5 ms·

Why is stress after trauma a 'disorder'? And how is it a solution to drug people up, making them forget this?

HeyLaughingBoy 4y ago
A long time ago my wife shattered her wrist. In the ER, they explained that they needed to reset it so it could be put in a splint before surgery could be scheduled. They weren't going to use anesthetic. She would be conscious of the pain as they moved her wrist into position, but they'd give her something so she wouldn't remember the experience. 15+ years later she remembers telling them to go ahead and do it, then there's a hole in her memory for about 10 minutes. I'd say that's one good solution.
- gateaux 4y ago
  Wow. Do you happen to know what it was they gave her?
  - roywiggins 4y ago
    I believe midazolam can cause amnesia, it's not technically an anesthetic in the sense that it doesn't knock you out, but it's a sedative. https://en.wikipedia.org/wiki/Midazolam https://en.wikipedia.org/wiki/Midazolam
    - atdrummond 4y ago
      Versed’s ads on radiology magazines literally say “For when they need to forget.”
  - lostlogin 4y ago
    Ketamine has been something I have seen used. The lack of reaction from people having broken bones manipulated while under its influence is very disconcerting.
- colanderman 4y ago
  Interesting -- I recently had a similar experience (very bad wrist fracture), but they used a nerve block instead. I was conscious and it was painful, but not unbearably or traumatically so. I wonder why a nurse would choose one over the other.
  - HeyLaughingBoy 4y ago
    Dunno. It was about 15 years ago and may have had something to do with the extent of the injury? She was 25 at the time and the orthopedic surgeon kept saying he couldn't imagine the amount of energy it took to do that much damage to such young bones. The wrist was shattered into at least 5 pieces. This is one reason we always give a shoutout to Tria Orthopedics in the Twin Cities, MN region when someone needs an orthopedist: she was one of their first patients and the wrist maintained full range of motion after healing.
    - colanderman 4y ago
      Ah, mine was "only" three pieces... still the talk of the ER though :P They did insist on full anesthesia for the surgery (the fracture was unstable so I needed a plate). Glad to hear she recovered full range of motion; getting close myself.
minitoar 4y ago
It’s a disorder if the stress interferes with your daily life, e.g. you can’t hold down a job or your personal relationships suffer.
ska 4y ago
> Why is stress after trauma a 'disorder'? It isn't. Sometimes you can experience trauma, then experience stresses, and react to the stress in normal ways. The disorder is when this doesn't happen, and you have atypical reactions to stress, which can be debilitating.
runnerup 4y ago
Because sometimes there's no war left to fight but the soldiers still can't return their minds to civilian life. They're disabled, unable to hold down a job reliably, unconfident in their ability to do normal tasks like go grocery shopping without having a debilitating panic attack which causes additional heart damage every time. There's tons and tons of examples why stress after trauma is a disorder. Also a very good wikipedia article if you'd like a place to start: https://en.wikipedia.org/wiki/Post-traumatic_stress_disorder https://en.wikipedia.org/wiki/Post-traumatic_stress_disorder
kennywinker 4y ago
The "disorder" is a description of about how it's causing people pain / trouble in their lives. Experiencing something, and processing it, and it having a lasting impact on your life and your thinking isn't by definition disordered. But having it cause problems in your life, e.g. physical touch from people you trust causing panic attacks, that's a disorder. Forgetting, as a treatment, may be something some people want. To my eyes your comment is pretty dismissive ("drug people up"). A little empathy, and an open heart goes a long way here.
eli 4y ago
PTSD is a serious medical condition. It's not merely a feeling of "stress."
api 4y ago
It is if it sticks around long after the original triggering trauma is gone and prevents you from leading a healthy life.
travisjungroth 4y ago
Not all stress after trauma is a disorder. A disorder, by definition, is a big problem. It’s “an illness or condition that disrupts normal physical or mental functions”. Think PTSD as “disorder from stress from trauma”. How is it a solution? If giving people a drug reduces disorders and that benefit outweighs the cost, then it’s generally considered a good idea.
kennedywm 4y ago
PTSD has strong negative impacts on a person’s life. Treating it mitigates these negative impacts.
gilbetron 4y ago
Spoken like someone that hasn't experienced PTSD.
tsimionescu 4y ago
That's a bit like asking "why is pain after an injury a 'disorder'"? Just like some people are left with persistent recurrent pain in an otherwise healthy and recovered limb (often known as rheumatism), some people are left with persistent recurrent stress after trauma - such as suddenly bursting out crying or cowering in fear after incidentally remembering trauma that happened 20 years ago while doing the dishes. When this sort of thing happens, we call it "post-traumatic stress disorder", and are looking for ways to treat patients. Making them forget the event is one possible treatment, and there are others (such as trying to disassociate the event itself and the strong negative feelings). Just like acute pain is useful to keep us healthy, acute stress is very important. But chronic pain and post-traumatic stress are not useful to anyone, they are failure modes of these otherwise useful systems, and it makes sense to try various ways of correcting them.
- to1y 4y ago
  >That's a bit like asking "why is pain after an injury a 'disorder'"? It isn't. If anything that supports OPs point
  - xboxnolifes 4y ago
    Disorder doesn't mean an unexpected outcome. It's a disruption in the norm for the system. The stable state for a human body is not constant pain.
  - tsimionescu 4y ago
    I should have said (and I believe explained in the rest of the comment) that it's a bit like asking "why is pain after an injury a 'disorder'" of a person suffering from chronic pain. PTSD is a disorder beacause it is a chronic version of a completely normal accute reaction.
- JamesianP 4y ago
  I don't consider any kind of acute pain acceptable personally. Even if short-lived. Unless it's needed as a signal to pull your hand out of a fire or something.

A long time ago my wife shattered her wrist. In the ER, they explained that they needed to reset it so it could be put in a splint before surgery could be scheduled. They weren't going to use anesthetic. She would be conscious of the pain as they moved her wrist into position, but they'd give her something so she wouldn't remember the experience. 15+ years later she remembers telling them to go ahead and do it, then there's a hole in her memory for about 10 minutes. I'd say that's one good solution.

gateaux 4y ago
Wow. Do you happen to know what it was they gave her?
- roywiggins 4y ago
  I believe midazolam can cause amnesia, it's not technically an anesthetic in the sense that it doesn't knock you out, but it's a sedative. https://en.wikipedia.org/wiki/Midazolam https://en.wikipedia.org/wiki/Midazolam
  - atdrummond 4y ago
    Versed’s ads on radiology magazines literally say “For when they need to forget.”
- lostlogin 4y ago
  Ketamine has been something I have seen used. The lack of reaction from people having broken bones manipulated while under its influence is very disconcerting.
colanderman 4y ago
Interesting -- I recently had a similar experience (very bad wrist fracture), but they used a nerve block instead. I was conscious and it was painful, but not unbearably or traumatically so. I wonder why a nurse would choose one over the other.
- HeyLaughingBoy 4y ago
  Dunno. It was about 15 years ago and may have had something to do with the extent of the injury? She was 25 at the time and the orthopedic surgeon kept saying he couldn't imagine the amount of energy it took to do that much damage to such young bones. The wrist was shattered into at least 5 pieces. This is one reason we always give a shoutout to Tria Orthopedics in the Twin Cities, MN region when someone needs an orthopedist: she was one of their first patients and the wrist maintained full range of motion after healing.
  - colanderman 4y ago
    Ah, mine was "only" three pieces... still the talk of the ER though :P They did insist on full anesthesia for the surgery (the fracture was unstable so I needed a plate). Glad to hear she recovered full range of motion; getting close myself.

minitoar 4y ago

It’s a disorder if the stress interferes with your daily life, e.g. you can’t hold down a job or your personal relationships suffer.

ska 4y ago

> Why is stress after trauma a 'disorder'? It isn't. Sometimes you can experience trauma, then experience stresses, and react to the stress in normal ways. The disorder is when this doesn't happen, and you have atypical reactions to stress, which can be debilitating.

runnerup 4y ago

Because sometimes there's no war left to fight but the soldiers still can't return their minds to civilian life. They're disabled, unable to hold down a job reliably, unconfident in their ability to do normal tasks like go grocery shopping without having a debilitating panic attack which causes additional heart damage every time. There's tons and tons of examples why stress after trauma is a disorder. Also a very good wikipedia article if you'd like a place to start: https://en.wikipedia.org/wiki/Post-traumatic_stress_disorder https://en.wikipedia.org/wiki/Post-traumatic_stress_disorder

kennywinker 4y ago

The "disorder" is a description of about how it's causing people pain / trouble in their lives. Experiencing something, and processing it, and it having a lasting impact on your life and your thinking isn't by definition disordered. But having it cause problems in your life, e.g. physical touch from people you trust causing panic attacks, that's a disorder. Forgetting, as a treatment, may be something some people want. To my eyes your comment is pretty dismissive ("drug people up"). A little empathy, and an open heart goes a long way here.

eli 4y ago

PTSD is a serious medical condition. It's not merely a feeling of "stress."

api 4y ago

It is if it sticks around long after the original triggering trauma is gone and prevents you from leading a healthy life.

travisjungroth 4y ago

Not all stress after trauma is a disorder. A disorder, by definition, is a big problem. It’s “an illness or condition that disrupts normal physical or mental functions”. Think PTSD as “disorder from stress from trauma”. How is it a solution? If giving people a drug reduces disorders and that benefit outweighs the cost, then it’s generally considered a good idea.

kennedywm 4y ago

PTSD has strong negative impacts on a person’s life. Treating it mitigates these negative impacts.

gilbetron 4y ago

Spoken like someone that hasn't experienced PTSD.

tsimionescu 4y ago

That's a bit like asking "why is pain after an injury a 'disorder'"? Just like some people are left with persistent recurrent pain in an otherwise healthy and recovered limb (often known as rheumatism), some people are left with persistent recurrent stress after trauma - such as suddenly bursting out crying or cowering in fear after incidentally remembering trauma that happened 20 years ago while doing the dishes. When this sort of thing happens, we call it "post-traumatic stress disorder", and are looking for ways to treat patients. Making them forget the event is one possible treatment, and there are others (such as trying to disassociate the event itself and the strong negative feelings). Just like acute pain is useful to keep us healthy, acute stress is very important. But chronic pain and post-traumatic stress are not useful to anyone, they are failure modes of these otherwise useful systems, and it makes sense to try various ways of correcting them.

to1y 4y ago
>That's a bit like asking "why is pain after an injury a 'disorder'"? It isn't. If anything that supports OPs point
- xboxnolifes 4y ago
  Disorder doesn't mean an unexpected outcome. It's a disruption in the norm for the system. The stable state for a human body is not constant pain.
- tsimionescu 4y ago
  I should have said (and I believe explained in the rest of the comment) that it's a bit like asking "why is pain after an injury a 'disorder'" of a person suffering from chronic pain. PTSD is a disorder beacause it is a chronic version of a completely normal accute reaction.
JamesianP 4y ago
I don't consider any kind of acute pain acceptable personally. Even if short-lived. Unless it's needed as a signal to pull your hand out of a fire or something.