Help in Healing: Post-Traumatic Stress Disorder and Paralysis
A diagnosis of paralysis changes how people live. Relationships, health, jobs, and financial situations are altered. For some, the incident that caused paralysis may be traumatic, sudden, or violent and may bring about post-traumatic stress disorder.
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Background
The U.S. population in 2021 was approximately 333 million people. The latest estimated incidence rate of traumatic spinal cord injury (SCI) is 54 in one million people. This equals about 18,000 new cases a year.
The prevalence of people living with paralysis in the U.S. is estimated at 5.4 million people of which 1.4 million have a spinal cord injury.
Causes of Paralysis
The spinal column envelops and protects the spinal cord, which consists of 33 vertebrae, cartilage, and small spaces called foramen – the passageway for spinal nerves. Direct injury to the foramen increases the risk of paralysis.
Groups at an Increased Risk of a Spinal Cord Injury
The most common causes of spinal cord injury (SCI) are motor vehicle accidents and falls. Other causes include:
- Acts of violence – mostly gunshot wounds and assaults
- Sports injuries
- Surgery
- Industrial accidents
- Diseases
- Military related
Other risk factors can include alcohol or substance use and not wearing proper protective gear such as seatbelts or sports equipment. Furthermore, people aged 16-30 or over 65 may become paralyzed because of dangerous falls. Approximately 78% of new SCI cases are male. The loss of mobility may increase the risk of mental health disorders such as post-traumatic stress disorder (PTSD).
The Military and SCIs
The majority of paraplegic veterans are men between the ages of 18 and 25.
Military personnel face situations that most civilians will never encounter. For example, combat places military personnel at risk of paralysis from gunshots, shrapnel, conventional military explosives, or improvised explosive devices (IEDs).
Returning home after becoming paralyzed can affect military personnel in different ways. Some may be able to adjust to life after becoming paralyzed, while others may experience post-traumatic stress disorder (PTSD).
Post-Traumatic Stress Disorder
The National Center for PTSD, a part of the U.S. Department of Veterans Affairs, reports approximately six out of 100 people will have PTSD.
Post-traumatic stress disorder may develop after a person has experienced a scary, dangerous, or shocking situation. Feelings of fear during or after a traumatic event are expected. Fear is a healthy feeling that is part of our body's “fight or flight” response in traumatic situations. This response helps protect or respond to a dangerous situation.
Most will recover from the feelings they experienced during a fearful event. But, some will continue to have feelings of fear or anxiety. Feelings of fear or anxiety that last for an extended period may be PTSD.
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Treatment for PTSD
There are healthy ways to treat PTSD. First, it is vital to find a mental health professional who is trained to work with individuals with PTSD. Therapists can use psychotherapy, brain stimulation therapy, and/or medication to treat the symptoms.
Psychotherapy
Psychotherapy is also known as talk therapy. Often, a therapist will use cognitive behavioral therapy (CBT) to address PTSD. CBT can consist of exposure therapy (learning to manage fear by safely and gradually exposing a person to the trauma) or cognitive restructuring (replacing feelings of guilt or shame with realistic ways to think about the event).
Medication
Two types of serotonin reuptake inhibitors (SSRIs) are approved by the U.S. Food and Drug Administration (FDA) to help manage PTSD symptoms. SSRIs can decrease or prevent feelings of sadness, anger, worry, or emotional numbness.
Brain Stimulation Therapy
Brain stimulation therapies activate or inhibit the brain with electricity. Electrodes may be either implanted in the brain or placed on the scalp. Another option is inducing electricity after applying magnetic fields on the head.
Therapists will use brain stimulation therapies after psychotherapy or medication proves to be ineffective.
Conclusion
PTSD after having an SCI is not uncommon. If you think you may have PTSD symptoms, talk to your doctor about seeing a mental health professional. Or you can seek help from a mental health therapist directly.
Christina Sisti, DPS, MPH, MS, is a bioethicist and health care policy advocate. She works to create awareness and improve healthcare policy for those with long-term health issues.