By Caroline Platzman
The physical effects of Post Traumatic Stress Disorder (PTSD) can be unpredictable. If you have experienced something inexplicably horrifying, the entirety of your being, both mental and physical, is undoubtedly impacted. In PTSD patients, the intense fear associated with the traumatic event doesn’t ever seem to let up; heart-stopping panic attacks, on-edge paranoia, and crippling anxiety associated with the trauma begin to haunt the day-to-day.
Although PTSD is considered a psychological disorder, it is important to understand the physical effects the disorder has on a person. In fact, physical pain is one of the most common symptoms of PTSD. Some traumas are directly impactful physically, however, the impact of others may be more discreet. The physical effects of PTSD can be trying, as they can be both induced and sustained by the psychological effects of the disorder.
What are triggers?
Symptoms of PTSD are sensitive and are often triggered by queues in a person’s life. Triggers of symptoms can be both internal and external, meaning they are provoked either by thoughts and feelings or by environmental markers such as places, smells, and sounds. A trigger is essentially any sensation going on inside your body that tells you something is up. Triggers such as visiting a certain place, or hearing yelling and other loud or shocking noises are often reported by PTSD patients to initiate terrifying flashbacks. Triggers are the first physical effect in a domino-like chain of physical effects.
How do the psychological symptoms and the physical symptoms of PTSD intertwine?
According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the range of physical and psychological effects of PTSD are categorized into four clusters:
Intrusion involves the reliving of a traumatic experience through flashbacks, hallucinations, nightmares, night terrors and other prolonged psychological distress. These memories are unwarranted and recurrent, meaning they typically happen without warning and without mercy. To make matters worse, the psychological impact of intrusive thoughts and memories can render a person physically vulnerable – mobility, concentration, sleep, eating habits, overall mood and inner peace are all affected by intrusion.
The hippocampus, the area of the brain that helps us distinguish between past and present memories, may shrink in those with PTSD. This change in brain chemistry can lead to flashbacks, hallucinations, and other intrusive thoughts and feelings accompanied by physical effects. Because flashbacks and hallucinations feel so real, as if the trauma were happening again, then and there, they initiate a physiological response to genuine anxiety and fear – increased heart rate, sweating, shaking, and intense, sometimes crippling emotions. Nightmares and night terrors interrupt a person’s ability to sleep properly, thus resulting in decreased quality of sleep and the stacked physical repercussions of this, such as insomnia, fatigue, and body pains.
Avoidance refers to the disengagement of oneself from people, places, things, and memories that are reminders of trauma. A PTSD patient may avoid returning to the location of their trauma, or get rid of any items that might trigger a reminder of it. Avoidance can mean the disruption of daily routine, the inability to go to work or school, and anxieties that put stress on relationships with others and oneself. Avoidance can be extremely physically debilitating if a patient limits themselves in where they go, who they see, and how they move through the various facets of life.
Negative alterations in cognitions and mood
PTSD affects your outlook about yourself and the world. A person suffering from PTSD may experience persistent feelings of fear, guilt, discomfort, isolation, paranoia, or shame triggered by their trauma. Those with PTSD are more likely to develop depressive and anxiety disorders, chronic stress, and even suicidal ideations. In fact, depression and PTSD are almost always comorbid, meaning symptoms overlap, creating a battle with twice the magnitude that both the mind and body have to fight.
When you are recovering from a trauma and also depressed, you may struggle to enjoy life because of depressive symptoms. A trauma survivor may experience intense feelings of sorrow associated with the trauma, the inability to remember certain parts of the trauma, and daily activities interrupted by constant anxiety and the possibility of having an episode. PTSD can cause someone to lose interest and motivation in the things they once found enjoyable, or even necessary, such as bathing, exercising, or making a living.
The distressful symptoms of PTSD may interfere with memory and concentration, making these daily tasks even more daunting. Additionally, it can be difficult to connect and maintain relationships with others. Negative alterations can lead to self-destructive behaviors such as self-isolation, self-harm, and substance abuse.
Physical effects of these emotional symptoms can include chronic pain, fatigue or lethargy, and a lack of motivation to participate in physical activity, which leads to a decrease in stamina. Negative alterations in cognitions and mood can severely dismantle the trajectory of a person’s physical health, as research suggests chronic mental stress can induce or exacerbate physical pain further.
Arousal and reactivity
The amygdala, which is responsible for emotion and fear processing, may increase in size in the brains of PTSD patients and cause overactive fear, or hyperarousal. Hyperarousal refers to an abnormal increase in a person’s response to sensory stimulation. It induces feelings of anxiety, alertness, irritability, or anger in response to thoughts and memories of trauma. Someone who is hyperreactive is easily startled, has difficulty concentrating, and may be prone to irritability, emotional outbursts and mood swings. Hyperarousal initiates a person’s fight-or-flight mode and triggers feelings of uneasiness and paranoia, as well as physical sensations including increased heart rate, shaking, sweating, and pumping adrenaline.
Sensory overload can be overwhelming, leaving a person hypervigilant and on-edge. In some patients, hyperarousal can trigger panic attacks, muscle weakness, dizziness, shortness of breath, nausea or stomach pain, and even distort hearing and vision. Some sufferers report having issues speaking, or stuttering due to the constant anxiety. Stress can initiate vomiting and other digestive issues in patients. Tension and fear can cause muscle tension, spasms and weakness in patients as well as chronic pain, fatigue, restlessness and insomnia.
How do the symptoms of PTSD affect a person’s overall physical health?
All of the strain that PTSD puts on a person’s mental health and body increases their risk for developing physical health complications and illnesses. Research suggests that PTSD is associated with poorer physical health compared to those without PTSD.
Severe cases of PTSD have a number of overarching physical health repercussions that can stem from symptoms, including:
- Chronic pain
- Body aches
- Muscle weakness and tension
- Difficulty sleeping/insomnia
- Difficulty eating/change in appetite
- Digestive problems
- Respiratory problems/trouble breathing
- Heart palpitations, increased heart rate and risk of heart-related problems
- Poor cardiovascular health
- Gastrointestinal disorders
- Musculoskeletal disorders
- Worsening of existing medical problems due to chronic stress and/or pain
Currently, research suggests that the link between PTSD and physical health problems may be attributed to a variety of factors, including mental stress, chronic pain, comorbid depression and anxiety disorders, and a heightened risk for substance use (National Center for PTSD, 2019). It makes sense – trauma can mean an array of different things, meaning the consequences, both mental and physical, can be unfathomably endless.
Much research claims that PTSD is associated with premature aging, heart disease, diabetes, and dementia. Thus, treatment may need to include anti-aging, heart disease, and other medical medications in conjunction with mental health treatment. Additional research is needed in order to further unpack the relationship between PTSD symptoms and poor physical health.
As a community, we need to do a better job of taking care of our trauma survivors. Someone with PTSD is likely dealing with a battle that is unfathomable to you and I, and building a solid understanding of why PTSD is so hard to deal with, both mentally and physically, is a start towards more inclusive and effective treatment options.
Thankfully, PTSD is manageable and treatable. There are ways to relieve stress and reduce physical arousal. If disturbing thoughts and feelings regarding a traumatic event persist for over a month and interfere with your ability to live your life, seek a mental health professional in order to begin treatment and prevent symptoms of PTSD from getting worse.
For more information, check out:
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Fifth edition. 2013.
Beck, J.G. & Palyo, S.A. (September 2005). Post-traumatic stress disorder symptoms, pain, and perceived life control: Associations with psychosocial and physical functioning. Pain, 117(1-2): 121-127. doi: 10.1016/j.pain.2005.05.028
Jankowski, K. (2019). PTSD and Physical Health. National Center of PTSD. U.S. Department of Veterans Affairs.
McFarlane, A.C. (2010). The long-term costs of traumatic stress: intertwined physical and psychological consequences. World Psychiatry, 9(1): 3-10. https://doi.org/10.1002/j.2051-5545.2010.tb00254.x
About Caroline Platzman
Caroline Platzman is a Behavioral Health Counselor working with adults diagnosed with schizophrenia. She is passionate about mental health, journalism, nonprofit advocacy, and public relations. Caroline is also a dedicated guitarist and artist in her free time.
Pin for later!