It’s All In Your Head
It’s so easy to say, “Well of course it is!” But it’s really not.
Though it starts up there in the noggin closet, post-traumatic stress disorder actually involves the entire body. It is a an automatic, uncontrolled physical reaction to a perceived threat that fires up the sympathetic nervous system, that half of the autonomic nervous system that pulls our fingers away from a hot flame, throws our hands out in front of us when we fall, and kicks the doctor when he taps our knee with a hammer. It involves the liver, the kidneys, and the gastrointestinal tract, too, because no one part of our bodies has as much a singular purpose as we may think.
The intellectual parts of our brains, the bits of it that you’re using right now as you read this, are actually relatively small in comparison to the whole. There are huge chunks of grey matter dedicated to processing things like auditory and visual inputs, heart rate and respiration, sexual arousal and other fun stuff, memory storage and retrieval, all things that have nothing to do with conscious thought, including the hypothalamus and the amygdala, where the threat and fear response begins.
This is all technical nit-picky junk, though, and not at all what people mean when they say, “It’s all in your head.” What they mean when they say it is that we’re being lazy. They’re saying that it’s an affectation we’ve adopted for some reason, like a hairstyle, and that we could probably be rid of it if we really wanted to. I had a boss once, who was aware of my diagnosis, and after I booked off one night because of a major panic attack, he told me the following day that I could not simply call in sick because I wanted a day off.
This is what they mean when they say that.
The reason there’s so much stigma surrounding most mental health issues is that people who’ve never dealt with it themselves cannot understand it like they could a heart attack, or the loss of a limb, even though they may never have personally experienced those, either. It’s outside of their comfortable frame of reference. In fact, post-traumatic stress disorder is very much like both of those things. There are physical changes in the body, wounds and injuries both cellular and organ-wide, that scar over and never return to proper, previous, form or function. Through extensive effort, we can manage the effects, learn to walk properly again as if with a prosthetic, or adopt lifestyle changes to keep from overexerting a diseased heart, but the wound will always be there.
If you have PTSD and you’re reading this, you’re probably nodding your head by now. If you’re reading this but have never suffered that injury or the disorder that comes from it (the two terms are not mutually exclusive, by the way), consider replacing the term mental health issue with horrible shark attack in your own head, and maybe then it might make more sense.
For a more detailed description of the various other body parts involved, check out Anatomy of an Anxiety Attack. It has pretty pictures.
Be sure to read Common Misconceptions About PTSD Part I, too.