Post-Traumatic Stress Disorder (PTSD)


Overview
PTSD is a disorder that develops in many people who have experienced a shocking, scary, or dangerous event. Nearly everyone will experience a range of reactions after trauma, yet most people recover from initial symptoms naturally. Those who continue to experience problems may feel stressed or frightened even when they are not in danger. Symptoms usually begin early, within 3 months of the traumatic incident, but sometimes begin years afterward. Symptoms must last more than a month and be severe enough to interfere with relationships or work to be considered PTSD. The course of the illness varies. Some people recover within 6 months, while others have symptoms that last much longer. In some people, the condition becomes chronic.

Symptoms of PTSD
Symptoms may be categorized as follows:

  • Avoidance
  • Arousal and Reactivity
  • Cognition and Mood

Avoidance symptoms include: Staying away from places, events, or objects that are reminders of the experience and avoiding thoughts or feelings related to the traumatic event.

Arousal and reactivity symptoms are usually constant instead of being triggered by things that remind one of the traumatic events. These symptoms can make the person feel stressed and angry. They may make it hard to do daily tasks, such as sleeping, eating, or concentrating, being easily startled, feeling tense or “on edge” having difficulty sleeping and having angry outbursts

Cognition and mood symptoms can begin or worsen after the traumatic event.,. These symptoms can make the person feel alienated or detached from friends or family members, trouble remembering key features of the traumatic event, negative thoughts about oneself or the world, distorted feelings like guilt or blame and loss of interest in enjoyable activities.

Re-experiencing Symptoms may cause problems in a person’s everyday routine. The symptoms can start from the person’s own thoughts and feelings. Words, objects, or situations that are reminders of the event can also trigger re-experiencing symptoms including: Flashbacks—reliving the trauma over and over, including a racing heart or sweating; bad dreams and frightening thoughts

PTSD and the “Endocannabinoid System”
PTSD creates a “malfunction” of the body’s Endocannabinoid System. The endocannabinoid system is integrally related to memory, specifically to memory extinction. Memory extinction is the normal, healthy process of removing associations from stimuli. Dr. Raphael Mechoulam, the “grandfather” of cannabis research, explained that an animal which has been administered an electric shock after a certain noise will eventually forget about the shock after the noise appears alone for a few days. Mice without endocannabinoid systems simply never forget - they continue to cringe at the noise indefinitely.

Researchers found that people with PTSD had lower levels of anandamide (an endogenous cannabinoid compound), compared to those who did not show signs of PTSD. Innate to all mammals, anandamide (our inner cannabis) triggers the same receptors that are activated by THC (Tetrahydrocannabinol) and other components of the marijuana plant.

One feature of PTSD is an endocannabinoid deficiency. The body stops producing an adequate supply of endocannabinoids to fill receptor sites., This is where the cannabinoids found in marijuana may play a therapeutic role by replenishing these missing endocannabinoids. Researchers think marijuana pharmaceuticals might bring PTSD patients relief from their unpleasant memories.

Acta Psychiatrica Scandinavica (Scandanavian Psychiatric Journal) says: “We propose that the endocannaboid system, which is homoeostatic in cortical excitation and inhibition, is dysfunctional in mood and related disorders. Anandamide, tetrahydrocannabinol (THC) and Cannabidiol (CBD) variously combine antidepressant, antipsychotic, anxiolytic, analgesic, anticonvulsant actions, suggesting a therapeutic potential in mood and related disorders.

Treatment:
According to “Expert Opinion On Investigational Drugs” (a monthly peer-reviewed medical journal covering developments in pharmaceutical research): “There is currently no effective pharmacotherapy for PTSD and therefore the discovery of novel, evidence-based treatments is particularly important”.

Over the years, doctors have slowly begun to realize that psychiatric drugs commonly prescribed for conditions such as anxiety or depression provide little relief to individuals affected by post-traumatic stress disorder. Having taken notice of the astounding numbers of patients finding relief by using Cannabis products, psychiatrists and neuroscientists are attempting to explain how cannabis might help patients with PTSD.

Scientists have determined that normal CB-1 receptor signaling deactivates traumatic memories and endows the brain with the gift of forgetting., Skewed CB-1 signaling, due to endocannabinoid deficits (low serum levels of anandamide), results in impaired fear extinction, aversive memory consolidation, and chronic anxiety, the hallmarks of PTSD.

CBD, a non-psychoactive component found in many strains of cannabis, interacts with the serotonin system in a certain area of the brain in a way that disrupts the formation of negative associative memories.

Studies (Reviews):
New Mexico Study:

Background: New Mexico was the first state to list post-traumatic stress disorder (PTSD) as a condition for the use of medical cannabis. There are no published studies, just case reports and “reviews.” These describe the effects of cannabis on PTSD symptoms. The purpose of the New Mexico “review” was to report and statistically analyze psychometric data on PTSD symptoms collected during 80 psychiatric evaluations of patients applying to the New Mexico Medical Cannabis Program from 2009 to 2011.

Methods: The Clinician Administered Post-Traumatic Scale (CAPS-the gold standard for measuring subjective symptoms in PTSD) was administered retrospectively and symptom scores were then collected and compared in a retrospective chart review of the first 80 patients evaluated.

Results: Greater than 75% reduction in CAPS symptom scores were reported when patients were using cannabis compared to when they were not.

Conclusions: Cannabis is associated with reductions in PTSD symptoms in most patients, and a prospective, placebo-controlled study is needed to determine efficacy of cannabis and its constituents in treating PTSD.

New York University has shown how people suffering from PTSD actually have lower levels of endocannabinoids in their body, and in turn have more cannabinoid receptors to compensate.

Previous research from Brazil has shown that THC, or tetrahydrocannabinol, the psychoactive component in cannabis, is even more potent than CBD at disrupting contextual fear memory reconsolidation. Their experiment also showed that CBD and THC administered together could potentially provide relief for PTSD with minimal psychological side effects.