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What If PTSD Is More Physical Than Psychological? Evidence from new study

165 points by jcfrei 10y ago

deleted 10y ago
[deleted]
ChuckMcM 10y ago
I can certainly believe that there is more going on than just stress, and the argument that compression waves travelling through the brain can damage it is pretty compelling. The question then is how would you block it? How would you protect yourself from a compression (blast) wave such that it went "around" your head rather than through it. Is there some material that could conduct that energy preferentially?
- mamon 10y ago
  It's not the matter of material but shape. Soldier would have to wear something that completely surrounds his head, like motorcycle helmet. Which is very uncomfortable to wear if you have to wear it all the time.
  - dvanduzer 10y ago
    When I talk to experienced motorcyclists, the biggest issue isn't the physical sensation of wearing a helmet. The problem is changing the acoustics around your ears. An enclosed helmet that "hears" like a human, but filters the spikes (powering your iPod in the process)?
    - dctoedt 10y ago
      > An enclosed helmet that "hears" like a human, but filters the spikes (powering your iPod in the process)? A friend of mine is a big hunter; he has over-the-ear hearing protectors (battery-powered electronics) that do just that.
  - evan_ 10y ago
    The article seems to imply even that wouldn't be perfect- shock waves can and do travel through the bloodstream.
- glibgil 10y ago
  Stop sending people to war would help
  - ChuckMcM 10y ago
    True, although I'm also concerned about people who are in the area when a bomb goes off (and there has been way too much of that lately). How much does damage? Is the damage reparable? What how far away must you be? If not reparable then treatable? The big data point here is the actual injury, vs the psychological injury.
    - jcoffland 10y ago
      Maybe we need to design more friendly bombs which only kill people in the blast radius (in a nice way) but don't compress the brains of those outside of that radius. Those soldiers launching bombs need a safe work environment. Perhaps we should get OSHA involved.
  - dunmalg 10y ago
    Thousands of years of violent human history suggest that designing a better helmet to mitigate TBI is likely to help more people than wishing war would go away.
    - dvtv75 10y ago
      In the article, if you read all of it, they suggest point to a study that suggests a better helmet may be of no use in preventing the injury. If you search for "animal" in the article, you should find it. On the other hand, if the majority of people who want to join the army understand the dangers they face (in addition to death and dismemberment) then we might find that they held a war, and nobody came.
      - Houshalter 10y ago
        Having a war where nobody shows up would be great. Sadly wars usually happen because one side shows up and leaves the other side with no choice.
- bane 10y ago
  The evidence that TBI is becoming a real problem is certainly compelling, but PTSD occurs in many people who didn't suffer from this. However, I'm on the side that thinks that periods of intense stress can produce a permanent, possibly physical, change in a person. These periods can be prolonged or particularly intense moments.
lwwlww99 10y ago
What if not only PTSD but all psychological phenomena were, by their very nature, rooted in the physical chemistry of the brain? How bizarre would that be?
- jschwartzi 10y ago
  In a sense, they are. If we accept that the brain is what gives rise to our perception and personality, and to our experience of ourselves, then it stands to reason that all psychological phenomena arise from a configuration of the brain. It turns out that dumping chemicals into the brain can affect its configuration. But it doesn't follow that the new configuration leads to any more desirable psychological state than the old configuration.
- spangry 10y ago
  That's crazy talk!
- adrusi 10y ago
  Sigh this topic always comes up. From a materialist perspective (which is the only perspective that makes sense in medical science), yes, any psychological phenomenon is ultimately a physical phenomenon. But when people talk about the psychological/physiological dichotomy, they're talking about causes. A psychological cause for an ailment is one that is brought about by thinking — by the brain operating normally without any external interference. A physiological cause is one that requires an external agent, like concussive force applied to the brain, or asphyxiation. Psychiatric illnesses are an interesting edge case because they usually deal with the balance of various chemicals in the brain that are supposed to be there. That balance can be influenced both by external factors (like taking a psychoactive drug, such as an antidepressant SSRI) and by just thinking. It's not as well understood how thinking influences brain chemistry, but meditation, for instance, certainly does.
- manmal 10y ago
  Even if it were like that, things like the gut-brain connection (or rather, interaction) would destroy all hope for a neat separation of brain vs the rest.
ginko 10y ago
https://www.youtube.com/watch?v=hSp8IyaKCs0 https://www.youtube.com/watch?v=hSp8IyaKCs0
_delirium 10y ago
A historical quibble with the article, It was first known as shell shock, then combat fatigue and finally PTSD, and in each case, it was almost universally understood as a psychic rather than a physical affliction. This underplays a pretty significant history of doctors considering it a physical condition, as the old name "shell shock" itself suggests. The article does mention one such doctor, Fredrick Mott, but there were a number of them, and the debate recurred again during World War II, when a number of doctors used the term "postconcussion syndrome", again implying a disorder caused by physical brain trauma. Here's a review article: http://www.simonwessely.com/Downloads/Publications/Military/historical/Jones%202007%20-%20shell%20shock%20mtbi.pdf http://www.simonwessely.com/Downloads/Publications/Military/... The article is right though in that in the past 50 years or so it's been mainly understood as a psychological disorder.
- PeterWhittaker 10y ago
  The article covers this: there were those who suggested physical causes, but they were, quite literally, out of fashion: Cf the article's mention of the, in this case, possibly incorrect and ultimately distracting influence of Freudians and other proponents of non-conscious, non-physical causes.
  - _delirium 10y ago
    The article doesn't really cover this. It makes it sound like there was only "one British doctor" in 1916 who thought the cause was physical trauma, whose "views were soon eclipsed by those of other doctors who saw shell shock more as a matter of emotional trauma", a consensus that thereafter "held sway for decades", not to be questioned again until "yet another European war broke out", the Balkan Wars of the 1990s. That is not really an accurate picture. There was more than just Mott with that view even in the World War I era, and the article forgets one minor European war between World War I and the Balkan Wars, during which the question was reopened, with a number of physicians in the 1930s-50s arguing for a physical cause. The article wants to position this as a radical new proposal overturning 100 years of ironclad consensus, while in reality it's more of a recurring proposal that has had periodic champions.
ruffrey 10y ago
With a background in philosophy and neuroscience, I cringe at articles like this drawing a distinction psychological and physical. They are simply the same thing.
- whatshisface 10y ago
  >They are simply the same thing. Not really, not in any useful way. To draw an analogy to computers, a "lesioned" transistor can be expected to produce an entirely different class of bug than an incorrect line of code. While a missing semicolon is technically a case of misplaced electrons, it really wouldn't be helpful to think of it in the same way you would think of 50,000V of misplaced static charge.
  - naasking 10y ago
    It's a false analogy though. Brains don't run software the way computers run software. The brain's behaviour is emergent from its physical structure.
    - prutschman 10y ago
      A computer's behavior is no less emergent from its physical structure.
      - naasking 10y ago
        Except computer behaviour isn't emergent from its structure, it's emergent from its programming which happens after its structure is fully formed. And neural structure changes during its operation, which most computers don't. They aren't remotely the same thing. Certainly you can simulate this operation of neural structure, but to suggest they are effectively the same is to suggest that cars and mice are effectively the same. They're both just made of matter aren't they?
        prutschman 10y ago
        In order to understand computation it's obviously useful to humans to think in an abstract way about what we're trying to accomplish with a computer, and how. The distinction we draw between computer hardware and computer software is obviously part of that understanding. That said, programming is "merely" inducing specific alterations to the electrical charge distribution in the hardware of the computer. The computation we ascribe to the computer is the product of the physical changes induced in the structure of the computer by our act of programming it. As far as the physical artifact of the computer is concerned, as opposed to our mental model of it, there is no clear distinction to be made between hardware and software. That doesn't make the distinction we draw in practice an inappropriate metaphor.
nickpsecurity 10y ago
I have it. I'm pretty introspective, too. I'd say it's almost certainly physical in many if not most cases. I can actually feel that. The thoughts and mental energy normally ran smoothly through my mind. After injury to back & center, especially the stress of it, it's as if a shockwave went through my mind blowing fuses or something. That's best way I can describe feeling and effect. Certain paths and things just aren't there or light up when they shouldn't. The wiring from input(s) to outputs(s) is broken where it's no longer performing the function it should. Far as stress aspect, it similarly ignites electrical and biochemical activity that flows through sensitive parts of the brain. We know those parts organize themselves expecting certain flows or weights. I'd default on position that they could be damaged by overflows slamming them. They'd get damage resulting in impaired function with rerouting of sorts attempted. The result would be replacing that function or maybe new + old happening side-by-side with old still broken. Would explain intermittent failures that seem to relapse to an imprint of whatever caused the stressor. So, just a few thoughts combining what I learned studying those parts of the brain with my own experience of how a broken one works and doesn't.
k-mcgrady 10y ago
Shouldn't a distinction then be made between 'shell shock' and PTSD as experienced by people that haven't been in war zones? In other words what soldiers experience is not PTSD, it's a different physical ailment (probably in addition to PTSD actually).
- arca_vorago 10y ago
  USMC combat vet of OIF here, and very much this. I now have my "ptsd" under control and it is mild compared to many of my buddies, but if there is one thing I can impart is that "ptsd" is simply too broad a term. Combat vets have different kinds of trauma, from tbi to various psychological ones and more, and grouping them all up does them all a disservice. I have done quite a bit of thinking on the subject, and I think many of the approaches for both treatment and diagnosis are wrong, but thats a thesis paper for another time.
supgg 10y ago
And what about a weaponized myco? https://www.youtube.com/watch?v=sT25HhAVhhU https://www.youtube.com/watch?v=sT25HhAVhhU
parasubvert 10y ago
I found this article interesting but frustrating. Conflating PTSD (a mental illness that is caused by traumatic experience) with concussive traumatic brain injury isn't helpful. I kept thinking it would be more interesting (and aligned to the headline) to look at PTSD sufferers brains when they didn't have a known physical injury to their brains.
- PeterWhittaker 10y ago
  Ah, but you seemed to have the point about many of these injuries being non-concussive, in the sense of not causing concussion. This is an additional mechanism, heretofore unidentified, causing a significantly different injury than concussion.
  - eric_h 10y ago
    I'm not convinced that the injury is significantly different. The mechanics certainly are: rather than the the brain trauma being caused by the brain bouncing off the skull, it's because the whole system is hit by a wave of pressure, but the end result is likely quite similar, though perhaps magnified when subject to an explosion (a holistic TBI, if you will). The difference, I suspect, is that rather than the injury being confined to a specific place that has a lesion in the brain, it's rather the entire brain that gets affected. I was in a car accident ~7 years ago that effectively erased 5 days of my life from my memory, and took me 6 months to fully recover from (though I suspect I'm still not quite the same as I was before the accident, but as far as anyone else can tell I am). The only physical remnant from that accident is a small scar on my scalp. One of the things I learned from the doctors that attempted to assess the damage to my brain is that the number of TBIs caused by IEDs in Iraq and Afghanistan very much informed and changed the way that doctors treat TBIs here in the states. Also, always wear a seat belt, whatever the circumstances. I'd be dead if I hadn't been wearing one.
    - PeterWhittaker 10y ago
      The article discusses the physical differences between concussion injuries and this other form of injury, as revealed through detailed imagining of brain tissues. I'm asking this purely out of curiosity and to foster discussion: what is about this aspect of the article you find unconvincing? Thanks!
ajarmst 10y ago
What if we had decades of good research showing that the physical/psychological distinction is not a helpful one, and therapies that don't take both into account are generally less effective for most pathologies?
Madmallard 10y ago
Or, get this, and this is super radical of an idea I know: There is not much of a separation between physical and psychological in the first place. Every part of the body is interconnected--as people develop disease, often times mental symptoms develop secondarily so. Depression and anxiety are super common in all sorts of illness states. There are numerous studies showing cellular dysfunction and rampant oxidative stress connecting to the more serious mental illnesses.
- adammunich 10y ago
  I never understood why people rarely take this approach. It's not as if these things occur in isolation.
  - SolaceQuantum 10y ago
    There is a long medical history of treating things in isolation in order to understand fundamental aspects of biology and such. While the rest of science has more or less moved on from this mindset, the medical field hasn't fully yet.
    - deleted 10y ago
      [deleted]
    - kordless 10y ago
      It's called measuring things. It's what we do, after all.
      - MarkPNeyer 10y ago
        Measurement is great. I'm all for it. But there's a serious problem with scientism in the modern world. I think it's great to develop a way of looking at the world that 'takes people out' - we can predict the motion of the moon without regard to what people think or feel about how the moon will move. The moon's motion does not take our feelings into account. It starts to get really silly, though, when you try to use those same techniques to look at people. "How do people behave, in the absense of people" is a very silly question to ask, but it seems like that's what we try to do when we look at people through the lens of modern scientific methods. Every person is different and has a different personal history. The idea that you can formulate some 'general rule' for how people behave is as baseless as trying to come up with a 'general rule' for computers. It makes much more sense to look at different software patterns and how they operate, rather than trying to snip a transistor and then see how the graphical output changes, which is effectively what we do in mental health medicine.
InclinedPlane 10y ago
Sigh. What they mean is "what if two different conditions with different causes have been previously considered to be the same thing?"
slr555 10y ago
The title of this article extremely poorly chosen. The DSM-5 criteria for PTSD defines this condition in terms such that a great number of patients meet the criteria who have never been exposed to blasts of any kind. Yes, there may be significant numbers of patients like those the article describes who suffer from a previously uncategorized blast injury phenomenon that has sometimes been attributed to PTSD but the author is drawing the wrong Venn diagram for the reader. The new entity does not begin to subsume the entire PTSD population. This matters because too many patients whose symptoms have been stigmatized anyway will now be left with the impression that "real" PTSD is only associated with a history of blast exposure.
- InclinedPlane 10y ago
  Yup. Moreover, it's possible, and in fact quite likely, to have both. Having an IED go off near you might result in blast injury to your brain, which produces one set of symptoms. But it's also pretty likely to cause PTSD as well. That sort of thing is a harrowing experience, more so if you witnessed someone you cared about getting killed or injured in the blast as well, that's an easy candidate for setting you up for PTSD. But the symptoms you experience afterward will end up being a mix of both conditions. I find it interesting that people seemed to have figured out "shell shock" fairly early on simply intuitively. But whereas early treatments focused on it as an almost mechanical thing, and something to be overcome so that soldiers could be put back into the fight, it took a greater sensitivity to psychological issues to realize that PTSD was also a factor though in so doing there was a tendency to attribute all symptoms to PTSD. Now we've rediscovered shell-shock, but I hope we don't forget that PTSD is real and important as well. And we don't view shell-shock as simply a hurdle to overcome so we can get the greatest battlefield efficiency out of wounded soldiers. We've come a long way since WWI in how we treat soldiers, and I hope we don't regress.
jcoffland 10y ago
The desire for such a distinction is strong. We prefer to attribute illness to physical causes because in our society we blame the patient for mental but not for physical illness. This disparity drives the push to find physical causes to which we can more comfortably redirect blame. Such as DNA, leptin, bacteria, enzymes, etc. It is wise to be skeptical of any new findings which fit too well with human desires and thus make "good" articles.
- joyeuse6701 10y ago
  Agreed, it is certainly worth the skepticism, but also worth the skepticism behind the medical communities insistence that it wasn't related. One aspect of history that always concerned me was why 'modern war' had the effect it had compared to antiquity. The horrors of war have been repeated historically, but not like this.
- SmirkingRevenge 10y ago
  I'm not sure. We have both strong desires to escape blame, but also the strong desires to blame others. And once we've become accustomed to blaming people for a particular thing, it's hard to let go. To what extent the mental is distinct (or not) from the physical body/brain, well... we have no frakking clue. We have a laundry list of disorders previously thought to be purely "mental", that are now known to be physical. Then the rest we just kind of blame people for. I think really what we should ask is, "Does blame work in case X, Y or Z"? e.g. - Does blame cause your child to do better in school and stop acting like a monster? Yes? Great, use blame. - Does blame cause PTSD victims to get over it? No? Then stop blaming them, lets find another way (possibly physical) to fix it.
gnaritas 10y ago
> Physicalism of the mind isn't unanimously accepted in philosophy. Much philosophy is just bad science. Pontificating over unanswerable questions is little more than a waste of time. Philosophy's greatest achievement was science, which is a better way to explore reality because logic alone isn't enough, it needs to be backed by evidence. Physicalism is all that is known to exist, those asserting otherwise have no evidence to back their claims and are basically asserting magic.
- naasking 10y ago
  > Pontificating over unanswerable questions is little more than a waste of time. You clearly don't understand philosophy. Some philosophers like hearing their own voice talk about such questions, just like some physicists are themselves crackpots. Most philosophers are trying to properly define an otherwise ill-defined subject, and the only way to do that is via various types of thought experiments, just like Einstein did when he formulated his theory of relativity. Or did you not know that science is natural philosophy?
  - gnaritas 10y ago
    Seems you didn't really digest what I said, I understand philosophy just fine. You've quoted one sentence out of context and pretended I said all philosophy is wasting time on unanswerable questions, I didn't. Additionally your last sentence makes it utterly clear you didn't actually read my entire reply as I said philosophy's greatest achievement was science, so to ask if I know science is natural philosophy is a dead giveaway you're not paying attention at all.
    - naasking 10y ago
      I commented on that specific line because that exact sentiment is all too common, and entirely unjustified.
      - gnaritas 10y ago
        And I just justified it. "Unanswerable questions" != philosophy, I was critiquing a subset of philosophy, the useless subset, like arguments for God's existence, useless nonsense asking meaningless questions.
birdDadCawww 10y ago
It is 2 way street physical damage can cause mental damage, vise versa.Pure psychological damage takes sometime to really cause physical damage I would imagine. PTSD Is a thing that we all suffer from as we get older and get bumps and experience trauma. this is a great find. +1.
heisenbit 10y ago
A more accurate title for the NYT would have been What if SOME PTSD is more physical than psychological. The are a number of mental conditions that have more than one cause. Brain is a complex system and one disturbs it in one place or another and at the surface it all looks the same. Computers are similar - one place it goes wrong and the screen it looks like BSOD. There is a real value of finding one clear physical cause->effect opening targeted opportunities for treatment and prevention. But then there are plenty of people with PTSD that have not been anywhere near a blast. It may be one piece of a huge puzzle.
- TazeTSchnitzel 10y ago
  Yes, this article seems to reinforce the notion that PTSD is the exclusive domain of combat veterans, which is very far from reality.
sandworm101 10y ago
PTSD is common amongst soldiers, but it is far from a soldier's disease. It hits lots of people far away from any hint of a battlefield. Train drivers suffer it (they may witness many suicides). Doctors suffer it. Some types may even suffer it at a higher rate than soldiers (pediatric oncology). If there is a physical injury that results in similar symptoms, then that syndrome should probably be given a different name in order that it be separated from the wider disease that seems to have no physical trigger.
otempomores 10y ago
Medieval cure put ptyds near a implosion Inb4 triggered medievalists

165 points by jcfrei 10y ago

deleted 10y ago

[deleted]

I can certainly believe that there is more going on than just stress, and the argument that compression waves travelling through the brain can damage it is pretty compelling. The question then is how would you block it? How would you protect yourself from a compression (blast) wave such that it went "around" your head rather than through it. Is there some material that could conduct that energy preferentially?

mamon 10y ago
It's not the matter of material but shape. Soldier would have to wear something that completely surrounds his head, like motorcycle helmet. Which is very uncomfortable to wear if you have to wear it all the time.
- dvanduzer 10y ago
  When I talk to experienced motorcyclists, the biggest issue isn't the physical sensation of wearing a helmet. The problem is changing the acoustics around your ears. An enclosed helmet that "hears" like a human, but filters the spikes (powering your iPod in the process)?
  - dctoedt 10y ago
    > An enclosed helmet that "hears" like a human, but filters the spikes (powering your iPod in the process)? A friend of mine is a big hunter; he has over-the-ear hearing protectors (battery-powered electronics) that do just that.
- evan_ 10y ago
  The article seems to imply even that wouldn't be perfect- shock waves can and do travel through the bloodstream.
glibgil 10y ago
Stop sending people to war would help
- ChuckMcM 10y ago
  True, although I'm also concerned about people who are in the area when a bomb goes off (and there has been way too much of that lately). How much does damage? Is the damage reparable? What how far away must you be? If not reparable then treatable? The big data point here is the actual injury, vs the psychological injury.
  - jcoffland 10y ago
    Maybe we need to design more friendly bombs which only kill people in the blast radius (in a nice way) but don't compress the brains of those outside of that radius. Those soldiers launching bombs need a safe work environment. Perhaps we should get OSHA involved.
- dunmalg 10y ago
  Thousands of years of violent human history suggest that designing a better helmet to mitigate TBI is likely to help more people than wishing war would go away.
  - dvtv75 10y ago
    In the article, if you read all of it, they suggest point to a study that suggests a better helmet may be of no use in preventing the injury. If you search for "animal" in the article, you should find it. On the other hand, if the majority of people who want to join the army understand the dangers they face (in addition to death and dismemberment) then we might find that they held a war, and nobody came.
    - Houshalter 10y ago
      Having a war where nobody shows up would be great. Sadly wars usually happen because one side shows up and leaves the other side with no choice.
bane 10y ago
The evidence that TBI is becoming a real problem is certainly compelling, but PTSD occurs in many people who didn't suffer from this. However, I'm on the side that thinks that periods of intense stress can produce a permanent, possibly physical, change in a person. These periods can be prolonged or particularly intense moments.

lwwlww99 10y ago

What if not only PTSD but all psychological phenomena were, by their very nature, rooted in the physical chemistry of the brain? How bizarre would that be?

jschwartzi 10y ago
In a sense, they are. If we accept that the brain is what gives rise to our perception and personality, and to our experience of ourselves, then it stands to reason that all psychological phenomena arise from a configuration of the brain. It turns out that dumping chemicals into the brain can affect its configuration. But it doesn't follow that the new configuration leads to any more desirable psychological state than the old configuration.
spangry 10y ago
That's crazy talk!
adrusi 10y ago
Sigh this topic always comes up. From a materialist perspective (which is the only perspective that makes sense in medical science), yes, any psychological phenomenon is ultimately a physical phenomenon. But when people talk about the psychological/physiological dichotomy, they're talking about causes. A psychological cause for an ailment is one that is brought about by thinking — by the brain operating normally without any external interference. A physiological cause is one that requires an external agent, like concussive force applied to the brain, or asphyxiation. Psychiatric illnesses are an interesting edge case because they usually deal with the balance of various chemicals in the brain that are supposed to be there. That balance can be influenced both by external factors (like taking a psychoactive drug, such as an antidepressant SSRI) and by just thinking. It's not as well understood how thinking influences brain chemistry, but meditation, for instance, certainly does.
manmal 10y ago
Even if it were like that, things like the gut-brain connection (or rather, interaction) would destroy all hope for a neat separation of brain vs the rest.

ginko 10y ago

https://www.youtube.com/watch?v=hSp8IyaKCs0 https://www.youtube.com/watch?v=hSp8IyaKCs0

_delirium 10y ago

A historical quibble with the article, It was first known as shell shock, then combat fatigue and finally PTSD, and in each case, it was almost universally understood as a psychic rather than a physical affliction. This underplays a pretty significant history of doctors considering it a physical condition, as the old name "shell shock" itself suggests. The article does mention one such doctor, Fredrick Mott, but there were a number of them, and the debate recurred again during World War II, when a number of doctors used the term "postconcussion syndrome", again implying a disorder caused by physical brain trauma. Here's a review article: http://www.simonwessely.com/Downloads/Publications/Military/historical/Jones%202007%20-%20shell%20shock%20mtbi.pdf http://www.simonwessely.com/Downloads/Publications/Military/... The article is right though in that in the past 50 years or so it's been mainly understood as a psychological disorder.

PeterWhittaker 10y ago
The article covers this: there were those who suggested physical causes, but they were, quite literally, out of fashion: Cf the article's mention of the, in this case, possibly incorrect and ultimately distracting influence of Freudians and other proponents of non-conscious, non-physical causes.
- _delirium 10y ago
  The article doesn't really cover this. It makes it sound like there was only "one British doctor" in 1916 who thought the cause was physical trauma, whose "views were soon eclipsed by those of other doctors who saw shell shock more as a matter of emotional trauma", a consensus that thereafter "held sway for decades", not to be questioned again until "yet another European war broke out", the Balkan Wars of the 1990s. That is not really an accurate picture. There was more than just Mott with that view even in the World War I era, and the article forgets one minor European war between World War I and the Balkan Wars, during which the question was reopened, with a number of physicians in the 1930s-50s arguing for a physical cause. The article wants to position this as a radical new proposal overturning 100 years of ironclad consensus, while in reality it's more of a recurring proposal that has had periodic champions.

ruffrey 10y ago

With a background in philosophy and neuroscience, I cringe at articles like this drawing a distinction psychological and physical. They are simply the same thing.

whatshisface 10y ago
>They are simply the same thing. Not really, not in any useful way. To draw an analogy to computers, a "lesioned" transistor can be expected to produce an entirely different class of bug than an incorrect line of code. While a missing semicolon is technically a case of misplaced electrons, it really wouldn't be helpful to think of it in the same way you would think of 50,000V of misplaced static charge.
- naasking 10y ago
  It's a false analogy though. Brains don't run software the way computers run software. The brain's behaviour is emergent from its physical structure.
  - prutschman 10y ago
    A computer's behavior is no less emergent from its physical structure.
    - naasking 10y ago
      Except computer behaviour isn't emergent from its structure, it's emergent from its programming which happens after its structure is fully formed. And neural structure changes during its operation, which most computers don't. They aren't remotely the same thing. Certainly you can simulate this operation of neural structure, but to suggest they are effectively the same is to suggest that cars and mice are effectively the same. They're both just made of matter aren't they?
      - prutschman 10y ago
        In order to understand computation it's obviously useful to humans to think in an abstract way about what we're trying to accomplish with a computer, and how. The distinction we draw between computer hardware and computer software is obviously part of that understanding. That said, programming is "merely" inducing specific alterations to the electrical charge distribution in the hardware of the computer. The computation we ascribe to the computer is the product of the physical changes induced in the structure of the computer by our act of programming it. As far as the physical artifact of the computer is concerned, as opposed to our mental model of it, there is no clear distinction to be made between hardware and software. That doesn't make the distinction we draw in practice an inappropriate metaphor.

nickpsecurity 10y ago

I have it. I'm pretty introspective, too. I'd say it's almost certainly physical in many if not most cases. I can actually feel that. The thoughts and mental energy normally ran smoothly through my mind. After injury to back & center, especially the stress of it, it's as if a shockwave went through my mind blowing fuses or something. That's best way I can describe feeling and effect. Certain paths and things just aren't there or light up when they shouldn't. The wiring from input(s) to outputs(s) is broken where it's no longer performing the function it should. Far as stress aspect, it similarly ignites electrical and biochemical activity that flows through sensitive parts of the brain. We know those parts organize themselves expecting certain flows or weights. I'd default on position that they could be damaged by overflows slamming them. They'd get damage resulting in impaired function with rerouting of sorts attempted. The result would be replacing that function or maybe new + old happening side-by-side with old still broken. Would explain intermittent failures that seem to relapse to an imprint of whatever caused the stressor. So, just a few thoughts combining what I learned studying those parts of the brain with my own experience of how a broken one works and doesn't.

k-mcgrady 10y ago

Shouldn't a distinction then be made between 'shell shock' and PTSD as experienced by people that haven't been in war zones? In other words what soldiers experience is not PTSD, it's a different physical ailment (probably in addition to PTSD actually).

arca_vorago 10y ago
USMC combat vet of OIF here, and very much this. I now have my "ptsd" under control and it is mild compared to many of my buddies, but if there is one thing I can impart is that "ptsd" is simply too broad a term. Combat vets have different kinds of trauma, from tbi to various psychological ones and more, and grouping them all up does them all a disservice. I have done quite a bit of thinking on the subject, and I think many of the approaches for both treatment and diagnosis are wrong, but thats a thesis paper for another time.

supgg 10y ago

And what about a weaponized myco? https://www.youtube.com/watch?v=sT25HhAVhhU https://www.youtube.com/watch?v=sT25HhAVhhU

parasubvert 10y ago

I found this article interesting but frustrating. Conflating PTSD (a mental illness that is caused by traumatic experience) with concussive traumatic brain injury isn't helpful. I kept thinking it would be more interesting (and aligned to the headline) to look at PTSD sufferers brains when they didn't have a known physical injury to their brains.

PeterWhittaker 10y ago
Ah, but you seemed to have the point about many of these injuries being non-concussive, in the sense of not causing concussion. This is an additional mechanism, heretofore unidentified, causing a significantly different injury than concussion.
- eric_h 10y ago
  I'm not convinced that the injury is significantly different. The mechanics certainly are: rather than the the brain trauma being caused by the brain bouncing off the skull, it's because the whole system is hit by a wave of pressure, but the end result is likely quite similar, though perhaps magnified when subject to an explosion (a holistic TBI, if you will). The difference, I suspect, is that rather than the injury being confined to a specific place that has a lesion in the brain, it's rather the entire brain that gets affected. I was in a car accident ~7 years ago that effectively erased 5 days of my life from my memory, and took me 6 months to fully recover from (though I suspect I'm still not quite the same as I was before the accident, but as far as anyone else can tell I am). The only physical remnant from that accident is a small scar on my scalp. One of the things I learned from the doctors that attempted to assess the damage to my brain is that the number of TBIs caused by IEDs in Iraq and Afghanistan very much informed and changed the way that doctors treat TBIs here in the states. Also, always wear a seat belt, whatever the circumstances. I'd be dead if I hadn't been wearing one.
  - PeterWhittaker 10y ago
    The article discusses the physical differences between concussion injuries and this other form of injury, as revealed through detailed imagining of brain tissues. I'm asking this purely out of curiosity and to foster discussion: what is about this aspect of the article you find unconvincing? Thanks!

ajarmst 10y ago

What if we had decades of good research showing that the physical/psychological distinction is not a helpful one, and therapies that don't take both into account are generally less effective for most pathologies?

Madmallard 10y ago

Or, get this, and this is super radical of an idea I know: There is not much of a separation between physical and psychological in the first place. Every part of the body is interconnected--as people develop disease, often times mental symptoms develop secondarily so. Depression and anxiety are super common in all sorts of illness states. There are numerous studies showing cellular dysfunction and rampant oxidative stress connecting to the more serious mental illnesses.

adammunich 10y ago
I never understood why people rarely take this approach. It's not as if these things occur in isolation.
- SolaceQuantum 10y ago
  There is a long medical history of treating things in isolation in order to understand fundamental aspects of biology and such. While the rest of science has more or less moved on from this mindset, the medical field hasn't fully yet.
  - deleted 10y ago
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  - kordless 10y ago
    It's called measuring things. It's what we do, after all.
    - MarkPNeyer 10y ago
      Measurement is great. I'm all for it. But there's a serious problem with scientism in the modern world. I think it's great to develop a way of looking at the world that 'takes people out' - we can predict the motion of the moon without regard to what people think or feel about how the moon will move. The moon's motion does not take our feelings into account. It starts to get really silly, though, when you try to use those same techniques to look at people. "How do people behave, in the absense of people" is a very silly question to ask, but it seems like that's what we try to do when we look at people through the lens of modern scientific methods. Every person is different and has a different personal history. The idea that you can formulate some 'general rule' for how people behave is as baseless as trying to come up with a 'general rule' for computers. It makes much more sense to look at different software patterns and how they operate, rather than trying to snip a transistor and then see how the graphical output changes, which is effectively what we do in mental health medicine.

InclinedPlane 10y ago

Sigh. What they mean is "what if two different conditions with different causes have been previously considered to be the same thing?"

slr555 10y ago

The title of this article extremely poorly chosen. The DSM-5 criteria for PTSD defines this condition in terms such that a great number of patients meet the criteria who have never been exposed to blasts of any kind. Yes, there may be significant numbers of patients like those the article describes who suffer from a previously uncategorized blast injury phenomenon that has sometimes been attributed to PTSD but the author is drawing the wrong Venn diagram for the reader. The new entity does not begin to subsume the entire PTSD population. This matters because too many patients whose symptoms have been stigmatized anyway will now be left with the impression that "real" PTSD is only associated with a history of blast exposure.

InclinedPlane 10y ago
Yup. Moreover, it's possible, and in fact quite likely, to have both. Having an IED go off near you might result in blast injury to your brain, which produces one set of symptoms. But it's also pretty likely to cause PTSD as well. That sort of thing is a harrowing experience, more so if you witnessed someone you cared about getting killed or injured in the blast as well, that's an easy candidate for setting you up for PTSD. But the symptoms you experience afterward will end up being a mix of both conditions. I find it interesting that people seemed to have figured out "shell shock" fairly early on simply intuitively. But whereas early treatments focused on it as an almost mechanical thing, and something to be overcome so that soldiers could be put back into the fight, it took a greater sensitivity to psychological issues to realize that PTSD was also a factor though in so doing there was a tendency to attribute all symptoms to PTSD. Now we've rediscovered shell-shock, but I hope we don't forget that PTSD is real and important as well. And we don't view shell-shock as simply a hurdle to overcome so we can get the greatest battlefield efficiency out of wounded soldiers. We've come a long way since WWI in how we treat soldiers, and I hope we don't regress.

jcoffland 10y ago

The desire for such a distinction is strong. We prefer to attribute illness to physical causes because in our society we blame the patient for mental but not for physical illness. This disparity drives the push to find physical causes to which we can more comfortably redirect blame. Such as DNA, leptin, bacteria, enzymes, etc. It is wise to be skeptical of any new findings which fit too well with human desires and thus make "good" articles.

joyeuse6701 10y ago
Agreed, it is certainly worth the skepticism, but also worth the skepticism behind the medical communities insistence that it wasn't related. One aspect of history that always concerned me was why 'modern war' had the effect it had compared to antiquity. The horrors of war have been repeated historically, but not like this.
SmirkingRevenge 10y ago
I'm not sure. We have both strong desires to escape blame, but also the strong desires to blame others. And once we've become accustomed to blaming people for a particular thing, it's hard to let go. To what extent the mental is distinct (or not) from the physical body/brain, well... we have no frakking clue. We have a laundry list of disorders previously thought to be purely "mental", that are now known to be physical. Then the rest we just kind of blame people for. I think really what we should ask is, "Does blame work in case X, Y or Z"? e.g. - Does blame cause your child to do better in school and stop acting like a monster? Yes? Great, use blame. - Does blame cause PTSD victims to get over it? No? Then stop blaming them, lets find another way (possibly physical) to fix it.

gnaritas 10y ago

> Physicalism of the mind isn't unanimously accepted in philosophy. Much philosophy is just bad science. Pontificating over unanswerable questions is little more than a waste of time. Philosophy's greatest achievement was science, which is a better way to explore reality because logic alone isn't enough, it needs to be backed by evidence. Physicalism is all that is known to exist, those asserting otherwise have no evidence to back their claims and are basically asserting magic.

naasking 10y ago
> Pontificating over unanswerable questions is little more than a waste of time. You clearly don't understand philosophy. Some philosophers like hearing their own voice talk about such questions, just like some physicists are themselves crackpots. Most philosophers are trying to properly define an otherwise ill-defined subject, and the only way to do that is via various types of thought experiments, just like Einstein did when he formulated his theory of relativity. Or did you not know that science is natural philosophy?
- gnaritas 10y ago
  Seems you didn't really digest what I said, I understand philosophy just fine. You've quoted one sentence out of context and pretended I said all philosophy is wasting time on unanswerable questions, I didn't. Additionally your last sentence makes it utterly clear you didn't actually read my entire reply as I said philosophy's greatest achievement was science, so to ask if I know science is natural philosophy is a dead giveaway you're not paying attention at all.
  - naasking 10y ago
    I commented on that specific line because that exact sentiment is all too common, and entirely unjustified.
    - gnaritas 10y ago
      And I just justified it. "Unanswerable questions" != philosophy, I was critiquing a subset of philosophy, the useless subset, like arguments for God's existence, useless nonsense asking meaningless questions.

birdDadCawww 10y ago

It is 2 way street physical damage can cause mental damage, vise versa.Pure psychological damage takes sometime to really cause physical damage I would imagine. PTSD Is a thing that we all suffer from as we get older and get bumps and experience trauma. this is a great find. +1.

heisenbit 10y ago

A more accurate title for the NYT would have been What if SOME PTSD is more physical than psychological. The are a number of mental conditions that have more than one cause. Brain is a complex system and one disturbs it in one place or another and at the surface it all looks the same. Computers are similar - one place it goes wrong and the screen it looks like BSOD. There is a real value of finding one clear physical cause->effect opening targeted opportunities for treatment and prevention. But then there are plenty of people with PTSD that have not been anywhere near a blast. It may be one piece of a huge puzzle.

TazeTSchnitzel 10y ago
Yes, this article seems to reinforce the notion that PTSD is the exclusive domain of combat veterans, which is very far from reality.

sandworm101 10y ago

PTSD is common amongst soldiers, but it is far from a soldier's disease. It hits lots of people far away from any hint of a battlefield. Train drivers suffer it (they may witness many suicides). Doctors suffer it. Some types may even suffer it at a higher rate than soldiers (pediatric oncology). If there is a physical injury that results in similar symptoms, then that syndrome should probably be given a different name in order that it be separated from the wider disease that seems to have no physical trigger.

otempomores 10y ago

Medieval cure put ptyds near a implosion Inb4 triggered medievalists