"I see a fleeting shadow out of my field of vision. I hear the
crunch of leaves or a car whizzing by. And it starts again," says Deb
Mulligan, a 38-year-old advertising executive who was brutally raped on
the sidewalk in front of her rural Ohio home one moonless fall night
eight years ago. "Twigs snapping around me are enough to send me into a
sweat. The wind will whip up, and suddenly I can feel the knife cutting
into my throat, my blouse being ripped from body. I almost think, just
for a moment, that there is blood running down my neck."
Robert Morris was thankful when USAir flight #5050 pulled away from
the LaGuardia airport gate on time. A traveling salesman, Morris closed
his eyes in hopes of refreshing himself for the next day's sales
presentation. When next he opened them, the wing of his DC-10 was
slamming into the East River break wall.
"The fuselage had broken into three pieces, and I was sinking
fast," recalls Morris. Handicapped with prostheses below both knees, it
took incredible strength for Morris to pull himself to the surface for
air. Then the debris hit his body. "I stayed underwater as long as I
could to avoid the smoke. As I came up, a woman grabbed onto my already
weighted body and screamed 'don't let me die.'" I hung on to her, and we
treaded water together until the helicopters pulled us out."
More than two years later, Morris still gets terrified in
situations he can't control. And swimming is out of the question.
Twenty years after he watched a Jeep hit a land mine in Vietnam and
explode, Jerry still sees that moment as if he were there. Although he
can conjure the image from memory all too easily, it usually comes
unbidden. He can be watching a television comedy when suddenly he sees
and feels the smoke and thump of the explosion, the Jeep flying into the
air, his buddies sent sprawling--mangled and dead. Every time Jerry
relives that scene, he repeats the same, all-too-familiar thoughts: "It
shouldn't have happened. We were in a convoy. The road had been checked.
I had been on the team that cleared it."
The traumatic scene always brings back the same flood of intense
fear, guilt, and sadness--feelings that break through the numbness
blanketing Jerry's emotions since that day.
The scene returned again for him in 1988 as he sat in a room at the
West Haven VA Medical Center, just outside New Haven, Connecticut. Jerry,
along with 14 other Vietnam veterans, was given a dose of the drug
yohimbine--an extract from the bark of a tropical African tree--as part
of an experiment to explore the links between traumatic events and
changes in brain chemistry.
Jerry, like all the other veterans in the study, was suffering from
posttraumatic stress disorder, or PTSD. Common symptoms include
flashbacks, jumpiness and irritability, insomnia and nightmares, guilt,
and intense panic--often in response to something only vaguely
reminiscent of the original trauma. PTSD is not confined to combat
veterans; its symptoms can afflict victims of violent crimes, airplane
crashes, earthquakes, or other natural disasters--and the number of
Americans who experience such trauma in a given year could be in the
millions.
Nine of the 15 veterans in the study, including Jerry, experienced
a panic attack when the yohimbine became active in their brain; the six
others experienced flashbacks. These particular symptoms occurred along
with other PTSD symptoms. Yohimbine is used clinically to boost the heart
rate and blood pressure in patients whose systems are failing. The drug
energizes the sympathetic nervous system, causing it to act as though it
were confronting an emergency: The heart races, pupils dilate, and blood
rushes to the muscles in the "fight or flight" response.
In most people the changes do not induce panic or even discomfort.
But Jerry and eight other Vietnam veterans in the study reacted so
severely that they felt they were reliving the dangers of the
battlefield.
That a drug should trigger most of the posttraumatic stress
symptoms in many of those who suffer from the emotional aftermath of
trauma is but one of severe pieces of evidence pointing to a new and
surprising scientific consensus: Traumatic events--even a single episode
like Jerry's---can alter the brain's chemistry.
"Our hypothesis is that people who have been through intense trauma
may never be the same biologically," says Dennis Chamey, M.D., chief of
clinical neuroscience at the National Center for PTSD, in West Haven,
Connecticut, and one of the investigators in the yohimbine study.
Dr. Charney is linked through the center to a network of other
researchers who are trying to pierce the mystery of PTSD with an eye
toward developing more effective treatment. A six-year-old project of the
Department of Veterans Affairs (formerly known as the Veterans
Administration), this network is a unique research-and-treatment
consortium located at four VA medical centers. The Clinical Neuroscience
Division, in West Haven, is devoted to studying the biology and
psychopharmacology of the aftermath of trauma.
Posttraumatic stress disorder is a new name for an old phenomenon.
"Whenever there's been a major disaster or war, you see a wave of
descriptions of the same problem," says John Krystal, M.D., who directs
the West Haven VA Medical Center's Laboratory of Clinical
Psychopharmacology.
That consistency in descriptions was one of the early clues that
suggested there might be underlying neurological changes resulting from
trauma.
Tags:
brain,
break wall,
dc 10,
field of vision,
fleeting shadow,
fuselage,
laguardia airport,
mulligan,
old advertising,
Panic Attack,
prostheses,
PTSD,
robert morris,
rural ohio,
s sales,
sales presentation,
television comedy,
three pieces,
thump,
time jerry,
trauma,
traveling salesman,
twigs,
usair flight,
veteran
