Posted by Pfinstegg on November 21, 2002, at 10:26:07
In reply to anyone have Post traumatic stress disorder?, posted by nicole1011 on November 18, 2002, at 21:15:49
To my way of thinking, which has been greatly influenced by all the posts here, including the ones in the archives, and the research these have led me to do, I think nearly everyone here can be considered to have some variety of PTSD. Maternal stress and depresson during fetal life begins by setting the HPA axis to "high", childhood neglect and abuse and later life experiences of loss, fear, conflict etc. along with whatever genetic predisposition we may have, all lead to a common pathway of excessive CRH-ACTH-cortisol production in response to minimal stimuli. The presence of excessive cortisol and mineralocorticoids excreted by over-active adrenals damages the hippocampus and prefrontal cortex and thus the neurotransmitters which regulate the output and uptake of all the neurotransmitters- for serotonin, dopamine and epinephrine, and undoubtedly others not as well understood yet.I don't think the actual psychiatric diagnosis, whether it is bipolar or monopolar depression, panic disorder, social phobia, borderline or schizoid personality disorder- is very significant any longer, except in the sense that certain medications may be better for one or another of these. The two disorders which seem less related to stress, and more to genetic or physiological abnormalities, would be schizophrenia and OCD, although stress clearly does play a role in both of these also.
Because of having begun to think in this way, I am looking forward, very much, to treatments which will address the basic HPA axis dysregulation- they are definitely coming!
I also continue to value psychotherapy highly, when it is done well- I think that the sense of growth and mastery which one can gain from psychotherapy may be due to the power of a good human relationship to help moderate the HPA axis dysregulation. Well, I'll stop here, but would really like to know what others think of these ideas!
Pfinstegg
poster:Pfinstegg
thread:128209
URL: http://www.dr-bob.org/babble/20021116/msgs/128608.html