By Dr. Minal Mistry, Psychiatrist
In my professional practice, I diagnose and treat people with “Post-traumatic Stress Disorder”, or PTSD. I work in a specialized clinic for veterans and a general mental health clinic, and have noticed how common PTSD is becoming. PTSD has a lifetime prevalence of 7.8% in adult Americans, with women twice as likely as men to develop the disorder. PTSD is a widely recognized mental disorder that is potentially very disabling and impacts on the sufferer and their loved ones.
What is PTSD?
You may have heard of PTSD from the media as a condition that can affect ex-military and first responders who have been exposed to life threatening traumatic incidents in the course of their work e.g. war combat. You may have also come across people in the general population who suffered PTSD as a result of being involved in severe events - natural disasters such as earthquakes.
According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders fifth edition (DSM–5), symptoms to watch out for include:
Cancer and PTSD associations
A qualitative review, published in The Lancet this year, confirmed the connection between PTSD and cancer based on the trauma of dealing with a life-threatening medical diagnosis such as cancer. This strikes a chord with me as a close family member of mine received a diagnosis of cancer recently. The latest research suggests links between cancer and PTSD.
The researchers, Cordova and colleagues, showed that 37-60% of cancer survivors had PTSD symptoms. Specific aspects of phases of cancer diagnosis acting as a trauma include: events prior to an official diagnosis being made (“cancer-scare”), receiving the diagnosis, undergoing investigations with associated uncertainty, and worry about the cancer returning. They also state that, amongst other risk factors, having a prior history of trauma correlates with cancer-related PTSD.
The authors have stated that are warning signs that may predict who are more likely to get PTSD:
Cardiovascular disease is a consequence of, and a risk factor for, PTSD
We already know that cardiovascular disease (e.g. heart disease) and depression are closely linked because depression is a risk factor for heart disease, and having heart disease can increase the risk of depression. However, another 2017 The Lancet paper, a large systematic review and meta-analysis by Donald Edmondson and Roland von Känel, adds to this knowledge with respect to cardiovascular illness and PTSD.
Similar to the cancer and PTSD research, the authors stated that the environmental factors involved in receiving diagnosis and care for cardiovascular disease (e.g. being in an overcrowded emergency room, perceived poor communication with the clinician, exposure to other people who are close to death, and intensive care unit stay) may increase the likelihood of subsequent PTSD. They also revealed that the reverse is true: PTSD increases the risk of cardiovascular events by 53% (or 27% when the results were adjusted to take into account depression).
The researchers also raised our attention to warning signs to help predict who is more likely to experience PTSD-induced cardiac problems:
What does all this mean?
The significance of the findings from these Lancet research papers is two-fold:
The importance of understanding how our mental health interacts with our physical health (mind-body connection) should not be underestimated. We must look after our health so that our physical and mental health is being addressed simultaneously since they are intricately linked. Regardless of whether we are going through mental or physical illness, non-medication strategies (e.g. yoga, meditation, exercise, keeping active, healthy eating and lifestyle changes) can create harmony between the physical and mental – hopefully leading to a happier and healthier path in life.
Cite this article as: Minal Mistry (2017). Post Traumatic Stress Disorder and Physical Illness: The Beautiful Space-A journal of Mind, Art and Poetry. April 2017: TBSB116
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