PTSD and cancer

“I think the hardest part of cancer treatment is at the end – when everyone assumes you’re “cured” and you no longer need their help. You’re in your weakest, most devastated state, plus you no longer have the mission you had when you began this journey; to kill the cancer. The cancer is toast, but so are you, and now, like a soldier at the end of the war, you need help putting yourself back together, only everyone has gone home since they assume the war has been won” – Anonymous.

Before you feel affronted I am not referring to you, my friends or family who have been more loyal than even my dog when I am eating my third sixth meal of the day. And I want to say upfront I don’t think I suffered badly from PTSD; stress at work yes, but that’s a whole different story for another day.

But reading that quote made me feel sad. Too many people feel like this. So I wanted to try and understand why.

Traumatic stress is getting a lot of attention and research at the moment. In other words, understanding why some people who cope well at the time of a traumatic experience, become unwell at a later date. It might explain why this quote had such an impact with my group of friends.

Our brains are wired to protect us in a life threatening situation but this can mean some of our memories get the supersize treatment whilst other vital information gets lost down the inside of our skull. That’s got to have a lasting effect.

This is how I have understood and interpreted what happens in our brains. There are 3 main things which happen when experiencing any kind of trauma (with thanks to Time magazine and apologies to any neuroscientists for dipping in and out of the brain like a sherbet dib dab);

1. The prefrontal cortex stage – the CEO of your brain if you wish. When it is working well it does the job of focusing attention well on areas we choose, being rational and stopping ourselves from being too impulsive, like telling the Finance Director what we really think of them, for example. You will be using this prefrontal cortex right now to read this article. But when we are under threat, this part of our brain goes AWOL. It get’s shut down by all those stress chemicals. Yep, it goes to the pub and as a result we find it more difficult to make sense of the world or even remember or recall things in a rational way.

2. Then at some point, FEAR kicks in. Faced with a slurred prefrontal cortex he buddies up with the fear circuitry or to be precise the amygdala. For reference, let’s call this young pretender, the inexperienced but super keen graduate. And it will highjack your attention and decide where you should focus thank you very much. And these are not always useful things. It might be crazy details like in my case the surgical instruments to put me to sleep or the paper knickers. But whatever your ‘graduate’ decides you need to focus on gets hard wired into your memory as your brain is now in super efficient coding state during this period.

3. This young graduate employee, aka the fear circuitry then mucks around with another important area of your brain, the hippocampus. I told you he was inexperienced. This makes your hippocampus behave like an employee just before he is put on a PIP (performance improvement plan). You might prefer to call him a sales man, I couldn’t possibly comment. But when the wrong button is pressed in this hippocampus, your brain will have difficulty encoding memory and remembering contextual information. For example like what was going on during this trauma. And to make matters worse, it gets the time sequencing out of order. So whatever you do, don’t expect an accurate account afterwards.

So what does all this mean? How long lasting is it? What triggers it off again? And what do we do about it?

Well I am not qualified to answer any of those biggies, but the current thinking seems to be a combination of CBT, Pyschotherapy, medications and support groups. But at the very least, it does explain why it is so difficult to scrub away those traumatic ‘supersized’ memories and why we might not be as coherent about facts, dates and figures as we used to be.

So assuming you can put yourself back together again physically and mentally, the next challenge is coming up with a new mission.

Till next time x

P.S. just had another clear scan, 18 months and counting. Thank you as ever for your patience, love and support.