Intrusive thoughts are threatening thoughts that constantly occur to a person without conscious or voluntary control. These thoughts are capable of creating severe anxiety when they enter the mind. They play a vital role in Post-Traumatic Stress Disorder (PTSD), as they have a significant impact on the people affected by it.
Post-Traumatic Stress Disorder
Post-traumatic stress disorder is a type of serious anxiety disorder that develops after an intense experience of being involved in a traumatic event. For people with PTSD, the traumatic event repeatedly causes thoughts of fear, shock, anger, restlessness, and sometimes horror.
A traumatic incident is an event that causes physical or psychological distress. Each person’s reaction to a traumatic event is different based on one’s personality, beliefs, and previous experiences. In all cases, the individual experiences a traumatic event that causes intense fear and anxiety.
Different types of traumatic incidents include:
- witnessing or being involved in a severe road accident
- being a victim of violent or sexual assaults
- witnessing the violent death of loved ones, friends, or family
- witnessing terrorist attacks
- being held as a hostage or prison stay
- being involved in natural disasters including floods, tsunamis, or earthquakes
Intrusive Thoughts in PTSD
In addition to thoughts, images, sounds, smells, and feelings of a particular traumatic incident can also intrude severely upon a person with PTSD. People with PTSD are stuck in the memories and time during which they experienced the incident and are less attentive to their present life. Sufferers report a frequent recurrence of distressing memories. Patients also have nightmares about the event. They exhibit movements during sleep as a result of nightmares.
They feel as if the incident is taking place again and again in their life. These types of thoughts are known as flashbacks. The occurrence of flashback thoughts leads to deep distress and increases physical excitation and stress, including the heart rate. As a whole, these intrusive symptoms lead to intense stress and result in guilt, fear, anger, and grief.
Recurring thoughts about the incident: Sufferers have a graphic and dramatic image of the trauma that arises in their memory frequently. For instance, if a person has been attacked physically, he might see the image of the face of the attacker again and again. In the case of a car accident, the person may relive the memories or the sound of the particular incident or the images of injury and blood.
Nightmares: PTSD sufferers often have nightmares that may be about the incident or themes that are related to the traumatic event. A person who has been involved in a car accident will have nightmares about the accident. PTSD people who have been victims of assault dream of being chased by an attacker. In several of these dreams, the pursuer might not be the assaulter in real life.
Reliving the incident: In this symptom, the affected individual is detached from the real world and is stuck in the past trauma event. This type of reliving the incident is called "dissociation." Some people with this symptom act as if they are undergoing the traumatic situation physically. Others stare into empty space for a prolonged period, thinking of the incident.
Distress of the trauma: In this state, PTSD sufferers are frequently nervous and anxious when they are near the place where the incident occurred or while speaking to a person who is related in any way to the incident.
Body Sensations: Almost all PTSD patients suffer bodily sensations. They experience some physiological changes when they come into association with the person, situation, or conversation that reminds them of the incident. This leads to changes in physical parameters such as an increase in the body temperature, heartbeat, and blood pressure.
Impact of PTSD on the Brain
Recent studies have shown that people with PTSD have irregular or fluctuating stress hormones levels. When the human body is faced with danger, it automatically starts producing adrenal hormones that generate various stress reactions.
These reactions are called the “flight or fight” reactions that put the senses on full alert. In PTSD, victims experience a continuous production of elevated levels of flight or fight hormones, even when there is no actual present danger.
For people with PTSD, emotional processing occurs in different areas of the brain. The part of the brain which is thought to be primarily responsible for emotion and memory is known as the hippocampus. The size of the hippocampus in PTSD people seems to be smaller compared to other people.
Changes that occur in this part of the brain might be the reason for anxiety, flashbacks, and other memory problems. The smaller hippocampus may prevent memory from being properly processed and hence the anxiety that is generated from the flashbacks will not abate.
Reviewed by Liji Thomas, MD