PTSD May Not A Mental Disorder
June 11, 2016 5:55 AM   Subscribe

Recent research suggests that PTSD may be more of a physical issue than a psychological issue.
posted by COD (39 comments total) 17 users marked this as a favorite
 
This is about traumatic brain injury, not PTSD. It has no relevance for survivors of trauma like rape and child maltreatment such as neglect. It is bizarre that the NYT didn't even mention other types of trauma
posted by Maias at 6:17 AM on June 11, 2016 [39 favorites]


I genuinely hope that this research helps people with traumatic brain injuries to relieve their suffering. That said, this is profoundly disheartening:
Much of what has passed for emotional trauma may be reinterpreted, and many veterans may step forward to demand recognition...There will be calls for more research, for drug trials, for better helmets and for expanded veteran care...They also said it makes a big difference to be told they have a physical wound rather than a mental one, even if it is incurable.
It would be amazing if we could do a better job helping people with PTSD -- but why is it that calling it a physical (rather than a mental) illness makes such a difference? What's wrong with recognizing emotional trauma as a genuine hardship that should be taken seriously? Along with doing research on causes and treatments, we really need to demolish the stigma around mental illness -- it inflicts so much unnecessary suffering on people who are already in pain.
posted by ourobouros at 6:21 AM on June 11, 2016 [47 favorites]


(It's PTSD, not PSTD.)

I'm not getting a "strong link" vibe for PTSD specifically from this article. There is no attempt to study brain tissue in people who have PTSD but have never been in war or exposed to blasts on a regular basis. I have no doubt at all that these blasts cause brain damage and that Pearl is seeing the results in his slides, but it seems likely to me that people with blast sourced brain damage are probably also at a higher risk for PTSD in general.
posted by xyzzy at 6:21 AM on June 11, 2016 [3 favorites]


What a bizarre article. It never even occurred to anyone, in the writing or editing of this piece, that they should address the fact that people get PTSD from things other than blasts?

I also am not sure that I buy the distinction between "physical" and "psychological" issues. The brain is an organ. Everything that happens in it is physical.
posted by ArbitraryAndCapricious at 6:34 AM on June 11, 2016 [37 favorites]


Oh, great. Another way for the military to discount, deny, or underdiagnose. "Says here you've never been near any blasts, so it must not be PTSD. You're just a shitbag, I guess."
posted by Etrigan at 6:38 AM on June 11, 2016 [21 favorites]


What an outpouring of bile and negativity - over an advance in medicine. There are a tremendous number of people killing themselves over this. It's okay for this to be important even though there are also other people suffering.

If I were a gambling man, I'd bet that in the future, physical causes for other types of chronic emotional problems, like non-war-related PTSD, would also be discovered. This seems like a step on that path, to this layman.
posted by Western Infidels at 6:55 AM on June 11, 2016 [21 favorites]


As folks have pointed out, this article is really weirdly skewed. I think there's some really interesting ways that the physical trauma that causes things like CTE and the psychological trauma that's generally associated with PTSD may be linked in a host of cases, but the writer seems to want to replace one with the other simply to service the breathless, handwavey headline.

That being said, this is a fascinating and exciting time for this topic. I recently had dinner with one grad student working on CTE at a military academy in DC and another who was learning EMDR, which is currently considered the most effacious therapy for PTSD of all types. The overlap was not lost on them.

The former related how damaged neurons that cause CTE could be transplanted (in rodents) and effectively infect the healthy neurons of subjects who had not experienced physical trauma (you know, beyond base level lab rat stuff). The latter talked about how the memory processing that happens when we dream (which is simulated during EMDR by guided visualization and actual eye movement exercise) has a stark physical and chemical effect on neurons.

I guess what I'm trying to say is: the brain is a physical organ. This article is almost Dualist in its simplified A vs B tone.
posted by es_de_bah at 6:56 AM on June 11, 2016 [8 favorites]


Hm. As the daughter of a disabled veteran whose disability was caused by injuries from a blast, I actually thought what was discussed was really interesting and potentially promising, regardless of what labels you use. The point to me is that the labels might be wrong or at least inadequate.

I understand the criticisms above, but my father's behavior throughout my life can be described in all of the ways mentioned in the article as being common to those with these types of injuries. He's exhibited depression, anger, migraines, a lack of impulse control, abusive rage, etc. It's hard to know what's just him being a jerk with no filter and what's depression and rage from his life circumstances and what might be related to his blast injury.

I would love to get his brain to someone someday who could tell me if they see this pattern of brown dust, to at least know that much. I don't know that it would make me forgive him, because he's a person with agency and should've tried harder to control his impulses to emotionally and physically abuse his wife and kids, but it would at least be another puzzle piece.

My father is an extremely intelligent, iconoclastic man who nonetheless never controlled his bad behavior and bad impulses until it was too late. He ended up alone, he ate poorly, but with a former Marine's fortitude, he kept up a large property by rehabbing himself and weight-lifting through two strokes. The third one put him in assisted living and then a nursing home, where his habit of oppositional behavior and his depression have really made it hard for him to get good care.

Anything that fills in some of the why and how he got there would be interesting to me, and I'm sure to many other family members of injured veterans.
posted by limeonaire at 7:06 AM on June 11, 2016 [26 favorites]


I think all the negativity in the thread is caused just by the article picking a headline which doesn't actually reflect what it's about. It is not saying that "really PTSD is physical not emotional". It's talking about a very specific thing - that there are physical implications for soldiers who experience blasts. The article seems positive in the sense that - as is often the case with armies - the concerns of soldiers and researchers who have been saying that there are symptoms specific to being caught up in a bomb blast were being ignored. Now it seems that these concerns are being taken seriously and it mentions soldiers having to carry blast gauges which determine if they have been subjected to blasts of particular magnitudes after which they must be screened for brain injury. As someone who is anti-war but pro-soldier (if you're going to send people to kill and die for your country's desire for power and wealth you should at least damn well take care of them) I think this is a good thing. What it is not saying is that all PTSD diagnoses are wrong and really it's all physical.

This is of interest to me because I'm a therapist and I work mainly with victims/survivors of the conflict here and the vast majority of my clients have PTSD to varying degrees. And many of them have indeed been caught up in bombs, either actually been in a bomb blast and lost limbs, or felt the impact, or witnessed one, or saw the horrifying after effects. There is no doubting that there are psychological wounds caused by that, especially as some clients experienced or witnessed these events as children. And there are those who have PTSD because of non-bomb but conflict related trauma - being shot, witnessing shootings, losing a family member to violence, hearing gun battles...on and on. For me the really interesting part of this research is that specifically for those who were impacted by bombs there may also be physical impacts on the brain which are causing symptoms in addition to the emotional scars. This could be really useful knowledge in terms of treatment and approaches, and for me ties in well with the increasing acceptance in the field of the holistic approaches to trauma treatment, such as sensorimotor therapy, which adopt a neurological as well as psychological stance because the body and the brain hold and process trauma as a single entity.

As one of the soldiers quoted said:
Matthews told me that he thinks he can now distinguish between the emotional wounds he suffered — the survivor’s guilt, the bad dreams and night terrors — and the more concrete cognitive problems that he traces to his blast exposure. For people working in the field this increased understanding could be very useful IMO.
posted by billiebee at 7:13 AM on June 11, 2016 [35 favorites]


What an outpouring of bile and negativity - over an advance in medicine.
I think people are sort of targeting the article's approach to this advance, not the advance itself. As a person who suffers from a half dozen diagnosed mental illnesses (including PTSD) I very much look forward to the day that advances like these could lead to more precise diagnostic tools or even treatments for people with mental illnesses. But like some of the other posters I take exception to this weird and unnecessarily forced duality between mental vs. physical. If my bipolar brain is completely anatomically normal, I'll eat my couch.
posted by xyzzy at 7:17 AM on June 11, 2016 [15 favorites]


I think the point of the article is that the military has traditionally written off PTSD as a purely emotional issue, and given the inherent issues in military service coming forward for help for "mental issues" is something many soldiers won't do, or do very reluctantly. However, physical issues are a different issue. It's not good that there is still a stigmas associated with mental disease, but it is what it is, and if more soldiers are willing to come forward for help because their challenges are "physical" that is a net good.

Also, it seems there are bigger implications here for the military if PTSD is simply an expected result of being near numerous large concussions, and not something that can be managed with better training up front or better pills afterwards.
posted by COD at 7:31 AM on June 11, 2016 [3 favorites]


This article is not about PTSD, and the editor who picked the headline did a tremendous disservice to the excellent and important reporting about blast-related brain injuries in the article. The strongest thing you can really say relating to PTSD from what this recent work is finding is that many cases of PTSD among soldiers are in fact misdiagnosed cases of traumatic encephalopathy. (Or, more likely, that these soldiers are suffering from both.)

There is also growing evidence that repeated concussions can have an effect similar to blasts -- the brains of boxers and professional (American) football players often show similar markers to soldiers who've suffered blasts. A recent episode of the podcast Neuroscientists Talk Shop featuring Lee Goldstein gives an in-depth technical discussion of CTE, for those who are interested.
posted by biogeo at 7:40 AM on June 11, 2016 [16 favorites]


The article is pretty clearly talking about one specific kind of PTSD, which it appears may have nothing at all to do with the other kinds of PTSD. This is how medicine works - all kinds of problems get lumped together in one diagnosis and then later we figure out that we were actually lumping a bunch of similar symptoms with very different causes together. I'm not sure that needs to be explained in the article, but perhaps it does.
posted by ssg at 7:46 AM on June 11, 2016 [3 favorites]


PTSD is not blast overpressure brain injury. The brain injury stuff reaaaaallllly needs to be looked at. It is clearly being covered up in an unsurprising confluence of motivations -- the military needs to keep generating cannon fodder, the VA and the military do not want to pay for expensive treatments, and the service members themselves want to stay in the game. It is exactly like the deal with CTE in the NFL.

But this is not PTSD. Anyone who's been involved with PTSD on any level is naturally going to be infuriated by this dumpster fire of a headline in a nationally prominent publication.
posted by PsychoTherapist at 7:50 AM on June 11, 2016 [8 favorites]


To suggest that the military will use this sort of study to be dismissive of soldiers claiming emotional PTSD as being a shitbag seems unfair to our military. After all, there had been various terms for what we now call PTSD prior to Viet Nam, and with Nam, PTSD became a recognized problem and one that was also accepted in non military traumas. I think our military will recognize that one can have problems caused by physical damage caused by explosions as well as emotional damage caused by the horrors of war.
posted by Postroad at 7:56 AM on June 11, 2016


Breaking PTSD down into types is something the Military has done for a long time. The research on PTSD in ten of military research had always been on combat PTSD only (although the CAPS assessment is really good). When you look at that the research from the military has already been focused that way the title of the article makes more sense. PTSD vs TBI gets different funding and different approaches, and may lead to more individuals being diagnosed with a service disability which is a REALLY BIG DEAL.
posted by AlexiaSky at 7:57 AM on June 11, 2016 [3 favorites]


This article is not about PTSD, and the editor who picked the headline did a tremendous disservice to the excellent and important reporting about blast-related brain injuries in the article.

Yep. Other than the headline, "PTSD" (or the full term) is mentioned exactly three times and the whole point of the article is that neurological injuries caused by explosions are different from PTSD. Maybe the headline writer was just confused by the unfortunate ambiguity of the word "trauma"?
posted by A Thousand Baited Hooks at 8:10 AM on June 11, 2016 [2 favorites]


To suggest that the military will use this sort of study to be dismissive of soldiers claiming emotional PTSD as being a shitbag seems unfair to our military.

It is an unfairness that our military (along with many others) has earned over the course of centuries. I have witnessed with my own eyes subtle allegations of malingering whenever a medical problem cannot be solved rapidly.

It will not happen every time, but the danger is one that the military will have to actively work against.
posted by Etrigan at 8:17 AM on June 11, 2016 [6 favorites]


The military was still reluctant to take blast seriously or even to concede that the symptoms it caused were a matter of physical harm.

Well, right now the MO of militaries in general is to make loud noises, so they would of course resist deleterious statements about their main approach to peacekeeping.

In a tighter view, I believe the writer ought to have recast his essay. What I understand is that TBI's are important because they 1) haven't been generally studied, and their effects are sometime not apparent until years after the event that causes them, and 2) this is similar to the way PTSD affects people. His bent ought to have been: bring TBI into the list when you compute the cost of war.

A weakness in his essay is that it leaves room for inferences about the causes of PTSD that are misleading. Irony in this is because, when PTSD was being brought up as a typical combat injury, most people were ignorant of its effects; at first it was thought that a soldier had to experience combat to get it. Eventually it became apparent that PTSD applied even to people who were never in combat, but rather had suffered severe abuse of one sort or another. In the broader veiw, it took 20 years to get across the point that PTSD was as much an injury as was a broken arm.

It's worth knowing that many cases of PTSD have been accompanied by, or have caused, certain physiological changes. Of course, this article is not about how severe emotional trauma can scramble the body's chemical responses, causing the patient to react with wildly inappropriate feelings to everyday situations (as well as the dozens of other symptoms), and how PTSD might provide a platform for a cluster of other psychotic reactions. The article is about how TBI's can cause insidious and often hidden damages that come crawling out from under rocks to kill the soldier years after the event that caused the injury in the first place.

He's not wrong to plead for understanding that mental anguish is not a weakness of character. He is just a bit off center in the way he writes about TBI's.

By the way, "shell shock" is usually a conflation of a PTSD related event, and the temporary, stunned effect that sometimes happens to soldiers after a particularly fierce event. Combat related events do not cause PTSD in every soldier who experiences them. This sort of trauma is not that easy to diagram. Two soldiers fighting side by side in the same action may have a very different response to the battle. It ain't what it is, it's what it means. In the non-PTSD related version of shell shock, a trooper will have his holyshit moment, then drive on, without necessarily have it blossom into PTSD in times to come. In a Traumatic Brain Injury, the symptoms are analogous to a broken arm, except that they may take some months or years to present themselves.
posted by mule98J at 8:30 AM on June 11, 2016 [4 favorites]


Trauma is trauma is trauma.
The autonomic nervous system exists to avoid or address trauma -- flight/fight/freeze. This is primitive brain stuff; biology, not psychology.

The brain of a veteran who is raped by a commanding officer is subject to the same effects of chemistry and neuroplasticity
as the brain of a veteran who didn't get on the helo with the rest of his crew before it was shot down over Danang
as the brain of a veteran who lost a leg, forearm, ear, and three squadmates to a blast in Iraq - but not before growing up in a gang and being offered prison or enlistment -
as the brain of a veteran's child who spends their formative years subject to relational trauma, physical abuse, and being role modeled their traumatized parent's inability to self-regulate.

While I'm glad to see the vague and bureaucratically contingent possibility of a shift in "community standard of care" for veterans, it's still (figuratively) addressing the symptoms rather than the disease. War behavior is the product of disordered thinking, disordered thinking the product of trauma, and trauma is a potential issue for anyone with an autonomic nervous system. Enormous changes require incremental shifts, though, and these conversations are steps in a positive direction.
posted by sutureselves at 8:48 AM on June 11, 2016 [6 favorites]


Yeah, as someone who treats a lot of PTSD this headline drew me in and I am profoundly annoyed. The article is about a hypothesis that proximity to bomb blasts is causing histologic changes to brain tissue that probably affect cognition and behavior. I came in here to discuss all kinds of new evidence about how actual PTSD affects the way the CNS functions in measurable physical ways. Certainly there is a great deal of overlap between the number of people who survive close range bomb blasts and PTSD, but the article has few implications for the vast majority of people with PTSD, people who've never been exposed to bomb blasts.

Bad, bad science writing. Can't believe this got published in the NYT.
posted by Slarty Bartfast at 9:02 AM on June 11, 2016 [3 favorites]


Despite the headline, this article is not about PTSD, and it would be great to look past the error of the headline writer and consider the article for what it actually is about, which is blast-associated brain injury.

This is really quite good science writing with shitty science headline writing. Remember that journalists often do not get to choose the headline that is attached to their piece.
posted by biogeo at 9:21 AM on June 11, 2016 [7 favorites]


The title for this FPP is also unfortunate (no offense intended, COD, your title reflects the spin put on the article by the headline). It is trivially obvious that the claim that "PTSD may not [be] a mental disorder" is false, in that PTSD is characterized by maladaptive mental processing* and therefore is by definition a mental disorder. Even if this article were about PTSD, this would only be a question of the etiology (medical cause) of that mental disorder.

All mental phenomena have a neurobiological basis. Psychology vs. biology is a false dichotomy, and understanding the neurobiological basis of a mental phenomenon in no way means it is somehow non-psychological.

* Contextually maladaptive, at least. Arguably PTSD is in part characterized by adaptive psychological changes to deal with a dangerous and/or chronically stressful environment, which become maladaptive when they persists when the environmental stressors are removed. E.g., a hair-trigger fight-or-flight response in response to explosions is adaptive in a combat setting, but maladaptive in response to a car backfiring in a safe suburban neighborhood.
posted by biogeo at 9:37 AM on June 11, 2016 [5 favorites]


Isn't every pathology a physical one? Doesn't pure psychological diseases must have a physical substrate anyway?
posted by zouhair at 9:52 AM on June 11, 2016


To suggest that the military will use this sort of study to be dismissive of soldiers claiming emotional PTSD as being a shitbag seems unfair to our military

Fair to our military. I've had soldiers who have died because the military ignored or dismissed their PTSD, I can't imagine this wouldn't be used by more "no you're fine, suck it up" idiots.
posted by corb at 10:09 AM on June 11, 2016 [4 favorites]


Mental health issues can imply a need for a difference of treatment based on risk of behavioral alterations that are not present with physical injuries. People, rightly, are more afraid of someone with a lack of mental health because such people might not be counted on to make safe or sane decisions.

I say this as someone who has dealt with mental health issues- and who now takes safety issues into account when supporting (or choosing to avoid people) due to mental health issues.

There are reasons for the stigma that include very real safety issues and I think we should avoid using mental health labellings on people unless absolutely necessary and we should make labels clear if they do or don't contain risk of dangerous or aggressive behavior. If a label is sometimes a sign that we have to expect and tolerate abusive behavior from the person, people will start avoiding people with the label.

It's an issue that is more complex than just "ending stigma" and there are good reasons people would like to avoid being labelled mental ill (something that can take their power to make their own decisions and reduce peoples confidence they are trustworthy or capable of positions of power) and can be a very dangerous thing to apply to someone however nicely you do it.

I would prefer that a lot of what we call "mental illness" we describe as simply differences of skill sets and personality types coming with strengths and weakness. When there is actually a serious danger that requires a label to warn others, that is the only time the labels should be applied to people without their consent. We should be willing to modify school and work places much more than we do without labelling half the population mentally ill to accept human diversity and the fact that people with have difficulties with various skills sets and abilities in the work places.

For all the claims we're helping people we are still not addressing that poverty may both cause mental illness and trap people further in it because we still refuse to provide the level of modified school and work environments needed to truly address those who are differently abled being permitted to either A: earn high paying jobs that will not leave them impoverished or B: if the workplace doesn't want them offer them disability benefits that keep them our of poverty.

The brain is a very important organ as it carries a great deal of functions we identify as the core self. When you call someone mentally ill you are essential saying the core of who they are is ill. Their very consciousness- whether you can trust what they feel or believe- must now be questioned. You are saying society should be allowed to force medication or behavioral medication on the them to change them to "healthy", can reject what they experience as abuse as simply the person being "mentally ill" or not understanding why they should be subjected to a total loss of power over their own lives or healing process. It's a horrible abusive thing to do to someone without compelling evidence they are truly incapable of understanding their situation accurately (which means acknowledging that emotional pain might actually be accurate and not "wrong" or a biological misfiring in the sense the mental health industry wants everyone to agree with).

There's a lot we need to change to remove the stigma but I would say challenging the word choice of "mental illness" to begin with might be a required part of the process.

This article could have detangled the core issue relating to PTSD related to blasts from PTSD as a larger concept and would have been informative rather than confusing and misleading.

I can see why anyone who can avoid the label of mental illness would want to because there is not amount of making it sound nice or acceptable that saying a persons consciousness is ill will not come with stigma and avoidance of said person.
posted by xarnop at 10:12 AM on June 11, 2016


The second comment on the New York Times website if you sort for upvotes is: [para phrase . . .] fine article but terrible headline!
posted by bukvich at 10:14 AM on June 11, 2016 [3 favorites]


That comment is bizarre in so many ways, xarnop, that I can't even think how to address it without derailing the entire conversation!

I actually don't think the problem is just the headline, although the headline is certainly the worst thing about the article. I think that there probably needed to be a paragraph explaining that blast injuries don't explain all negative after-effects of combat or other trauma, and this inquiry is part of an ongoing and broad effort to understand the biology of post-traumatic dysfunction. Literally: just a paragraph. I wonder if there was one, and it was cut for space.
posted by ArbitraryAndCapricious at 10:27 AM on June 11, 2016 [3 favorites]


EMDR, which is currently considered the most effacious therapy for PTSD of all types.

Is this true? I read a number of studies of EMDR some 7 or 8 years ago, and, at the time, it was shown to be effective in treating PTSD caused by single traumatic events but less effective than CBT when treating PTSD caused by long, ongoing traumatic situations. I must avail myself of some university's jstor account and look into this.
posted by The Great Big Mulp at 10:37 AM on June 11, 2016 [1 favorite]


Most pop-neuro reporting still assumes a false dualism with the brain having both material and non-material properties, I think in part because it's the common view among the lay public even when this idea was (mostly) left behind many decades ago in the medical community. It also functions as a disingenuous way to frame stories like this with a click-baity undercurrent of "isn't the brain so magical and mysterious?!" which does such a grave disservice to the science being done. This article doesn't go down that path explicitly, but it's there implicitly in the background.
posted by MillMan at 1:06 PM on June 11, 2016


What the military has assumed in the past should not be used as a guide to what takes place today. I know a few vets who continue to get help from the V.A. Hospitals for PTSD., and their problems are recognized as real ones caused by combat in Viet Nam and not imaginary stuff they had used to while in service. Of course the military in the past had often ignored or belittled those claiming problems while in active service, but then, too, the medical community in general also was largely unaware of the reality of PTSD.
posted by Postroad at 3:19 PM on June 11, 2016


EMDR, which is currently considered the most effacious therapy for PTSD of all types

This is not true. It works no better than cognitive processing therapy or prolonged exposure (which ARE considered to be the gold standard treatments). Also, EMDR is highly controversial among PTSD researchers. The supposed "active ingredient" of EMDR--the wand/eye movements--has no theoretical basis for its effectiveness. That is, there is no theoretical reason to believe that would do anything useful in treating PTSD, and no research that supports the presence of some mechanism that would make it important. Instead, what's presumed to be effective about EMDR by much of the PTSD research community is the active ingredients from prolonged exposure, since EMDR involves having people engage in exposure to previously-avoided memories just like prolonged exposure. The view is, EMDR took this foundation and added the wand, made it proprietary, and called it a New Thing. If the wand added something, EMDR would be more effective than prolonged exposure. But it's not.

That said, people who have PTSD have at least 2 solid treatment options, 3 if you count EMDR, that are highly effective in treating PTSD. It is not considered a life sentence anymore. At our clinic, most of our patients no longer have PTSD after 12 sessions of cognitive processing therapy or prolonged exposure. These treatments work really, really well.
posted by deus ex machina at 6:52 PM on June 11, 2016 [7 favorites]


Umm, yeah, mental disorders ARE physical disorders, because brains are physical and so are neurotransmitters and, you know, all atoms.

I've worked with patients with TBI and it's super debilitating but tends to cause fairly distinct behaviors. Yes, I imagine with combat vets it's hard to separate out what is TBI and what is PTSD in some cases, like when the primary symptoms are rage outbursts.

The sad fact is that society treats "physical" illness completely differently to "mental" illness. I'm reminded of the case of the woman in Dallas who killed her baby but cutting off its arms because a vision of Jesus told her to. When it was thought she was mentally ill, prosecutors were pushing for maximum criminal sentence, but as soon as she had a brain scan and they found a tumor, suddenly, "Oh, I guess she was sick and couldn't help it." And there was basically no resistance to finding her Not Guilty by Reason of Insanity and having her sent to a hospital for treatment. As if there is any functional difference between a brain tumor causing command hallucinations and a mental disorder causing command hallucinations.

The fact of the matter is a large proportion of people still don't believe psychiatric illnesses are real, much the way I'd imagine people felt about germs 100 years ago.
posted by threeturtles at 9:20 PM on June 11, 2016 [6 favorites]


And to address the issue of whether it's "better" have mental illness or TBI, I'd take mental illness any day of the week. There are treatments for mental illness that are extremely effective, including for PTSD. There's a lot less that can be done for TBI because it's literally brain damage, and tends to involve behaviors that can be very difficult to predict or avoid. (Generally rage and violent outbursts.) I had the difficult task of trying to find a housing situation for someone with TBI who was unable to continue to live with his family and couldn't care for himself, but his violent outbursts meant pretty much all the options were closed to him. Those are the kind of people who generally wind up in jail because there aren't treatment facilities meant for them.
posted by threeturtles at 9:28 PM on June 11, 2016 [1 favorite]


Many mental illnesses cause literal brain damage, including anxiety disorder and depression. Shrinkage in key areas can be seen in brain imaging.
posted by xyzzy at 9:43 PM on June 11, 2016 [1 favorite]


It would be a very significant thing to discover that all this time, there's been an unknown physical consequence to a commonplace mechanism of war, such that even people who on the face of it seemed unhurt were actually profoundly damaged by it. On both sides.

Like if we'd been using plutonium bullets for many decades and just now discovered that radiation causes cancer.

(I agree with everybody here who is troubled by how this potential discovery is being framed in terms of "explaining away" PTSD or whatever)
posted by edheil at 10:14 PM on June 11, 2016


The Cure For Fear (previously)
posted by jeffburdges at 4:07 AM on June 12, 2016


It would be a very significant thing to discover that all this time, there's been an unknown physical consequence to a commonplace mechanism of war, such that even people who on the face of it seemed unhurt were actually profoundly damaged by it. On both sides.
It would be very significant, but I don't think that it's going to turn out to be that simple. Repeated exposure to blasts is a signature of the conflicts in Iraq and Afghanistan, because of the widespread use of IEDs and because improvements in body armor and other defensive technology mean that military personnel often survive IEDs without visible injuries that would get them removed from the conflict. Repeated exposure to blast was also a signature of trench warfare in World War I. But it wasn't that common, for instance, in Vietnam. It's entirely possible, and really important, that this might explain some of the problems that veterans face after combat. But it's very unlikely that it's going to be a blanket explanation for PTSD, because PTSD affects a lot of people who haven't been exposed to repeated head trauma.
posted by ArbitraryAndCapricious at 8:35 AM on June 12, 2016


Fascinating. Next thing we might even find that PTSD is a physical injury that happens because of spinal nerve compression. WHY IS NOBODY INVESTIGATING THIS?
posted by meehawl at 10:35 PM on June 12, 2016


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