It is no surprise that posttraumatic stress disorder causes a variety of psychosocial problems. The negative effects of PTSD on the long-term psychological health of individuals are well-documented. In addition to higher rates of anxiety, depression and substance use, those battling PTSD face challenges in their marriages and other intimate relationships, problems at work and school and in their social lives.
But what about physical health? Is it possible that PTSD can lead to serious medical ailments? Research shows that yes, this may indeed be the case.
A peer reviewed study published in the highly respected medical journal The Lancet revealed that high levels of stress were associated with increased risk for cardiovascular disease. Yes, PTSD is linked to heart disease in some shape, form or fashion. The study also revealed that the more stress a person is under, the more likely he or she will experience chest pain, heart failure or stroke.
Moreover, these individuals are more likely to experience these problems earlier than others. So, what is the connection between PTSD and heart disease? It is not clearly known. However, it is believed and hypothesized that stress is associated with increased activity in the amygdala. The amygdala is a small, almond-shaped structure in our brain that is responsible for a number of important functions. In addition to regulating memory and our ability to think through difficult and complex situations and make decisions, the amygdala helps us process our emotions.
In fact, the amygdala is often most associated with the varied feeling states that we experience. Related to our current discussion, it is believed that the more emotionally stressed we are, the more active this tiny “processing system” becomes. There are downstream effects.
Overly Active Amygdala
Prior research has also found that the amygdala is overly active in people with PTSD. This result makes sense as chronic emotional stress is a hallmark symptom and state of those with the disorder, particularly those with the more severe and chronic variants of PTSD. Although the direct mechanism for how a hyperactive amygdala in PTSD sufferers leads to heart disease is unclear, it is believed to somehow be related to our bone marrow. That’s right, our bone marrow–the stuff we hear and know very little about, but is critical to life.
Bone marrow is a fatty substance inside our bones that is responsible for producing blood cells, both red and white. Our red blood cells deliver oxygen to the tissues in our body. Our white blood cells are responsible for fighting off infections when we get sick. That is why your doctor will typically order blood work (Complete Blood Count [CBC]) when you are sick. He or she want to know if your white blood cells are elevated, which may mean you are fighting off some type of infection.
It is believed that an overactive amygdala tells our bone marrow to produce more white blood cells for whatever reason. This increase in white blood cell leads to the development of plaque in our arteries. It also causes them to become inflamed. This buildup of plaque and subsequent narrowing of the arteries from inflammation can lead to chest pain and, in extreme cases, a heart attack.
This most recent study only provides more support to the notion of the PTSD and heart disease connection. It is not the first to document a connection between the two. A 2015 study published in the American Journal of Public Health revealed that veterans with PTSD had a 50 percent greater chance of developing heart failure compared with those who did not have PTSD. In the same year, an article published in the journal Circulation reported that women with severe PTSD may have a 60 percent higher lifetime risk of heart disease.
As we learn more about the effects of PTSD on the heart (and other organs of the body) we will likely need to shift our view that PTSD is a purely psychiatric disorder. Instead, we will need to view the disorder more as a systemic “disease” that affects the entire body. Therefore, we should not be surprised to find out that effective treatment will not only improve a person’s quality of life, but possibly cause them to live longer.
Edmondson, D., & von Känel, R. (2017). Post-traumatic stress disorder and cardiovascular disease. The Lancet Psychiatry, 4(4), 320-329.
Roy, S. S., Foraker, R. E., Girton, R. A., & Mansfield, A. J. (2015). Posttraumatic stress disorder and incident heart failure among a community-based sample of US veterans. American Journal Of Public Health, 105(4), 757-763.
Sumner, J. A., Kubzansky, L. D, Elkind, M. S., Roberts, A. L., Agnew-Blais, J., Chen, Q., Cerdá, M., Rexrode, K. M., Rich-Edwards, J. W., Spiegelman, D., Suglia, S. F., Rimm, E. B., Koenen, K.C. (2015). Trauma Exposure and Posttraumatic Stress Disorder Symptoms Predict Onset of Cardiovascular Events in Women. Circulation, 132(4), 251-259.
*A previous version of this article was published in Military Times as part of Dr. Moore’s column Kevlar for the Mind.