Coronavirus, Stress and PTSD

“The line it is drawn, the curse it is cast

. . . As the present now will later be past

The order is rapidly fading

And the first one now will later be last

For the times they are a-changin [1].”

Among those ordered to stay at home, anxiety is prevalent as the unknown and feared intruder extends its infectious grasp. There is no longer any scientific doubt that repeated or chronic stress triggers inflammation in the body and brain [2]. Indeed, as an example, the current helpline calls for Intimate Partner Violence (IPV) are up by 25% during the ongoing epidemic.

“As families across the globe hunker down, there's another less obvious threat that is just as dangerous -- the potential spike in domestic violence as victims spend days and nights trapped at home with their abusers. For many, tensions are rising, there's nowhere to escape, and they have limited or no access to friends or relatives and no idea when it will end.” [3]

Stress can disrupt our ability to differentiate between rational and emotionally-based thinking. We have previously referred to this matter as a ‘top-down, bottom-up’ phenomenon. More specifically, survival reactivity emanating from the human brain’s limbic system becomes prominent over the Executive Functioning ability of the Frontal Lobes. How else do we explain people hoarding toilet paper? [4].

Another feature of stress is the disruption of sleep, which consequently weakens the immune system.

“Everybody knows that a night of tossing and turning can leave you feeling groggy, crabby, and listless. But did you know that chronic sleep deprivation, or even a single restless night, can also negatively impact systemic inflammation and the immune system? . . . A study showed conclusively that in healthy adults who were limited to 6 hours of sleep a night for one week, there was a change in their gene activity profile relative to when those same individuals were getting a full 8 hours of sleep a night. A total of 711 genes were distorted in their activity, caused by a lack of sleep. About half of those genes were actually increased in their activity, while the other half were decreased.” [5]

“The genes that were switched off by a lack of sleep were genes associated with the immune system (which indicated an increased risk of infection). In contrast, those genes whose activity levels were increased by way of a lack of sleep were genes associated with the promotion of tumors, long-term inflammation, stress, and—as a result—cardiovascular disease, atherosclerosis, stroke, dementia, and other conditions directly associated with inflammation.” [5]

Chronic inflammation can produce numerous health problems that include diabetes and heart complications [6]. Chronic stress can also be a precursor to varied anxiety issues, including Post-Traumatic Stress Disorder. [7] The stress/inflammatory factor appears to also be a central issue in depressive conditions. [8]

Brain functioning is generally protected from the rest of the body by a blood-brain barrier. However, with repeated or chronic stress, the barrier can become leaky, permitting inflammation to penetrate. [9] In particular, the Hippocampal region of the brain is particularly vulnerable regarding a weakening in the functions of learning and memory. A recent inquiry into these factors at Stanford University has found that stress can alter our ability to utilize our memory in the decision-making process.

“We draw on memory not just to project ourselves backward into the past but to project ourselves forward, to plan . . . Stress can rob you of the ability to draw on cognitive systems underlying memory and goal-directed behavior that enable you to solve problems more quickly, more efficiently and more effectively.” [10]

Many of our front-line first responders who daily face the invisible Coronavirus menace acknowledge that they are terrified. They are separated from their families and are exposed to the virus every day they serve. They continue to fear shortages of protective equipment, including gloves, masks, and gowns. The multiple traumatic events they experience on duty inevitably impact their emotional functioning. They desperately need an intervention similar to the one which remediates PTSD rapidly in our combat veterans. We believe that RESET Therapy could easily accomplish this purpose.

"Hospitals are already short-staffed as we are in a severe flu season. Long hours, shortage of protective gear, and testing limitation have some fearing that they are flying blind,’ explained Dr. Azadeh Shirazi, a board-certified surgeon, disease specialist, and founder of the California-based La Jolla Laser Surgery Center. ‘It's a harrowing scene when you are not protecting a limited supply of trained workers. We cannot afford to lose them.’”[11]

While the health and survival aspects from Coronavirus predominate, we await the emotional toll that is most certainly coming. Unfortunately, we face this onslaught with antiquated treatment interventions that are primarily cognitively-based within the context of a survival-based emotionally-driven issue. We simply don’t have the number of mental health therapists available to address the mass emotional impact that will be forthcoming for our health care professionals and first responder populations.

Over the past seven years, we have investigated binaural sound as the primary means through which to modify trauma/stress altered brain circuitry. Our findings continue to support our original hypothesis that a binaural sound that is unique to each individual can unlock long-term trauma memories stored in the hippocampus region of the brain. Throughout our inquiry, it has become apparent that the Reconsolidation process provides us with the opportunity to ‘drop-out’ the emotional aspect of the disruptive memory. qEEG material confirms the change forthcoming from the intervention that we have called RESET Therapy.

Perhaps this is the time to make the shift and take a quantum leap of faith. Due to the Coronavirus Pandemic, we welcome the involvement of our academic research colleagues interested in the mechanisms of action of trauma to join in our effort. Also, an audio engineer could be of immense assistance in this effort. RESET Therapy needs to be fully explored at levels that we, as clinicians, cannot alone accomplish. It’s time to do this properly through fully recognized research efforts. Colleagues, please consider joining us in this endeavor to address trauma-based issues. As mental health professionals, surely, we can develop the procedures and interventions that will benefit Coronavirus survivors well into the future.

We currently have the technology to remediate PTSD and stress-related issues in a one on one situation. What is especially evident from this pandemic is the need to effectively treat these conditions through the use of interactive computer-based technology. Research money and involvement are needed now, more than ever before, to enable a RESET system to be computerized and interactive, enabling patients to be treated within the home. As Bob Dylan so aptly told us – “The times they are a-changin.”

References:

[1] The Times They Are A-Changin’ | The Official Bob Dylan Site. (n.d.). http://www.bobdylan.com/songs/times-they-are-changin/

[2] Sahakian, B. J., Langley, C., & Kaser, M. (2020). How chronic stress changes the brain – and what you can do to reverse the damage. The Conversation. http://theconversation.com/how-chronic-stress-changes-the-brain-and-what-you-can-do-to-reverse-the-damage-133194

[3] Twitter, G. J. gjoseph@medianewsgroup com; @ginaljoseph on. (n.d.). Turning Point: Domestic violence calls up 25% during coronavirus outbreak. Macomb Daily. https://www.macombdaily.com/news/coronavirus/turning-point-domestic-violence-calls-up-25-during-coronavirus-outbreak/article_c8002218-7398-11ea-aa1e-07fb77afb726.html

[4] What’s the Deal With Hoarding Toilet Paper? (2020). Time, htpps//:time.com/5803273/hoarding-toilet-paper/

[5] Can Poor Sleep Increase the Risk of Colds, Coronavirus, or Chronic Inflammation? (2020, March 4). Amen Clinics. https://www.amenclinics.com/blog/can-poor-sleep-increase-the-risk-of-colds-coronavirus-or-chronic-inflammation/

[6] Furman, D., Campisi, J., Verdin, E., Carrera-Bastos, P., Targ, S., Franceschi, C., Ferrucci, L., et al., (2019). Chronic inflammation in the etiology of disease across the life span. Nature Medicine, 25(12), 1822–1832. https://doi.org/10.1038/s41591-019-0675-0

[7] Diminich, E. D., Clouston, S., Scott, S. B., Palekar, N., Santiago, E. D., Bromet, E., & Luft, B. (2019). BIOLOGICAL MARKERS OF AGING: CHRONIC STRESS AND COGNITIVE IMPAIRMENT IN RESPONDERS FROM THE WORLD TRADE CENTER. Innovation in Aging, 3(Suppl 1), S93–S94. https://doi.org/10.1093/geroni/igz038.354

[8] Singhal, G., & Baune, B. T. (2020). Chapter 6—Inflammatory Abnormalities in Major Depressive Disorder. In R. S. McIntyre (Ed.), Major Depressive Disorder (pp. 75–89). Elsevier. https://doi.org/10.1016/B978-0-323-58131-8.00006-9

[9] Marsland, A. L., Walsh, C., Lockwood, K., & John-Henderson, N. A. (2017). The effects of acute psychological stress on circulating and stimulated inflammatory markers: A systematic review and meta-analysis. Brain, Behavior, and Immunity, 64, 208–219. https://doi.org/10.1016/j.bbi.2017.01.011

[10] University, S. (2020, April 2). Stress disrupts our ability to plan ahead. Stanford News. https://news.stanford.edu/2020/04/02/stress-disrupts-ability-plan-ahead/

[11] Coronavirus takes drastic toll on health-care providers across United States | Fox News. (2020). https://www.foxnews.com/health/coronavirus-takes-drastic-toll-on-healthcare-providers-across-the-united-states