"I understand that nobody understands me, but I cannot be someone I'm not," Audrey Tautou.
(Audrey Justine Tautou is a French actress and model, 1976-present).
Monday, October 30, 2017
John Glenn
"If there is one thing I've learned in my years on this planet, it's that the happiest and most fulfilled people I've known are those who devoted themselves to something bigger and more profound than merely their own self interest," John Glenn.
(John Herschel Glenn Jr. was a United States Marine Corps aviator, engineer, astronaut, and United States Senator from Ohio. In 1962, he became the first American to orbit the Earth, circling it three times, 1921-2016).
Sunday, October 29, 2017
Maurice Sendak
"Once a little boy sent me a charming card with a little drawing on it. I loved it. I answer all my children's letters... I sent him a card and I drew a picture... I wrote, 'Dear Jim: I loved your card.' Then I got a letter back from his mother and she said, 'Jim loved your card so much he ate it.' That to me was one of the highest compliments I've ever received. He didn't care that it was an original Maurice Sendak drawing or anything. He saw it, he loved it, he ate it," Maurice Sendak.
(Maurice Bernard Sendak was an American illustrator and writer of
children's books. He became widely known for his book Where the Wild
Things Are, first published in 1963).
Simone De Beauvoir
"I am awfully greedy; I want everything from life. I want to be a woman and to be a man, to have many friends and to have loneliness, to work much and write good books, to travel and enjoy myself, to be selfish and to be unselfish," Simone De Beauvoir.
( Simone Lucie Ernestine Marie Bertrand de Beauvoir was a French
writer, intellectual, existentialist philosopher, political activist,
feminist and social theorist, 1908-1986).
Personalized PTSD Treatment- Pan's Labyrinth
INTRODUCTION:
Life is hard, and it is normal for
human beings to have upsetting memories, feel on edge, or have trouble sleeping
after this type of event. It may even affect daily life and function as
effectively during normal daily activities such as attending school, performing
at work, or spending quality time with people. With majority of cases, time
heals these bruises within a few weeks or months. However, whenever these
symptoms persist for longer than a few months, it is possible to have PTSD.
Whenever
a disturbing life event occurs to a person, ‘Post Traumatic Stress Disorder’ or
‘PTSD’ can develop. Individuals with PTSD find themselves continuously
re-living these traumatic memories forcing them to avoid people, places, or
situations that can trigger symptoms of PTSD. These triggers can change the
mood and thinking pattern of the individual. At some point or another in their
lifetime, up to 7% of Americans find themselves struggling with PTSD. [C]
For some, PTSD symptoms may appear in
different period of one’s life different from the traumatic event and may even
come and go over time.
Although symptoms of PTSD usually begin soon after the traumatic event, there
are cases where symptoms do not appear until months or even years later. It is
also very common to see these symptoms appear and disappear on their own. [A]
Stanford University Medical Center
conducted studies that focused on predicting, with high accuracy, which
individuals with PTSD will benefit the most from psychotherapy (a common
treatment option for PTSD). Brain imaging was key to making this discovery.
Although psychotherapy is the only effective treatment available for PTSD, not
much is understood on why and how this type of therapy works as well as who
benefits the most from it. [C]
BACKGROUND INFORMATION:
PTSD
(posttraumatic stress disorder) is a mental health problem that
some people develop after experiencing or witnessing a life-threatening event,
like combat, a natural disaster, a car accident, or sexual assault. [A] In
instances where individual’s memory is triggered of the trauma it is typical
for him or her to have intense emotional and physical reactions accompanying
the trigger. [B]
In some cases, even
getting injured during an event can make it more likely to develop PTSD. Combat
and sexual assault are the most commonly associated forms of trauma found in
individuals suffering with PTSD. The number of traumatic experiences, age at
exposure, and gender are just some personal factors contributing to an
individual’s development of PTSD. The life events after these events are also
key as exposure to stress or lack of social support afterwards can contribute also.
[A]
It is extremely
important to remember that PTSD is NOT a sign of weakness, but that one has
overcome great although painful life experience(s). PTSD can happen to anyone
and several factors can increase the chances that a certain individual will have
PTSD. The many variables and/or factors that contribute to one having PTSD is
out of the person’s control in that they have experienced a very intense or
long-lasting traumatic event. [A]
Other problems that
manifest from traumatic experiences into chronic physical pain, employment difficulties,
and trouble in maintaining or forming relationships are common in individuals
struggling with PTSD. Behaviorally, individuals experience heightened
reactivity to stimuli (hypervigilant), become hostile, practice
self-destructive behavior, social isolation due to overwhelming anxiety and
depression.
Symptoms include
nightmares and flashbacks which lead to insomnia, avoidance of situations that
could trigger memories of the trauma drastically affecting the quality of ones’
life, and sever mistrust of people around them. In addition, emotional
detachment and/or unwanted thoughts are also common.
Specifically speaking there are 4 types
of PTSD symptoms (although each varies from person to person).
The first type of
PTSD symptom is known as, “Re-living the event” or “re-experiencing symptoms”
where unpleasant memories and nightmares make the individual relive the event
similar a flashback.
The second type is
whenever the individual “Avoids situations” that could trigger memories of the
traumatic event. This causes the person to avoid conversations on this specific
topic, having thoughts related to the event, and avoiding activities.
The third type includes
the perception the individual has of themselves but also the perception of the
world and people around them. This PTSD symptom is called, “Excessive/more
negative beliefs and feelings” and it causes a loss of interest in activities
one enjoys, feels guilty or shame along with the overwhelming feeling of the
world as being a dangerous and frightful place. Subsequently, individuals
suffering with PTSD have difficulty trusting others. In addition, they feel
numb or find it hard to feel happiness.
State of being on constant alert of
surroundings is the fourth type of symptom, “hyperarousal” causing the
individual to always be looking out of danger affecting the ability to sleep
and/or concentrate. Feelings of anger can arise suddenly, are easily startled,
or have unhealthy habits such as drug usage, alcohol, smoking, or reckless
driving.
Even children can have PTSD and experience symptoms which differ depending on age. Ages 6 and younger may get upset if their parents are not nearby, display trouble sleeping, or act out the trauma through their play activities. Between ages 7 to 11, the trauma may also be displayed through drawings and stories. Their nightmares can become increasingly aggressive and irritable. Children with PTSD between these ages have difficulties with school and/or friends. When a child is between ages 12 and 18 their symptoms are more like adults’ symptoms (experience depression, anxiety, withdrawal, or reckless behavior such as substance abuse, running away from home, etc.) The great news is that PTSD is curable, and the following treatments can get rid of symptoms altogether.
Trained individuals who guide patients
through distressful time periods in life or mental disorders through talk
therapy are known as clinical psychologists. There are different types of
psychotherapy that clinical psychologists use to help individuals struggling
with PTSD.
Prolonged Exposure (PE) is a form of psychotherapy where the
individual talks about the trauma repeatedly until the memories are no longer
upsetting. Through this process, when completed successfully, helps to get
control over the thoughts, feelings, and possibly even perspective on the
traumatic event.
A similar kind of therapy is called Eye
Movement Desensitization and Reprocessing (EMDR), where patients focus on
the sounds and/or movements when speaking of the trauma. This approach helps
the brain approach and eventually work through these unpleasant memories.
However, when
speaking of psychotherapy, the most effective treatment, at least for PTSD, has
been cognitive behavioral therapy (CBT) including cognitive therapy and
exposure therapy.
One type is Cognitive Processing
Therapy (CPT) where you learn skills to understand how trauma changed your
thoughts and feelings. Changing how you think about the trauma can change how
you feel.
There are also psychiatrists who
prescribe the medications needed in treatments of PTSD. Typically, these
medicals include some type of SSRI’s which ease symptoms of depression and
anxiety to help patients reach their goals of healing. SSRIs (selective
serotonin reuptake inhibitors) and SNRIs (serotonin-norepinephrine reuptake
inhibitors), which are also used for depression, are effective for PTSD.
Another
medication called Prazosin has been found to be helpful in decreasing
nightmares related to the trauma. It is incredibly important to note that benzodiazepines and atypical antipsychotics should
generally be avoided for PTSD treatment because they do not treat the core PTSD
symptoms and can be addictive.
*[Please
note, that if you or someone you know is experiencing such symptoms for over
four weeks causing great distress or interfere with daily life functioning, it
is possible that he or she can have PTSD.] *
RESEARCH:
Stanford University Medical Center
conducted studies that focused on predicting, with high accuracy, which
individuals with PTSD will benefit the most from psychotherapy (a common
treatment option for PTSD). Brain imaging was key to making this discovery.
Although psychotherapy is the only effective treatment available for PTSD, not
much is understood on why and how this type of therapy works as well as who
benefits the most from it. [C]
The pair of studies had researchers
measuring brain activity during 5 tasks assigned to participants and researchers looked for the
associations key to reducing symptoms of PTSD after treatment. Studies
conducted such as these help the medical field closer to giving patients
personalized treatment. One of the studies focused on whether brain activity
levels before treatment could help scientists predict which participants would
respond well to prolonged exposure therapy.
The first step of the procedure involves psychotherapy where scientists
had patients revisit traumatic experience(s) specific to each person. Revisiting traumatic experiences allows
for decrease in emotional response. Since everyone is different, not all cases
of PTSD will benefit from this treatment. Prolonged exposure therapy for PTSD consists of a series of sessions and
assignments. This approach leads patients to slowly approach similar memories
and situations that can trigger a reaction. Patients begin by
imagining scenarios that trigger their PTSD symptoms -- such as a crowded park.
Gradually these individuals progress enough to bring themselves to these very
situations.
Prolonged Exposure Therapy
(or ‘PET’) functioned in achieving the goal of these studies of measured brain
scans of 66 individuals with PTSD as they completed 5 tasks which triggered
various emotional and cognitive functions. These tasks involved showing
patients images of faces or scenes to evoke either happy, neutral, or positive
emotions. Such tasks can also involve responding to questions about such
content.
Prior to receiving prolonged exposure therapy, patients
with both lower activity in the amygdala and higher activity in various regions
of the frontal lobe while viewing faces with fearful expressions showed a
larger reduction in PTSD symptoms following therapy.
The amygdala (located deep within the primitive
region of the brain’s alarm system and plays a key role in emotional
responses). The frontal lobe is the
outer layer of the human brain in the area behind the forehead; it plays a role
in complex functions such as behavior, personality and decision-making.
The researchers
discovered that patients with greater activation in a deep region of the
frontal lobe when ignoring the distracting effects of conflicting emotional
information -- such as a picture of a scared face with the word
"happy" written across it -- responded better to exposure therapy. The
better able the brain is at deploying attention- and emotion-controlling
processes, the better you respond to treatment.
The way the human brain
responds to emotional regulation and processing tasks gives scientists and
researchers the ability to predict the effectiveness of PET with up to 95.5
percent accuracy. This kind of screening approach (using the less expensive and
more widely available electroencephalogram rather than fMRI) could help doctors
determine the best course of PTSD therapy in the future, the researchers said.
RESULTS:
Therapy has been
found to change connectivity in the brain between the frontopolar cortex and
regions of the brain located closer to emotional processing areas. Using a non-invasive method for
stimulating brain activity known as ‘transcranial magnetic stimulation’ or
‘TMS’, researchers worked to activate the frontopolar cortex in ‘healthy’
individuals. At the same time, they recorded brain activity with fMRI and
confirmed that the frontopolar cortex modulated downstream activity in lower
cortical regions closer to emotion-processing parts of the brain. This process
can confirm whether the frontopolar cortex is important in processing
emotions.
PET
led to lasting changes in participants' brains associated with the improvement
in PTSD symptoms by better understanding the ways in which PTSD brains function
and how linking brain activity patterns determine how well patients responded
to treatment. Such personalized treatments for PTSD
individuals could be pivotal in helping many struggling to live normal,
functioning lives. [The concluding results of these studies have been published
online in The American Journal of Psychiatry.]
When participants
were instructed to regulate their emotional response to an image of a negative
or stressful scenario, noticeable changes were observed in frontopolar cortex
activity. Changes in frontopolar cortex activity were also detected when
participants were resting or in a non-focused state. It was surprising for
researchers to discover that the frontopolar cortex plays such a key role in
prolonged exposure therapy. Typically, and for majority of scientific studies,
the primary focus has been the emotional processes that occur in PTSD through
the functioning of the amygdala.
By the fourth week,
fMRI scans revealed elevated activity in the front-most region of the frontal
lobe known as the frontopolar cortex. This area of the brain, the most recently
evolved region, balances both the internal and external attention spans of
individuals as well as aiding in coordination of multiple processes such as
multitasking and remembering future ‘to-do’ list items.
Greater frontal lobe
activity and less amygdala activation predicts better treatment outcomes. Based
on these findings, researchers activated an area of frontal cortex with TMS
probes while imaging the brain. These explorations allowed for the researchers
to determine whether TMS helped individuals with PTSD better respond to
‘prolonged exposure treatment’.
They found that doing
so inhibited activity in the amygdala, and the degree to which that happened
also predicted the degree to which a patient's symptoms improved. In the
future, stimulating this region may help increase patients' responsiveness to
psychotherapy. Indeed, some small-scale studies in which therapeutic TMS was
used daily on the same region of the frontal cortex, without the addition of
psychotherapy, have already shown promising results.
CONCLUSION:
These results help to
better understand psychotherapy and psychiatric disorders which will help fight
negative stigmas surrounding these illnesses and their treatments. Such studies
give hope to people struggling with PTSD as they undergo treatment laying the
foundation for new treatments based on our understandings of brain circuitry.
Psychotherapy
function will be to amplify the attention towards an internal regulatory
process that mediates ones’ emotions. Alterations in the activity produced at
the frontopolar cortex indicates a shift in frontopolar function. Using
psychotherapy as a tool to train this region of the brain for successful
regulation of emotions can improve overall symptoms of PTSD individuals and
emotional well-being.
Therefore,
psychotherapy can be used as a tool in training the frontopolar cortex region
of the brain to amplify attention toward an internal regulatory process that
mediates successful emotion regulation. The degree to which activity in the
frontopolar cortex increased following therapy was associated with the degree
of improvement in PTSD symptoms and emotional well-being.
Links:
*Please note! These images are not
mine. They were found on various tumblr, pinterest, google image sites! If any
are yours please let me know so that I can give you credit for them! Also the
people in the images have no relation to the diseases, illnesses, or cancers I
write about. Thanks so much & enjoy~
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