Episode 001: Hello world! My name is Elias Diam, MD, but folks know me as Doctor
Dan. Welcome to the PTSD Academy Podcast!!

In today’s episode, we will cover the DSM-V criteria, trust, what I call “the Big Three” (PTSD, Major Depression, and Insomnia), and the importance of a safe partner during trauma recovery.

A complete and up-to-date research definition of the term
“Posttraumatic Stress Disorder” can be found at https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd.

There is an interesting history here regarding what
really happened with the creation of the PTSD as an official diagnosis. Vietnam
veteran activists, lobbyists and politicians pushed to get it added to the DSM
3 in 1980.

In society, however, PTSD is often mis-attributed to mean things like confusion, anger, and flashbacks. An innumerable amount of conditions could cause these such as trauma, sleep deprivation and memories, but none of them are specifically listed in the research definition of PTSD.

Have no fear. The writers of the DSM were shamed when
only two weeks before the scheduled release of the DSM V, the NIH announced it
was cutting off funding for DSM-related research in favor of research for the
neurobiological mechanisms underlying the symptom complexes. That’s when I was
in training, so was never tested on the DSM criteria by the board. Lol.

The reality is that a PTSD survivor has a heightened
level of tension and activity in their bodies relative to normal controls. That
means that the “fight or flight” mechanism is on – and stays on. If you’re body
feels like it’s always in the middle of the worst moment of your life, you can
bet it’s going to get worn out eventually. And that’s exactly what happens.

How to
treat PTSD

Mainstream USA medicine says the medications and
psychotherapy (talk therapy) combined provide the best results, though an
ever-increasing number of therapies are getting added to the list of approaches
that can reduce certain symptom complexes. For example, yoga, tai chi, Reiki,
meditation and acupuncture all have some level of evidence for relief of some
of the symptoms related to PTSD. Tools like these attempt to reset the body’s
stress point back down to the level it was prior to the trauma. In theory.

It turns out, the effectiveness of any PTSD treatment is intensely dependent on how well the trauma survivor begins to implement trust back into their lives. Forgetting the eager expectation that the worst case scenario will always happen. This means that the trauma caused an alteration to the risk assessment and monitoring tasks being completed by the brain.

PTSD signs
and symptoms

The hallmark of good PTSD therapy is to delve deep into
how the relationship between PTSD, depression and insomnia work in the
survivor’s life in order to help them accomplish their life goals. To start us
off in this topic of how the Big Three work together, let’s do a quick primer
on the Biology of PTSD.

After the stress of trauma, about 20% of survivors
develop PTSD. After a few years, even without any treatment, that number
reduces on its own to 4%. (This topic is discussed in more detail in my book,
Combat PTSD in America: Toward a Permanent Solution. Available at