We Ask an Expert About the Common Causes of PTSD
When Elevate’s own Aspen Jewel and Dr. Merchant went live on FB a while back, they dove right into the subject of post traumatic stress disorder (PTSD) causes. But first, a bit about Tyler Merchant, DO: He’s one of our wonderful and compassionate cannabis doctors at Elevate Holistics. In addition, he’s the medical director of Holistic Family Medicine and Obstetrics LLC, with located in Sedalia, MO.
Dr. Merchant’s Experience
While he is not a psychiatrist, Dr. Merchant has seen his fair share of people living with PTSD. According to him “With PTSD, and to be upfront with everybody here who’s listening in, I am not a PTSD expert, focused just on PTSD. That’s not my sole expertise, and I’m not a psychiatrist. I’m a family doctor, but I work a lot with patients with mood disorders and traumas.”
After listening to his experiences and insights, it’s apparent that Dr. Merchant has some super-helpful knowledge and understanding to share from a medical standpoint. When Aspen jumped right in with causes of PTSD questions, he offered some real and raw answers.
What Are PTSD Causes?
Aspen (Elevate Holistics): So let’s just talk about PTSD. And how does someone get PTSD? How does it work? What is it?
Dr. Merchant: Good question. So we actually at this point, don’t have a firm understanding of the actual pathophysiology or meaning of the process that it takes. Or why some people get it when exposed to this thing that other people can. But then again, I guess it’s the same as with depression or anxiety. Why are some people more predisposed to things than others? But typical triggers aren’t really that surprising. So a significant number is, for example, combat veterans. Even people who actually haven’t been in the line of fire or in a situation where they witnessed gruesome deaths in front of them or bad injuries but even just the thought of being someplace that is dangerous can provoke, can be a trigger for it in some folks.
Kinds of PTSD Triggers
We tend to think of soldiers with PTSD and how war is what triggers PTSD. But Dr. Merchant points out that PTSD in rape victims is common as well. Warning: some of this may be difficult to read.
Dr. Merchant: One thing that’s been kind of surprising to me though, and it’s only just from having more and more experience, unfortunately. Well, I guess it depends on how you look at it. I mean, it’s a very rewarding thing to work with PTSD patients. But it’s also quite sad to see how many people suffer from this on an ongoing basis. And from what I’ve seen in this—I don’t pretend to make it represent statistically what is out there in the country. But from what I’ve seen, it’s actually been, I would say less than a third of the patients that I see have PTSD from things like military service or combat experience.
I’ve seen far more people, unfortunately, over the last few months who have been victims of kidnappings, rapes and as disgusting and depressing as it is, unfortunately at the hands of people who are very close. I’ve had people who said my brother’s best friend, my uncle, my father. I had somebody even say, I was raped several times a week for 10 years straight.
Aspen (Elevate Holistics): That’s so hard. It’s even hard to hear.
Dr. Merchant: If you put yourself in this position, to have endured, to have suffered that once is awful, but to have it on an ongoing basis, repetitive abuse is just awful. And so that’s one side of things. So that’s the kind of trauma of “I’ve been a victim, I’ve experienced these things.” So that’s one piece.
Events That PTSD Is Caused From
Dr. Merchant continues to pull from his experience and tells us about other things that PTSD is caused by.
Dr. Merchant: Other triggers are things like witnessing something. So I’ve had a few people who were in prison and had said they had witnessed someone being stomped to death. And this isn’t something like … I’m sure people have seen a car accident or seen somebody shot or something like that. But these are really frankly, gruesome things that people see and experience.
And then there are other things that also don’t really surprise me. But they’re not like a discrete episode of something just awful. Not that the overall event isn’t awful. But things like, if somebody gets a really bad medical condition, and it doesn’t have to be terminal. It doesn’t have to be say somebody who just found out that she has breast cancer or he has prostate cancer or something like that. It doesn’t have to be that. It can just be, “Look my whole life has been turned upside down because I now have this condition.”
Negative Impacts on Patients
Next, the cannabis doctor discusses how lack of healthcare and the perceived disinterest of doctors can negatively impact patients with PTSD and mood disorders.
Dr. Merchant: And you add the problems that society has in general. And this is irrespective of how you feel about it politically or how you think we should fix it. But there are more and more people who, for whatever reason, don’t have access to health care. Or frankly, just don’t prioritize health care or have people who are caring for them to prioritize on their behalf.
And then there are other pieces that are just kind of extra. Maybe somebody saw a doc once and he was just completely countless. Didn’t seem interested at all. The doc or therapist doesn’t have to be mean. Doesn’t have to not understand. But all it takes is me looking around, tapping fingers, looking at my keyboard instead of locking eyes with the patient. That really demonstrates the importance of why a rapport with whatever physician and therapist you work with is so important. So that’s what I would say upfront is anybody who’s seeking care for PTSD; be sure that you mesh well with the doc.
Psychological and Physical Symptoms of PTSD
Finally, Dr. Merchant brings up some of the effects that PTSD triggers in people.
Dr. Merchant: Really, there are several pieces of PTSD. One, there’s something that you can identify as bringing it on. Unlike things like depression, where maybe somebody will say, well, I don’t know. I’ve just always felt bad. And I’m sure it gets worse if certain things get worse in life.
But with PTSD there’s a discrete event. And then the other things are, people have both psychological and oftentimes very physical manifestations of it. So the psychological pieces, I’m cranky, I’m irritable. I’m just angry. And I don’t know why I’m depressed. And so you can have elements of depression and anxiety in it. And then there’s the kind of the transition from physical to mental, and that is insomnia. Clearly, that’s a very physical thing, but it’s also very common to hear people just not be able to shut the brain off. Just can’t get to sleep.
And then the purely physical is, if I’m exposed to any kind of noise, I start to tremble or feel chest pain or get short of breath. I literally feel like I’m choking or dying. These are things that come up often. And people having flashbacks, nightmares, waking up in cold sweats. And so you can tell just by the vast number of symptoms that people can have. How significant of an impact PTSD can have on people’s lives.
Recap: What Causes Post Traumatic Stress Disorder?
- There’s no firm understanding of why some people experience PTSD and others do not.
- In Dr. Merchant’s experience, soldier PTSD is common, but sexual assault and continued abuse is a prevalent cause as well.
- Other situations that may cause PTSD include witnessing gruesome death or having your quality of life decreased by an illness or condition.
- Lack of health care or doctors that you don’t mesh with can negatively affect PTSD patients.
- PTSD can cause psychological and physical symptoms.
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