genes that that were responsible
for keeping up the immune system. Interesting, did they factor
in the fact that they've lived in Detroit? Well, that
was funny. I guess, in some horribly dark comic goal
way is that the researchers were from New York City
and they traveled to Detroit to find a hundred people
with PTSD. I'm sure they could have found that New York.
(20:21):
I guess they cast their lot in Detroit for some reason.
We love Detroit. By the way, We've been getting a
lot more emails lately because I think people pick up
newly and hear us dashing Detroit and they don't realize
it's been a running joke now for five years, as
almost six years. We love Detroit. Who doesn't exactly um.
(20:42):
And then, of course, the most important factor with this
or any other mental disorder is what they called a
trauma membrane, which is that support network your friends and
your family if you've got a strong one, and it's
a strong one in the right way. Like you point out,
they can be well meaning, but the person receiving that
(21:02):
membrane and that protection it has to do do right
by them. Yeah, and then they can't just be like, well,
you know, just just on the bright side, you know,
don't worry about that. Like, however, you're you're experiencing this
and getting over it. You're doing it wrong. Do it
this way. That's not gonna help, right. But basically the
point is if you are single alcoholic veteran that is
(21:28):
a loner living by yourself, it doesn't like to think
about your problem. Yeah, and like your tiny little apartment.
Then that's like the worst case scenario for PTSD. Yes. Yeah,
Like we said, the military is at a greater UM
risk just from being exposed to these situations and being
exposed to him over and over and over again. UM.
(21:50):
And but one of the other reasons that the military,
especially the military of late UM is at risk is
be because brain injuries where the quote signature wound of
the Iraq War I don't remember thanks to UM roadside
bombs I e. D. S UM, there are a significant
(22:12):
amount of head injuries. Are treatment of head injuries advanced
enough so that we could save lives where they wouldn't
have been before, Like people were exposed to head injuries
like in countless other wars. But now we've gotten to
the point where we can save those people's lives. The
problem is that their brains are changed. They've undergone what
(22:33):
Charles Myers called shell shock mild traumatic brain injury, which
again is almost indistinguishable and possibly one and the same
in some cases as PTSD. Yeah, and imagine the uncertainty
of guerrilla warfare and things like roadside bombs. Um, Like,
(22:53):
you can be prepped somewhat for for battle and we'll
get to that here in a little bit. What they're
trying to do the more and more of these days
with that, but with these guerrilla tactics that are going
on in the Middle East, with with suicide bombers and
car bombs and things like that, it's like kind of
the perfect prescription for eventual ps PTSD. Yeah. I'm trying
(23:13):
to trick to take the trauma out of it. Yeah.
Um yeah, we mentioned earlier, remember the optimistic personalities less
likely in the optimist believes in order in the universe. Well,
guerrilla warfare is like the opposite of order in the universe.
Are you starting to see like this pattern, Like all
this stuff is on the table. Yeah, it's just now
(23:34):
a matter of connecting it. And it seems like neurology
is going to be the field that does that, I think, so,
you know, so counseling obviously is step one. Um, and
this goes down in a couple of ways. The old
favorite cognitive behavioral counseling, which we talked about quite a bit,
which apparently I'm told by will Savey is not really
(23:55):
called that. It's cognitive processing therapy. I think he said,
I haven't really I've seen it call that, but okay
in his note, so we'll stick with the cognitive processing therapy. Well.
A couple of the aims there um are to basically
limit the amount of that excessive retrieval to sometimes it's like, hey, um,
(24:17):
every day for like from from nine to nine thirty,
you can think about this in a healthier way and
then you put it away for the day. So that's
one way they can do it. Yeah. Another way is
to just lessen the um, lessen the memories impact on
like how bad it was, maybe by pointing out some
of the good things, like what about the valorie you
(24:37):
showed during battle right by saving your buddy's life. He
died and you watched him die, but you also tried
to drag him his safety. So you tried, and that
you put yourself at risk and you really need to
commend yourself for that. Like carry that around too, it's
gonna balance out the horrible nous. So not like you
need to forget all this, but you need to bring
it back to an acceptable level where you can live
(24:58):
your life exactly. And one of the reasons are one
of the reasons it's not an unacceptable levels because this
memory has become so grossly exaggerated through the process of
this um this I guess memory retrieval, fearful memory retrieval,
over and over and over again. Like I think most
memories are enhanced or bad, you know, like you remember
(25:20):
like that prom in high school is way better than
it really was, or that breakup that you suffered was
really actually those usually get better with time. But you
know what I'm saying, right, Yeah, But I think, Chuck,
imagine that while you were see when whenever you retrieve
a memory, you're adding to it. That's how like sense
go from you know what you initially thought of, what
you know ten years after smelling the thing, you think
(25:41):
of the same thing with fearful memory retrieval. But when
your memory is being retrieved and your life is in
the gutter and you're addicted to drugs and you're scared
out of your mind, and then you compound that under
the original memory over and over again, then it's just
gonna get worse and worse and more and more exaggerated.
(26:02):
And yeah, one of the one of the or the
point of cognitive processing therapy is cognitive restructuring, like literally
reordering the brain by taking that memory head on and
saying no, no, no, like this didn't really happen like this,
and you're not paying enough attention to that, right. Another
type of therapy that is not is fun, although I
(26:23):
don't know if the other is actually fun, but exposure
therapy it's pretty hardcore. It's like to pull your knees
up to your chest and just rock back and forth
kind of therapy. Yeah. I mean it's basically to relive
it over and over and over um in great detail,
sometimes taking you to the actual place that it took place, um,
(26:46):
with the idea that eventually that fear extinction will happen
and you'll get over it. Right. Well, remember you were saying, like, um,
the song that was playing on the radio when when
you got in a car, right, they'd like to play that. Well,
welcome to hearing that song over and over and over again.
It doesn't again, when you're retrieving that memory in a
certain context and bad things aren't happening, and there's somebody
(27:09):
reassuring you saying like, look, you're okay, Like everything's okay.
Then you're relearning that memory again without the fear associated
with it, but you have to go through hell to
get there. Yeah, And it also stops avoidance in its tracks,
which is you know, if you if you're avoiding something.
The complete opposite of that is immersion therapy like that.
(27:31):
And then what they're finding is the best the best
results they are coming from a combination of therapy UH
and medication of course, because it helps to not be
freaked out of your mind when you're having to go
through exposure therapy and removing it. And a class of
(27:53):
drugs that helps with that. Our SSR eyes, our old
friend SSR eyes UM the two approved by the h
U S Food and Drug Administration or Zoloft and Paxel,
and those are actually the only two drugs approved by
the FDA to treat PTSD on label, not just the
only two SSR eyes, so use those with your therapy. UH.
(28:16):
They also have something called d clike co serine and
UM that is actually is that the one that's a
anti tuberculosis drug, and they found that it also helps
with PTSD. Yeah, they they noticed that, like it UM
cut down on fear by basically it agonizes your N
(28:36):
methyl d aspirtit receptors in m d A. Yes, now,
the and that enhances learning. So if you're going through
exposure therapy, you got a little um zolof going to
keep you calm and chilled out and able to go
through therapy, and you're taking dcs at the same time
to make you learn faster. UM, then that would probably
(28:59):
be a a good treatment for PTSD for some people. Yeah.
Beta blockers like uh, prop pen and all that's have
been long known to decrease stress levels. Yeah, and kill
Michael Jackson really is that what he was on? That
was the one his milk he called it. Oh he
had like the drip going yeah, yeah, I think that's
(29:21):
a little different than like described the pill. But this
is this UM. This drug specifically goes in there and
basically like m disconnects neurons so that there you don't
have that memory any longer. I read a paper once
on im using this drug to treat PTSD, and like
this guy was like, this is so effective that you're
(29:44):
basically rewriting history. It's like transhuman. It's it has like
that level of impact on some people. Interesting. Well, we
mentioned earlier the Army UM preparing soldiers for battle. Uh,
it is not just happening in a physical training way,
like learn how to shoot guns and do things like that.
(30:05):
Now it's happening very much on the mental level. Uh.
It was formerly called battle mind anymore, so that that
surprised me that they changed it. When was it from?
That was from Walter Reed Hospital too? Yeah, exactly. Now
they call it resilience training. That's way better exactly, and
it it actually didn't even start out as something to
(30:25):
help with PTSD, but they're learning that it can help. UM.
It's basically this, they handle the seven phases of deployment mentally.
They prepare you mentally for the seven phases like predeployment, deployment,
post deployment, redeployment, UM and everything from Hey, when you're
out of the Army or the Marine Corps and you're
(30:48):
driving your car around, you can't drive like you're angry
and like you were over there. If someone addresses you
in an aggressive manner, you can't handle it like you
did when you were in battle. Um, you didn't have
alcohol over there. Now you're back home, there's booze everywhere.
You can't go crazy with that stuff. And so all
of that put together they figured out ends up helping
(31:08):
out UM with PTSD, like rely on your family, they're
trying to encourage stuff like this, right. Well, also they
think it works because they're using it ahead of time,
like predeployment as part of training as well. So I
think like being exposed to horrors ahead of time, we'll
kind of keep you from going through I guess as
(31:30):
much of a trauma when you see it the real
thing a month later. Whatever. Yeah, what's interesting, Chuck, is
the Iroquois um had something like this. Yeah, after like
going and going to war, they were basically sequestered from
everybody else after they came back and we're assimilated. Yeah, exactly,
(31:50):
there's like a step down cooling period. Wow that the
Iroquois used because they would go totally insane while they
were in battle. Right, that makes sense where they won't
go berserk, know, the Vikings want berserker. Yeah, but I
think I think that you're equid took. Okay, So we're
talking about neurology being the key to this one chemical
that they have been studying is called Staffman Jason Staffman,
(32:15):
and that basically allows us to form fear memories from
our experience. So they're obviously working with this and mice
finding that lower levels of that are gonna decrease our
fear memories or our ability to form them at least.
So that's pretty you know, they're viding us on a
lot of fronts. Yeah, well, they're doing a lot of
research and you just need to put it together. What
(32:37):
else gastrin releasing peptide. Yes, they found that. Um. Apparently
this this chemical like signals the brain like calm down,
calm down, and um, if you have uh not enough
of it, you have an increased chance that you're going
to become fearful. Right. Um, so that's another one, uh
narrow peptide. Why we what do we talk about that in?
(32:58):
I don't remember. I we definitely talked about it. It's
it's basically our own bodies anti anxiety drug and um.
The levels of this are going to fluctuate depending on
what kind of stresses and traumas we've been through. And
once again, if that one's depleted, UM, then you're gonna
be less prone to overcome obstacles. Mentally. Yeah, they're actually
(33:18):
they're trying to figure out how to synthesize it. So
if it's as simple as like injecting some narrow peptide
wine into somebody's brain following a trauma, just to get
that a little extra boost, so you can, you know,
take this on and process it and shake it off.
I guess ecstasy. That's another one. M d N A,
m d M A. Uh. Not surprisingly when they have
(33:43):
treated people with PTSD, they felt better. Yeah, but it
was long lasting though, right? Was that the mushrooms? I
know we studied h that hallucogen mushrooms. Yeah, I don't
remember which one went back more more easily. Yeah, I
can't remember either. But there was a guy in that study,
the m d M A study who was like suicidal
(34:04):
for three years or two years. Oh no, that was
something different. The stelic Ganglian block. It's like in an
inoculation of just a local anesthetic, right, but just above
the clavical so it interrupts the the nerve transmissions of
your sympathetic nervous system, the fight or flight response. Yeah,
(34:24):
so it physically blocks it. Yeah, and it works apparently,
and it can last. There was one guy in that
study who was suicidal for um two years, and he
felt immediate relief. Yeah, the ecstasy. I think you said
that some people that experienced relief had never experienced relief
with therapy or any other drugs. So it's pretty interesting.
(34:46):
And then our old friend, the thinking cap, the transcranial
magnetic stimulator. UM. I don't know if that's what they
call it, is it? Yeah? Okay, Um, it's better than
a thinking cap. Yeah, that's true. They did a study
in two thousand four or twenty four male and female
patients suffering from PTSD and UM, they hooked up, you know,
(35:09):
the magnets to the head, stimulated blood flow to the brain,
and they found out that it had a nice effect
for the for the people. Yeah. Yeah, they think it
increased metabolism or something like that. Man, I think it's
a complicated thing, so it takes a complicated cure, you know,
because it's not just like, well it's this one thing.
(35:29):
It's like all over the brain and its emotions and
it's like fear and memory. It's just it's crazy, well yeah,
crazy and undo a memory the way that somebody formed it. Yeah,
it's pretty interesting stuff. So thank you very much to
Will Sovey for his help on that. And remember it's
PTSD awareness month, so we hope we've made you a
(35:52):
little more aware. Um and uh yeah, I'm very interested
to see how the research pans out. Yeah, me too.
It's SEMs like they made a lot of headway in
recent years. Um. If you want to learn more about PTSD,
you can go type those letters into the search bart
house to first dot com. It'll bring up the old
version of the article, but I'll work to get it updated. Okay, okay.
(36:15):
And since I said updated, it means it's time for
is it time for message break? Oh yeah, now listening man, Yes, okay, uh,
this is I'm gonna do a couple of DND emails
over the next a couple of weeks because we did
a podcast and Dungeon and Dragons. Boy, people loved it.
(36:37):
They did. That was a good one. Good feedback even
uh like the uber nerds were like, you guys did
a great job. Yeah, there are a couple who are
just like us, but for the most part, people liked it. Well.
This is from Christina and she was very nice. She
is from Cleveland. And that is Christina with a K
and Y and she says, guys, I love your show.
(37:00):
I'm Christina from Cleveland. I'm writing about the recent D
and D podcast because it reminded me of something that
happened recently. Both of my parents are huge nerds and
as a result had awesome nerd gaming daughters that as
me and my sister. Of course, Anyway, when they were dating,
my mom and my dad and my dad's four best friends,
my uncle's Bill, Larry, Calvin, and Carlton would get together
(37:22):
on weekends lay D and D all weekend long. Recently,
when Uncle Carlton was in town, he brought his old
reel to real taper quarter player and a bunch of
recordings of their D and D weekend sessions from the
mid eighties. That's awesome. It's like Brian posing now. Uh.
It was a hilarious trip in the time machine and
every session had its own unique quavor. Anytime they were
(37:43):
at Carlton's house, you'd hear jazz playing in the background,
for example, and they always say Larry was a god
among men as dungeon master. It was a ton of
fun listening to my young dad and his buddies and
their girlfriends and wives, joking, drinking, even a little toking
ha ha, oh my god and talking crap to each
other while they played the one story that they always
(38:03):
tell us when Carlton brought a friend who was new
to the group and loaned him a super awesome leveled
up acts since he knew he didn't have anything good
starting out. When the friend wouldn't return it, Uncle Carlton
killed his buddy's character, got his ax back, and they
continued on. Thanks for everything, Christina, that's pretty awesome. That's
a great dnd SOT. I would love to hear those takes.
(38:25):
Thanks Christina. Yeah. Really, Um, you know Brian Poston is
doing this this podcast, uh where he plays Dungeons and
Dragons with some friends and they just recorded same things.
He releases it as a podcast. I'll have to hear that. Yeah,
I love that, guys. Um. Well, if you want to
tell us a great story about your parents, we love
(38:45):
to hear those. Um. You can tweet to us at
s Y s K podcast. You can join us on
Facebook dot com slash stuff you should know. UH. You
can send us some email to Stuff podcast at the
Discovery dot com. UH. And by the way, thanks for
the letter, Steama. I forgot to say that uh, And
as always, you can join us at our home on
the web. Stuff you Should Know dot com for more
(39:14):
on this and thousands of other topics. Is it how
stuff works dot com. Jack Herds has quickly become the
online shopping destination for guys. Here's why everything on the
site is up off As a listener of Stuff you
Should Know, you can skip the membership waitlist and get
(39:34):
instant access at jack threads dot com, slash kate and
ow stuff that's Jack threads dot com slash no Stuff
Welcome to Stuff you should Know front House Stuff Works
dot Com. Hey, and welcome to the podcast. I'm Josh Clark.
Getting across from me as always is Charles W. Chuck Bryant.
And that makes this say you again, howdy, this is
stuff you should know. Let jump the gun there. That's okay, awkward,
(00:23):
I was talking a little fast. It's a little weird.
How's it going, It's going good, good. This is a
long awaited podcast. It is. We've been putting this off
for like a year at least, maybe even two or so. Um.
There is a guy, um who we need to give
a huge shout out to. His name is Will Sovey.
Is that who wrote us? Initially? Yeah, initially. He is
(00:46):
a clinician who studies PTSD, started out at Walter Read Hospital.
From the hospital. Basically he's like right there on the
front lines, not just treating, but like learning about PTSD
and uh no, no, only do we have to thank
Will for Basically we handed him this document, this article
and said, hey, how up to date is this? And
(01:07):
he sent back this great like annotated copy with all
this new stuff and basically said this is don't say this,
don't be stupid. That kind of stuff. Um, so we
have to thank not only Will, but we have to
thank his wife, Meg, who was the one who originally
turned Will onto stuff. You should know. So without Meg,
we would have no Will, and without Will, we would
(01:27):
probably have a grossly out of date and laughable PTSD
article to work from that would have haunted us. We
probably would have released a podcast and just pissed us off.
Still exactly. Yeah, So you have now taken his information
and redid your original article and now we are pretty
much up to date. Yeah, and I need to go
onto the site and like update the actual article, which
(01:49):
is harder than the rounds, you know, but to just
listen to this podcast for the time being, Okay, uh,
And this is really good timing, Chuck, because I found
out after we decided to do that, June is PTSD
awareness month. Yeah, and specifically June is PTSD Awareness Day.
So if you have a friend or a loved winn
(02:10):
or a coworker who suffers from post traumatic stress disorder,
be extranized to him on jun So we're talking about PTSD,
which is of course um abbreviation for post traumatic stress disorder,
and um, it's not a new disorder. I don't I
can't imagine like when it really first came about, although
(02:31):
it was first described in the Civil War. My guess
is that it came about the first time people started
encountering big time stresses, traumatic events. Yeah, they just didn't
know what the heck they call it exactly, you know. Um,
But it wasn't I guess until about the Civil War
that we saw casualties on such a colossal level that somebody,
(02:53):
a doctor named Jacob Mendi's Da Costa um described what
he called soldier's Heart. Yeah, before that, they were just like,
what's wrong with Goody Johnson? Exactly? It's just always freaking
out whenever, like he hears us play this song, right, well,
Goody short for good wife, So there's there's a lot
going on with Goody Johnson. Um that he she um,
(03:18):
So Da Costa is he he calls his things soldier heart,
soldier's heart, and it basically is like you you seem
to have some sort of heart failures techniccardia. Um, You're
you're very much stressed out. And Da Costa said, this
is probably a result of some sort of uh trauma
(03:39):
from the war. Right, But they initially, like you said,
thought it was cardiac based, because I'm sure dudes were like,
you know, my heart's racing exactly, you know, I'm freaking
out right, it's your heart. Then it can't possibly have
anything to do with your mind, which we know pretty
much nothing about. Right. That came about during World War
One when it was famously called shell shock. Charles Myers
(04:01):
in nineteen fifteen described it as and he was actually
onto something here that it could have been a resulting
from pressure from you know, artillery shells exploding nearby, and
how it affects the brain, like physically affected the brain, right,
And that's actually what he's talking about. Is called today
mild traumatic brain injury, yeah, which is UM with the
(04:23):
symptoms of which kind of overlap with PTSD. Yeah. I
think we covered that in Concussion. Some didn't we I
think we probably did too, because you know, some NFL
guys are, uh, former NFL players are like committing suicide
now here and there. Probably the same thing that was
an interesting episode was in the shell shock Yeah, so yeah,
so um, Charles Myers describes mild traumatic brain injuries and
(04:45):
calls them shell shock. So if you just go slightly
further afield and and um and kind of get a
little more into the psychology behind it, you arrive finally
at PTSD, the modern diagnosis of which first came about
in nine teen eight. Yeah, thanks to UM they really
started doing a lot of studying post Vietnam and UH
(05:07):
in nineteen eight three, Uh, they did a case study
that really just like opened up a wealth of information
to kind of get the ball rolling. And since then
we studied a lot, and we continue to because we're
still not exactly sure the best way to treat it. Uh.
And we've learned many many things since nineteen eighty about it, like, oh, well,
(05:28):
there's the part of the brain that stores memories of
fearful incidents. I think that's a venturo medial prefrontal cortex.
The size of that can have an effect on whether
or not you're at risk for PTSD. Some folks are
more prone than others. Uh. We'll get to all this
and more detail, of course, UM, Like women may not
get out as much then as men. Uh, how how
(05:51):
much danger you perceived yourself to be in, how intense
the danger was, how long the danger went on for
All of those are contributing factor to the development of PTSD. Yeah,
and it's and like you said, perception is the key
because it's your perceived reaction to it. It's not necessarily
the guy next to you might not have had any reaction,
(06:12):
you know, and gone through the same incident. Maybe two
people are in the same car accident, one person can
have that one person might not right, and it can
be that can be exclusively based on the perception of
the event. Yeah, um, you were saying, we're still learning
about it. It's true. We don't have even numbers on
the number of people with PTSD. That's shocking. I think
the v Yeah, I think the v A estimated UM
(06:34):
as many as eight hundred thousand veterans alone have PTSD. Well,
I think. I say it's shocking, but it is. It
can also be confused with things like depression and just
generalized anxiety, So it's very specific PTSD, So I sort
of get that right. But it has a huge effect
on people like depression and anxiety disorders in general. Do UM.
(06:57):
PTSD specifically is known to um increase unemployment, failed marriages,
domestic violence, and homelessness. In suicion, Yeah, suicide is a
big one too. Um, we have no idea how many
PTSD suffers commit suicide. But in two ten, I believe
Chuck UM twenty two veterans a day active and UM
(07:22):
former military a day twenty two we're committing suicide. And
I believe to two thousand ten not all of those
are necessarily PTSD related. But once we have a better
idea of how many people have PTSD, how many people
who have PTSD commit suicide, I have a feeling the
numbers are just gonna get bigger and bigger. I think
you're right, because we're still I mean, we're only like
(07:44):
a few generations removed from the concept of shell shock,
you know, and then even more from soldier's heart and
even more from what's wrong with Diddy Johnson were in
the lake swims? Okay, so I guess let's get on
the brass tacks. UM. Simply defined, it is a set
of symptoms that result from a trauma. UM. We hear
(08:07):
about a lot in military, obviously because they experience very
intense trauma more than most folks do. But it can
come about from accident, an assault, UM, natural disaster, anything
that you perceive as traumatic. It can come about. Yeah,
it can. It can the death of a loved one.
It doesn't even necessarily have to be ama a trauma
(08:29):
that happens directly to you. It can indirectly affect you,
and you can still develop PTSD from it. Um. But
the thing is that there's uh, if if somebody experiences
a trauma, I'm not going to develop PTSD. They normally
shake it off. Right. There's actually some some criteria for
an actual PTSD diagnosis. UM, So you have to the
(08:52):
symptoms basically have to present themselves over a certain period
of time for certain length of time, and certain symptoms
have to appear in the cornerstone of what's called the
symptom cluster of PTSD. All the symptoms you put together
to form a diagnosis. The cornerstone of those is re experience. Yeah,
and some of that can happen. But the thing I
(09:15):
kept coming across in these studies is what they called
excessive retrieval. So just like you know, it's one thing
to get an accident and be a little weird next
time you drive in the rain, or more careful or whatever,
but excessive retrieval means that it's like consuming your life. Nightmares,
day terrors, I mean, you name it, like a song
(09:35):
can spark it and you're just re experienced this thing
over and over in your mind. Yeah, And it doesn't
even necessarily have to be from something like a song
like the song that was playing on the radio when
your car you crashed your car um to trigger. It
can just come without any apparent trigger whatsoever. And the
big problem with this is not just like, oh man,
that was such a bummer that that happened to me.
(09:57):
It's your brain is remembering this in such a way
that the the same chemical cascade takes place as it
did when you were initially going through it. So for
all intents and purposes, at that moment, you're fully going
through that same experience again. And this happens again and
again and again and again. And that's the re experience
(10:20):
of the trauma. And that's the cornerstone symptom of PTSD. Yeah,
that's what of UH, one of what they call symptom clusters,
one of four. The other three are avoidance, which is
obviously speaks for itself. You're gonna avoid thinking about it.
Avoid you know, let's say you're in the military, might
not go to Fourth of July celebrations or other places
(10:41):
where they're big booms, um, numbness um. Doing anything you
can to numb it withdrawing alcohol and drugs. Yeah, that
can be a big problem with PTSD, going into it
and afterward, right right, And if you already had a
Drugger alcohol problem and you you develop PTSD, that can
be a really hard thing to treat and separate. And
(11:03):
the last one there is hyper arousal, which basically UM,
when you see movies, they'll portray this way movies A
lot is a soldier that's just jumpy and irritable and
I can't sleep. They feel unsafe, sort of paranoid, always
on guard. It's like your fight or flight response is
always on and it's gonna be exhausting. Yeah. Well, we
(11:24):
talked about like you can die from that kind of thing,
from prolonged stress, heightened stress, like it depletes your immune system,
and um, you can die as a result. And that's
one of the hallmarks of PTSD is you're just constantly
on guard. Yeah. Yeah, I can't imagine how tired you
must be. Plus you can't sleep on top of that, exactly. Yeah,
(11:44):
So it's a pretty awful condition to to have. UM.
And uh, one of the one of the criteria for
diagnosing this is that it's it's not short this can
go on a very long time. Um, there's three three
different types. There's acute, which is um acute PTSD the
symptoms come on uh and last about three months, right, Yeah,
(12:09):
it has to to be PFC. It has to go
beyond the one month period right after that. It's kind
of most people, I guess shake off a trauma within
a within a month. Yeah, if it keeps going on
after that, then you're in PTSD territory. If at lasts
three months, that was a cute PTSD, and you probably
should consider yourself lucky that that's all it was. Yeah,
that's true. You could also develop chronic PTSD UM where
(12:32):
the symptoms last more than three months and possibly a lifetime. UM.
And then there's delayed onset where the symptoms don't show
up for at least six months. And then I guess
it could be acute delayed on set or chronic delayed
on set. Yeah. And you point out here that kids
can get it too. It's not you know, we talk
about adults oftentimes, but uh, kids can present differently. Um.
You know, really poor behavior, really needy behavior, drawing things out.
(12:56):
And that's something you always see in movies too, Like
the kid drawing the plane car right and stuff like um,
or acting it out with dolls. That's another one too.
But as they grow up, they become a little more
just regular adult symptoms if they haven't you know, gotten
over by then, which is super sad. Yeah. So for
a very long time, Chuck researchers thought that everyone is
(13:18):
at equal risk of developing PTSD after going through trauma.
But they found, UM, I guess from studying really hardcore
since that Vietnam study, UM that there's actually risk factors
and protective factors that can keep people from developing PTSD
or can make you more likely to develop PTSD. Yeah.
One of the big ones is, um, if you've already
(13:41):
experienced a prior trauma, Yeah, because um, it's additive. So
it can actually mount up these things over the years,
and then there could be one final trauma that finally
triggers the PTSD. And you're more likely too if you've
experienced these things exactly. And you were saying, like, the
military's at greater risk than the average person because there
they are experienced a prolonged, intense trauma, and um, it
(14:08):
seems to me that PTSD is moving very quickly toward
it almost entirely brain based model UM. And one of
the reasons why is it finding like all these chemicals
and and UM genetic markers that are responsible for different aspects,
and it's like this clear pictures emerging. One of the
big ones is a gluco corticoid. Yeah, that's right, I
(14:31):
got it. It's a class of brain hormones and they
help control our stress response. So we were talking about
how UM, if you experience one trauma, you you're gluco
corticoid UM levels are depleted, because it's like, come on,
let's just hang in there. We'll hang in there if
you get another. If you experience another trauma and those
(14:54):
hormones are depleted already, then you're going to experience the
fear and stress of that far more acutely then you
would have had your glucocorticoid levels been normal. Yeah, that's
why it's compounding and additive. Well, and they also have
found that UM cortisol, which is a glucocorticoid, Elevated levels
(15:14):
of this can affect your memory in a negative way,
which can be positive if you have PTSD. So they
did a study in two thousand eight three month blind
double blind placebo controlled study, our favorite kind that sounds
like a real deal, where they gave these three soldiers
low low doses of cortisol or hydrocortisone, and um, they
(15:39):
found significant effects with no side effects and even evidence
of prolonged effect. So, um, I know later on in
the article you talk about one of the things they're
doing now is injecting people with hydrocortisone and like the
er Yeah, like immediately after an event, and it's it's
basically shown to decrease your memory, like you just don't
remember that stuff as well. Yeah, and it lowers the
(16:00):
stress response. I mean think about this, you're you're the
stress response is part of your immune system right where
it's at least connected in some really close way. Hydrocortizone
is like an anti dampens your immune response, So they
think that PTSD is like maybe a heightened stress response
(16:21):
or a heightened immune system response, and just giving somebody
like a regular shot of hydrocortizone, it's it's working. Yeah,
it's so weird. Well, because as to do with memory,
if you're if you're decreasing your ability to remember something,
you're going to increase the likelihood that you won't suffer
from bad memories, you know. Um, so some other risk
(16:42):
factors and protective factors. Uh, like what type of personality
you have factors? And this makes sense. If you're an
optimistic type, you're probably going to be less likely to
suffer PTSD. Yeah, you haven't here belief that there's order
to the umerg Does that is that specific to like
a belief in God. I think that that's one of
the accepted definitions of optimism or the optimistic personality. It's
(17:05):
interesting somebody who believes, yeah, not that it's not chaotic,
that there's reasons for things. Things happen for a reason.
So I wonder if an atheist is more likely to
get PTSD. I could see that interesting. Um, But it's
also that other people are generally good is another It's
like the second part of that definition. Uh, if you
are someone who tackles things head on and don't put
(17:29):
your problems on the back burners, obviously this is gonna wait.
If you're not putting it on the backburner, that means
you're going to have a less likelihood. Yeah, I got
all confused there. Yeah, because avoidance is one of the deal.
And if you have problem avoidance behavior avoidance behavior UM,
or you just like don't like to talk about problems
(17:50):
or don't like to think about things, You just rather
just kind of push it. It's probably true for any
mental disorder. If you're not prone to tackle it head on,
then it's just gonna get worse. Yeah, you know, yeah,
well that's one of the things about PTSD is like
your memories become exaggerated and bloated and way worse even
than the actual experience. If you are college graduate or
(18:12):
maybe even just went to college, then um, you're gonna
be less likely to have it. And we also pointed
out earlier that women are less likely to experience it
than men. Yeah, they're not entirely certain why. I don't know,
but that's strictly from the Vietnam study. I think, um,
it was something like thirty six percent of Vietnam veterans
(18:34):
who experienced hardcore combat. I don't know if that's the
term that you use, but you know what, I'm sorry
to work combat. Yeah, thirty six percent of males in
that situation had PTSD and eighteen percent of females did.
So what that's like twice as likely if you're male,
then a female UM. They think genes may have something
to do with it. They're looking to a gene called
(18:54):
the serotonin transporter gene. And there is a paper out
there that indicates that if you have a mutated gene
serotonin transporter gene, than it could impact your attention to
environmental threats, which could impact whether or not you get
PSD PTSD. Geez. So you remember we did that episode
(19:15):
Can my grandfather's diet shortened my life? About epigenetics? Well,
epigenetics possibly factor into UM PTSD as well. So epigenetics
is basically where the function of a gene is um
affected within somebody's lifetime changes basically right, So it's like
evolution on the basis of years rather than you know,
(19:39):
generations and generations UM. And there was a study in
Detroit of a hundred people who fit the criteria for
PTSD diagnoses, and they found that they had six or
seven times the epigenetic changes of the control group, and
that a lot of those epigenetic changes, most of them
(19:59):
UM had to do with genes that that were responsible
for keeping up the immune system. Interesting, did they factor
in the fact that they've lived in Detroit? Well, that
was funny. I guess, in some horribly dark comic goal
way is that the researchers were from New York City
and they traveled to Detroit to find a hundred people
with PTSD. I'm sure they could have found that New York.
(20:21):
I guess they cast their lot in Detroit for some reason.
We love Detroit. By the way, We've been getting a
lot more emails lately because I think people pick up
newly and hear us dashing Detroit and they don't realize
it's been a running joke now for five years, as
almost six years. We love Detroit. Who doesn't exactly um.
(20:42):
And then, of course, the most important factor with this
or any other mental disorder is what they called a
trauma membrane, which is that support network your friends and
your family if you've got a strong one, and it's
a strong one in the right way. Like you point out,
they can be well meaning, but the person receiving that
(21:02):
membrane and that protection it has to do do right
by them. Yeah, and then they can't just be like, well,
you know, just just on the bright side, you know,
don't worry about that. Like, however, you're you're experiencing this
and getting over it. You're doing it wrong. Do it
this way. That's not gonna help, right. But basically the
point is if you are single alcoholic veteran that is
(21:28):
a loner living by yourself, it doesn't like to think
about your problem. Yeah, and like your tiny little apartment.
Then that's like the worst case scenario for PTSD. Yes. Yeah,
Like we said, the military is at a greater UM
risk just from being exposed to these situations and being
exposed to him over and over and over again. UM.
(21:50):
And but one of the other reasons that the military,
especially the military of late UM is at risk is
be because brain injuries where the quote signature wound of
the Iraq War I don't remember thanks to UM roadside
bombs I e. D. S UM, there are a significant
(22:12):
amount of head injuries. Are treatment of head injuries advanced
enough so that we could save lives where they wouldn't
have been before, Like people were exposed to head injuries
like in countless other wars. But now we've gotten to
the point where we can save those people's lives. The
problem is that their brains are changed. They've undergone what
(22:33):
Charles Myers called shell shock mild traumatic brain injury, which
again is almost indistinguishable and possibly one and the same
in some cases as PTSD. Yeah, and imagine the uncertainty
of guerrilla warfare and things like roadside bombs. Um, Like,
(22:53):
you can be prepped somewhat for for battle and we'll
get to that here in a little bit. What they're
trying to do the more and more of these days
with that, but with these guerrilla tactics that are going
on in the Middle East, with with suicide bombers and
car bombs and things like that, it's like kind of
the perfect prescription for eventual ps PTSD. Yeah. I'm trying
(23:13):
to trick to take the trauma out of it. Yeah.
Um yeah, we mentioned earlier, remember the optimistic personalities less
likely in the optimist believes in order in the universe. Well,
guerrilla warfare is like the opposite of order in the universe.
Are you starting to see like this pattern, Like all
this stuff is on the table. Yeah, it's just now
(23:34):
a matter of connecting it. And it seems like neurology
is going to be the field that does that, I think, so,
you know, so counseling obviously is step one. Um, and
this goes down in a couple of ways. The old
favorite cognitive behavioral counseling, which we talked about quite a bit,
which apparently I'm told by will Savey is not really
(23:55):
called that. It's cognitive processing therapy. I think he said,
I haven't really I've seen it call that, but okay
in his note, so we'll stick with the cognitive processing therapy. Well.
A couple of the aims there um are to basically
limit the amount of that excessive retrieval to sometimes it's like, hey, um,
(24:17):
every day for like from from nine to nine thirty,
you can think about this in a healthier way and
then you put it away for the day. So that's
one way they can do it. Yeah. Another way is
to just lessen the um, lessen the memories impact on
like how bad it was, maybe by pointing out some
of the good things, like what about the valorie you
(24:37):
showed during battle right by saving your buddy's life. He
died and you watched him die, but you also tried
to drag him his safety. So you tried, and that
you put yourself at risk and you really need to
commend yourself for that. Like carry that around too, it's
gonna balance out the horrible nous. So not like you
need to forget all this, but you need to bring
it back to an acceptable level where you can live
(24:58):
your life exactly. And one of the reasons are one
of the reasons it's not an unacceptable levels because this
memory has become so grossly exaggerated through the process of
this um this I guess memory retrieval, fearful memory retrieval,
over and over and over again. Like I think most
memories are enhanced or bad, you know, like you remember
(25:20):
like that prom in high school is way better than
it really was, or that breakup that you suffered was
really actually those usually get better with time. But you
know what I'm saying, right, Yeah, But I think, Chuck,
imagine that while you were see when whenever you retrieve
a memory, you're adding to it. That's how like sense
go from you know what you initially thought of, what
you know ten years after smelling the thing, you think
(25:41):
of the same thing with fearful memory retrieval. But when
your memory is being retrieved and your life is in
the gutter and you're addicted to drugs and you're scared
out of your mind, and then you compound that under
the original memory over and over again, then it's just
gonna get worse and worse and more and more exaggerated.
(26:02):
And yeah, one of the one of the or the
point of cognitive processing therapy is cognitive restructuring, like literally
reordering the brain by taking that memory head on and
saying no, no, no, like this didn't really happen like this,
and you're not paying enough attention to that, right. Another
type of therapy that is not is fun, although I
(26:23):
don't know if the other is actually fun, but exposure
therapy it's pretty hardcore. It's like to pull your knees
up to your chest and just rock back and forth
kind of therapy. Yeah. I mean it's basically to relive
it over and over and over um in great detail,
sometimes taking you to the actual place that it took place, um,
(26:46):
with the idea that eventually that fear extinction will happen
and you'll get over it. Right. Well, remember you were saying, like, um,
the song that was playing on the radio when when
you got in a car, right, they'd like to play that. Well,
welcome to hearing that song over and over and over again.
It doesn't again, when you're retrieving that memory in a
certain context and bad things aren't happening, and there's somebody
(27:09):
reassuring you saying like, look, you're okay, Like everything's okay.
Then you're relearning that memory again without the fear associated
with it, but you have to go through hell to
get there. Yeah, And it also stops avoidance in its tracks,
which is you know, if you if you're avoiding something.
The complete opposite of that is immersion therapy like that.
(27:31):
And then what they're finding is the best the best
results they are coming from a combination of therapy UH
and medication of course, because it helps to not be
freaked out of your mind when you're having to go
through exposure therapy and removing it. And a class of
(27:53):
drugs that helps with that. Our SSR eyes, our old
friend SSR eyes UM the two approved by the h
U S Food and Drug Administration or Zoloft and Paxel,
and those are actually the only two drugs approved by
the FDA to treat PTSD on label, not just the
only two SSR eyes, so use those with your therapy. UH.
(28:16):
They also have something called d clike co serine and
UM that is actually is that the one that's a
anti tuberculosis drug, and they found that it also helps
with PTSD. Yeah, they they noticed that, like it UM
cut down on fear by basically it agonizes your N
(28:36):
methyl d aspirtit receptors in m d A. Yes, now,
the and that enhances learning. So if you're going through
exposure therapy, you got a little um zolof going to
keep you calm and chilled out and able to go
through therapy, and you're taking dcs at the same time
to make you learn faster. UM, then that would probably
(28:59):
be a a good treatment for PTSD for some people. Yeah.
Beta blockers like uh, prop pen and all that's have
been long known to decrease stress levels. Yeah, and kill
Michael Jackson really is that what he was on? That
was the one his milk he called it. Oh he
had like the drip going yeah, yeah, I think that's
(29:21):
a little different than like described the pill. But this
is this UM. This drug specifically goes in there and
basically like m disconnects neurons so that there you don't
have that memory any longer. I read a paper once
on im using this drug to treat PTSD, and like
this guy was like, this is so effective that you're
(29:44):
basically rewriting history. It's like transhuman. It's it has like
that level of impact on some people. Interesting. Well, we
mentioned earlier the Army UM preparing soldiers for battle. Uh,
it is not just happening in a physical training way,
like learn how to shoot guns and do things like that.
(30:05):
Now it's happening very much on the mental level. Uh.
It was formerly called battle mind anymore, so that that
surprised me that they changed it. When was it from?
That was from Walter Reed Hospital too? Yeah, exactly. Now
they call it resilience training. That's way better exactly, and
it it actually didn't even start out as something to
(30:25):
help with PTSD, but they're learning that it can help. UM.
It's basically this, they handle the seven phases of deployment mentally.
They prepare you mentally for the seven phases like predeployment, deployment,
post deployment, redeployment, UM and everything from Hey, when you're
out of the Army or the Marine Corps and you're
(30:48):
driving your car around, you can't drive like you're angry
and like you were over there. If someone addresses you
in an aggressive manner, you can't handle it like you
did when you were in battle. Um, you didn't have
alcohol over there. Now you're back home, there's booze everywhere.
You can't go crazy with that stuff. And so all
of that put together they figured out ends up helping
(31:08):
out UM with PTSD, like rely on your family, they're
trying to encourage stuff like this, right. Well, also they
think it works because they're using it ahead of time,
like predeployment as part of training as well. So I
think like being exposed to horrors ahead of time, we'll
kind of keep you from going through I guess as
(31:30):
much of a trauma when you see it the real
thing a month later. Whatever. Yeah, what's interesting, Chuck, is
the Iroquois um had something like this. Yeah, after like
going and going to war, they were basically sequestered from
everybody else after they came back and we're assimilated. Yeah, exactly,
(31:50):
there's like a step down cooling period. Wow that the
Iroquois used because they would go totally insane while they
were in battle. Right, that makes sense where they won't
go berserk, know, the Vikings want berserker. Yeah, but I
think I think that you're equid took. Okay, So we're
talking about neurology being the key to this one chemical
that they have been studying is called Staffman Jason Staffman,
(32:15):
and that basically allows us to form fear memories from
our experience. So they're obviously working with this and mice
finding that lower levels of that are gonna decrease our
fear memories or our ability to form them at least.
So that's pretty you know, they're viding us on a
lot of fronts. Yeah, well, they're doing a lot of
research and you just need to put it together. What
(32:37):
else gastrin releasing peptide. Yes, they found that. Um. Apparently
this this chemical like signals the brain like calm down,
calm down, and um, if you have uh not enough
of it, you have an increased chance that you're going
to become fearful. Right. Um, so that's another one, uh
narrow peptide. Why we what do we talk about that in?
(32:58):
I don't remember. I we definitely talked about it. It's
it's basically our own bodies anti anxiety drug and um.
The levels of this are going to fluctuate depending on
what kind of stresses and traumas we've been through. And
once again, if that one's depleted, UM, then you're gonna
be less prone to overcome obstacles. Mentally. Yeah, they're actually
(33:18):
they're trying to figure out how to synthesize it. So
if it's as simple as like injecting some narrow peptide
wine into somebody's brain following a trauma, just to get
that a little extra boost, so you can, you know,
take this on and process it and shake it off.
I guess ecstasy. That's another one. M d N A,
m d M A. Uh. Not surprisingly when they have
(33:43):
treated people with PTSD, they felt better. Yeah, but it
was long lasting though, right? Was that the mushrooms? I
know we studied h that hallucogen mushrooms. Yeah, I don't
remember which one went back more more easily. Yeah, I
can't remember either. But there was a guy in that study,
the m d M A study who was like suicidal
(34:04):
for three years or two years. Oh no, that was
something different. The stelic Ganglian block. It's like in an
inoculation of just a local anesthetic, right, but just above
the clavical so it interrupts the the nerve transmissions of
your sympathetic nervous system, the fight or flight response. Yeah,
(34:24):
so it physically blocks it. Yeah, and it works apparently,
and it can last. There was one guy in that
study who was suicidal for um two years, and he
felt immediate relief. Yeah, the ecstasy. I think you said
that some people that experienced relief had never experienced relief
with therapy or any other drugs. So it's pretty interesting.
(34:46):
And then our old friend, the thinking cap, the transcranial
magnetic stimulator. UM. I don't know if that's what they
call it, is it? Yeah? Okay, Um, it's better than
a thinking cap. Yeah, that's true. They did a study
in two thousand four or twenty four male and female
patients suffering from PTSD and UM, they hooked up, you know,
(35:09):
the magnets to the head, stimulated blood flow to the brain,
and they found out that it had a nice effect
for the for the people. Yeah. Yeah, they think it
increased metabolism or something like that. Man, I think it's
a complicated thing, so it takes a complicated cure, you know,
because it's not just like, well it's this one thing.
(35:29):
It's like all over the brain and its emotions and
it's like fear and memory. It's just it's crazy, well yeah,
crazy and undo a memory the way that somebody formed it. Yeah,
it's pretty interesting stuff. So thank you very much to
Will Sovey for his help on that. And remember it's
PTSD awareness month, so we hope we've made you a
(35:52):
little more aware. Um and uh yeah, I'm very interested
to see how the research pans out. Yeah, me too.
It's SEMs like they made a lot of headway in
recent years. Um. If you want to learn more about PTSD,
you can go type those letters into the search bart
house to first dot com. It'll bring up the old
version of the article, but I'll work to get it updated. Okay, okay.
(36:15):
And since I said updated, it means it's time for
is it time for message break? Oh yeah, now listening man, Yes, okay, uh,
this is I'm gonna do a couple of DND emails
over the next a couple of weeks because we did
a podcast and Dungeon and Dragons. Boy, people loved it.
(36:37):
They did. That was a good one. Good feedback even
uh like the uber nerds were like, you guys did
a great job. Yeah, there are a couple who are
just like us, but for the most part, people liked it. Well.
This is from Christina and she was very nice. She
is from Cleveland. And that is Christina with a K
and Y and she says, guys, I love your show.
(37:00):
I'm Christina from Cleveland. I'm writing about the recent D
and D podcast because it reminded me of something that
happened recently. Both of my parents are huge nerds and
as a result had awesome nerd gaming daughters that as
me and my sister. Of course, Anyway, when they were dating,
my mom and my dad and my dad's four best friends,
my uncle's Bill, Larry, Calvin, and Carlton would get together
(37:22):
on weekends lay D and D all weekend long. Recently,
when Uncle Carlton was in town, he brought his old
reel to real taper quarter player and a bunch of
recordings of their D and D weekend sessions from the
mid eighties. That's awesome. It's like Brian posing now. Uh.
It was a hilarious trip in the time machine and
every session had its own unique quavor. Anytime they were
(37:43):
at Carlton's house, you'd hear jazz playing in the background,
for example, and they always say Larry was a god
among men as dungeon master. It was a ton of
fun listening to my young dad and his buddies and
their girlfriends and wives, joking, drinking, even a little toking
ha ha, oh my god and talking crap to each
other while they played the one story that they always
(38:03):
tell us when Carlton brought a friend who was new
to the group and loaned him a super awesome leveled
up acts since he knew he didn't have anything good
starting out. When the friend wouldn't return it, Uncle Carlton
killed his buddy's character, got his ax back, and they
continued on. Thanks for everything, Christina, that's pretty awesome. That's
a great dnd SOT. I would love to hear those takes.
(38:25):
Thanks Christina. Yeah. Really, Um, you know Brian Poston is
doing this this podcast, uh where he plays Dungeons and
Dragons with some friends and they just recorded same things.
He releases it as a podcast. I'll have to hear that. Yeah,
I love that, guys. Um. Well, if you want to
tell us a great story about your parents, we love
(38:45):
to hear those. Um. You can tweet to us at
s Y s K podcast. You can join us on
Facebook dot com slash stuff you should know. UH. You
can send us some email to Stuff podcast at the
Discovery dot com. UH. And by the way, thanks for
the letter, Steama. I forgot to say that uh, And
as always, you can join us at our home on
the web. Stuff you Should Know dot com for more
(39:14):
on this and thousands of other topics. Is it how
stuff works dot com. Jack Herds has quickly become the
online shopping destination for guys. Here's why everything on the
site is up off As a listener of Stuff you
Should Know, you can skip the membership waitlist and get
(39:34):
instant access at jack threads dot com, slash kate and
ow stuff that's Jack threads dot com slash no Stuff
Stuff You Should Know News
Hosts And Creators
Josh Clark
Chuck Bryant
Show Links
Order Our BookRSSStoreSYSK ArmyAboutPopular Podcasts
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations.
Death, Sex & Money
Anna Sale explores the big questions and hard choices that are often left out of polite conversation.
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.