• Suffering a traumatic event can cause life-long anxiety problems, manifested in emotional and/or physiological issues.  This trauma-induced anxiety can be significant enough to rise to an even more serious condition known as post-traumatic stress disorder (PTSD).  Involvement in traumatic events, such as getting seriously injured in a motor vehicle collision, being the victim of sexual assault or a violent crime, or witnessing violence or warfare, increases the risk that someone will develop PTSD.  The authoritative text that health care professionals and experts rely upon to assist in diagnosing PTSD and other mental health disorders is known as the Diagnostic and Statistical Manual of Mental Health Disorders (DSM).  This text explains that exposure to a traumatic event can result in very specific reactions from each of four symptom clusters: intrusion of reoccurring memories of the event, avoidance, alterations in mood and cognition, and hyperarousal.

    PTSD is seen as a disorder that affects as many as 10 percent of people who experience traumatic events, per the U.S. Department of Veterans Affairs.  PTSD survivors suffer long-lasting symptoms in the form of disturbing flashbacks, insomnia, hyperarousal and anxiety that can lead to significant impairment.  In addition to suffering from distressing, and at times debilitating, memories of a traumatic event, people suffering from PTSD are also at increased risks for developing complications associated with cardiovascular disease and auto-immune diseases.

    A noteworthy study, with implications for future treatment remedies, from researchers at the Uppsala University and Karolinska Institutet, published December 10, 2015 in Molecular Psychiatry[1], found that people with PTSD have an imbalance between two important neuro-chemical systems in the brain: (1) serotonin, and (2) substance P.  The study indicated that the greater the imbalance between these chemicals, the more severe PTSD symptoms the patients demonstrate.

    Both of these neurochemical systems have independently been implicated in stress and anxiety, but interactions between them may be crucial for human anxiety conditions.  Researchers in the December 2015 study used PET scanners to measure the relationship between the two brain signaling systems.   Researchers examined the serotonin and substance P/neurokinin-1 (SP/NK1) systems individually as well as their overlapping expression in 16 patients with PTSD and 16 health controls.

    Participants were imaged with highly selective radiotracers that assessed serotonin transporter and NK1 receptor availability, respectively.  The results suggested that abnormal neurochemical system couplings contributes to the pathophysiology of PTSD and, consequently, that normalization of these couplings can be therapeutically important.

    While previous research has shown changes in brain anatomy and function in people with PTSD, this study is the first to actually show a shift in balance between neuro-chemical brain signaling systems with PTSD.  Researchers say the findings greatly improve understanding PTSD and could lead to better treatment.

    The authors of the study noted:

    “PTSD is often treated with selective serotonin re-uptake inhibitors (SSRIs) which have a direct effect on the serotonin system.  SSRI drugs provide relief for many, but do not help everybody.  . . . Restoring the balance between the serotonin and substance P systems could become a new treatment strategy for individuals suffering from traumatic incidents.”

    PTSD-type symptoms are often seen in patients who have survived a serious traumatic event, but it is also a diagnosis that is greatly misunderstood by health care professional and the attorneys that represent the injured party in a personal injury claim.  Not surprisingly, and something that is routinely observed on client matters we handle, PTSD may be initially  denied or contested by insurers wanting to deny payment for necessary treatment.

    If you or your patient is experiencing symptoms of psychological stress following a traumatic event, it is important they get their symptoms assessed, and, if needed, see an appropriate specialist for evaluation and/or treatment. The attorneys at Adler Giersch PS can assist patients seeking guidance while recovering from traumatic injury and while dealing with PTSD and respond to insurers that get in the way of healthcare recovery.  Please visit our website at https://www.adlergiersch.com, or contact us at 206-682-0300 for more information.  Consultations are complimentary and confidential.


    [1] Frick et al (2015): Overlapping expression of serotonin transporters and neurokinin-1 receptors in posttraumatic stress disorder: a multi-tracer PET study, Molecular Psychiatry


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