PTSD can effect anyone who has experienced a traumatic event, and Virtual Reality might be the answer to prevention and treatment of the condition.
PTSD: What is it?
Post-Traumatic Stress Disorder, or PTSD, is widely associated with war, soldiers, and the military. However, the American Psychiatric Association defines PTSD as a psychiatric disorder that can occur in anyone who has experienced or witnessed a traumatic event. These events can include the death of a loved one, the loss of an unborn child, a natural disaster, war or combat, rape, or a threat of sexual violence, serious injury, or death.
Known throughout history by names such as “shell shock” and “combat fatigue,” this disorder has long been misunderstood as something that can only happen in military veterans. A study conducted with the National Institutes of Health explains that PTSD is consistent with comorbid mental disorders like major depression, and evidence suggests it is hereditary. The study also states that exposure to a traumatic event doesn’t automatically defer to PTSD or depression. The rate of exposure, severity of exposure, pre-existing mental health issues, the individual’s own resiliency, and even gender differences can sway the level of impact.
PTSD can vary in severity, and each individual will have different symptoms depending on the event and how the brain reciprocated the trauma. Gretchen Neigh, an Associate Professor of Neurobiology at the Virginia Commonwealth University (VCU) School of Medicine, explains that the event had to have been a life-threatening stressor but what is considered stressful or traumatizing to one person might be different to another. Neigh states, “Sometimes, we can experience the same exact trauma – but some will develop PTSD while others will not.”
As we described in an earlier article, stress manifests in a “fight or flight” mode with an increase of the chemical cortisol – a key factor in activation. Cortisol, Neigh describes, is the most active in the morning and is supposed to have variability throughout the day. In the morning, cortisol should spike and “drift.”
“In PTSD, people tend to flap in the rhythm,” she explains, “Their cortisol sits in the middle, their depression is typically low, and the sympathetic system tries to pick up the slack – the fight or flight system doesn’t work like it’s supposed to.”
One way that PTSD is determined and measured is by evaluating the fear-potentiated startle response, a reflex that is increased when a previously presented cue is paired with an aversive stimulus. Neigh explains that with this test, a patient is taught to associate two events like a large noise with a blow of air on the neck. Eventually, the brain will hear the loud noise and expect the aversive stimulus (the blow of air). In those with PTSD, there is a failure to learn safety signals. “PTSD will tell the brain that it is safe, but the body doesn’t understand the safety.” The body will over respond (increased heart rate and sweaty palms) even though the individual knows they are safe.
PTSD is still a highly misunderstood disorder in the psychiatric and neurobiology community. “We don’t completely understand what happens,” said Neigh, “but we are getting better about predicting PTSD… and who can develop it.”
Virtual Reality in the treatment of PTSD
A project led and developed by gerontology and psychiatry research professor Dr. Albert “Skip” Rizzo from the University of Southern California has paved the way for the research, prevention, and treatment of PTSD by combining virtual reality with cognitive behavioral therapy to recode memory.
Recognized by the American Psychological Association as the first of its kind, Dr. Rizzo and his team have produced a fully immersive virtual reality 25 years in the making in order to help patients overcome phobias, improve social skills, and recover from traumatic events.
“VR [virtual reality] works by recreating the traumatic event for the person and helps them confront the trigger, but in a safe place,” said Rizzo.
Virtual reality environments in the early 1990s and the 2000s couldn’t create the effect that Rizzo and his team were trying to achieve. As technology evolved and their research continued, Rizzo and his team found the tool to be highly effective in treating other conditions in addition to PTSD to include phobias and autism. Even with the original, impoverished graphics, Rizzo explained that the scene didn’t have to be an exact replica to be effective.
“Rape, for example,” said Rizzo, “cannot be replicated. The way we work with sexual assault victims is by recreating the area it may have happened, such as a bar. This can be enough to trigger those same emotions from the original trauma, and we work from there.”
The treatment doesn’t work to erase or force the patient to forget an event, however. “We aren’t erasing the memory or making it go away,” said Rizzo, “but should that same memory trigger a PTSD event, it won’t be as strong as the previous.”
Symptoms of PTSD as outlined by the Anxiety and Depression Association of America (ADAA) can include the following:
- Re-experiencing the trauma through flashbacks and nightmares
- Emotional numbness, and avoidance of reminders of the trauma
- Self-isolation: avoiding places and people
- Sleeping difficulties
- Difficulty focusing
- Irritability and the inability to focus
Always contact a professional healthcare specialist if you are exhibiting any symptoms.
PTSD is a serious condition that is not self-diagnosable: it must be diagnosed and treated by an experienced health care provider. If you suspect that you, a friend, or a family member might suffer from PTSD, visit the ADAA website to find a therapist, or download a self-screening to share with your health care provider.
Do not hesitate to ask for help.
See the below infographic for more information on PTSD and the effects of Virtual Reality Exposure Therapy.
