Remediation Methods of PTSD and Possible Future Implications

 

              PTSD, or post-traumatic stress disorder, develops when an individual has gone through a fearsome or traumatic event and expresses symptoms after the event is over showing a continued response. Such experiences could include physical dangers such as veterans who have been in war or major events like 9/11. One could even develop PTSD from emotional abuse. Symptoms of PTSD include things like nightmares or hallucinations, emotional distress from stimuli that trigger the memory, memory problems, and constant alertness or anxiety as if one was reexperiencing the trauma.  It is an important mental illness that can be resistant to treatment and consume one who has it, so finding ways to combat PTSD, whether through therapy or medication, is a significant goal among psychologists and neuroscientists.

            In 2022, a study was released by Drs. Stephanie L. Grella, Amanda H. Fortin, Evan Ruesch et. al. titled Reactivating hippocampal-mediated memories during reconsolidation to disrupt fear. The aim of the study was to remediate previously formed memories of fear into neutral or positive memories using optogenetics. The scientists also used positive memories to combat and counter the negative or fear memories to reduce the negative one and, in turn, the negative response (PTSD response) that resulted from the fear memory. Previous studies have shown that the dorsal dentate gyrus (dDG) is where anxiety responses and fear memories are encoded, and one can disrupt these memories by inhibiting engrams associated with the fear memory in the dDG. In the Grella et. al. study, they fear conditioned mice using a shock protocol and during the trigger and recall of these memories for the mice, it was found that when positive memories were reactivated in the mice in the first half of the recall session, there was a greater rate of decrease in freezing response to the stress stimuli. The results of this study show that this method of using reconsolidation as interference in fear memories, optical reactivation, and positive memories to interfere in the hippocampus is successful in reducing the stress-inducing fear memory.  One important thing to note about their findings is that altering the dDG and interfering in the hippocampus only works to remediate fear memories, but other memories are left untouched by the technique. This a good side effect to find, as it ensures that this method can be used as a treatment for PTSD without altering any other important memories or information in the brain.

            Remediation is a great tool in therapy, especially for PTSD. A study released in 2018, Epigenetic Effects of PTSD Remediation in Veterans Using Clinical Emotional Freedom Techniques: A Randomized Controlled Pilot Study by Drs. Dawson Church, Garren Yount, Kenneth Rachlin et. al. looked to see what the genetic effects are from remediation of PTSD. One therapy that can remediate PTSD is emotional freedom techniques (EFT), which is a combination of established elements and treatment methods (exposure and cognitive therapy) with somatic stimulation (acupressure). EFT has proved efficient in reducing the effects of reducing post-traumatic stress disorder, among other psychological conditions. Church et. al. sought out the amount of correlation between gene expression and successful relief and remediation from PTSD after one has been treated with EFT. Their participants were a group of 16 veterans that displayed clinical PTSD made of two groups: one group was a group that had used EFT, and the other were a “treatment as usual” group that received EFT intervention after 10 weeks. All the participants ultimately received EFT, then were assessed by session evaluation forms. The participants were asked to compile a list of the summaries of their traumatic memories and rate their emotional distress for each one—when a memory provided a degree of 0 for emotional distress, they moved to the next on the list. 93 genes were targeted as a focus in this study. A blood sample was drawn before and after the treatment for each participant. The “treatment as usual” group had blood samples taken before and after the waiting period and before and after EFT treatment. The results showed firstly that 10 sessions of EFT were able to highly reduce the PTSD symptoms, as self-reported by the participants. They also found that changes in gene expression levels were measurable after the EFT treatment. The main genes identified in the study that had differing expression levels were ones that “are critical to the regulation of cellular immunity and inflammation” (Church et. al 2018). Evidence was found for the differential baseline expression of genes that are amenable and reactive to glucocorticoid signaling and inflammatory pathways, more specifically in male veterans that have PTSD.  Overall, EFT has positive effects on treating PTSD on both a psychological and a genetic level. This research can be used in the future as psychotherapy used as an intervention with the ability to influence epigenetic health.

            Both studies give us a good look into the current research surrounding PTSD treatment. Exposure therapy is a common treatment, as well as regular discussion-based therapy. Combine exposure therapy with acupressure for EFT treatment and you get effective EFT results, and remediation of fear memories is successful in reducing the negative memories and their associated stress responses. These provide a strong basis for future therapeutic advances in reducing PTSD and providing relief. It is a great thing to be able to remediate PTSD, in order to bring functionality back to those whose lives have been negatively impacted by the conditions caused by PTSD. I even believe that these results can be used for application to other mental conditions, such as generalized anxiety disorder and obsessive-compulsive disorder. The ability to reduce the effects of a persistent condition like PTSD with genetic alterations is a great thing—OCD is another persistent mental health disorder that, when severe, can need a multitude of therapy combinations to combat. Being able to alter it at a genetic level would provide much relief for those suffering from the condition and improve greatly their quality of life and ability to function at a higher level.

 

References

Bergland, Christopher. “The Neuroscience of Post-Traumatic Stress Disorder.” Psychology Today, Sussex Publishers, 5 Nov. 2013, https://www.psychologytoday.com/us/blog/the-athletes-way/201311/the-neuroscience-post-traumatic-stress-disorder.

Church, Dawson, et al. “Epigenetic Effects of PTSD Remediation in Veterans Using Clinical Emotional Freedom Techniques: A Randomized Controlled Pilot Study.” American Journal of Health Promotion, vol. 32, no. 1, 2016, pp. 112–122., https://doi.org/10.1177/0890117116661154.

Grella, Stephanie L., et al. “Reactivating Hippocampal-Mediated Memories during Reconsolidation to Disrupt Fear.” 2021, https://doi.org/10.1101/2021.09.16.460695.