People who experience a mini-stroke, often called a transient ischemic attack (TIA), have an increased risk of developing post-traumatic stress disorder, a new study finds. A TIA temporarily triggers a stroke-causing blockage in one of the arteries feeding blood to the brain. In a study published in October 2014 in the American Heart Association journal Stroke, a team of German and British researchers investigated the role that the experience of a transient ischemic attack can play in increasing any given person’s chances of developing a diagnosable case of post-traumatic stress disorder (PTSD), a mental health condition normally associated with exposure to other types of emotionally traumatic experiences.
Transient Ischemic Attack
Most strokes occur when a plaque deposit or some other form of obstruction blocks the normal flow of oxygen-rich blood to the brain’s vital tissues. The term for this type of stroke is an ischemic stroke (which differs in mechanism from a second type of stroke called a hemorrhagic or “bleeding” stroke). Before an artery completely closes and a true ischemic stroke occurs, some people experience warning signs called transient ischemic attacks, which occur when a blockage forms inside an artery but does not remain for long. While a TIA can last as long as five minutes, most of these temporary blockages resolve in about 60 seconds. Because of the short duration of a transient ischemic attack, most people don’t experience the brain damage associated with an ischemic stroke or a hemorrhagic stroke. When they first arise, transient ischemic attacks produce the same initial symptoms as a true stroke, and no one can tell in advance if a person is experiencing relatively harmless TIA symptoms or potentially catastrophic stroke symptoms. In addition, within a period of 365 days, roughly 33 percent of all people who experience a transient ischemic attack progress to a full stroke. For these reasons, doctors treat TIAs and strokes with equal seriousness.
Mental health professionals and other doctors can officially diagnose the presence of post-traumatic stress disorder in a person who experiences certain symptoms 30 days or more after exposure to a potentially life-threatening form of physical/emotional trauma. Classic PTSD symptoms include such things as unwanted and uncontrollable reliving of the original traumatic experience, a steep increase in negative daily mental states, a compelling urge to stay away from any reminders of a traumatic experience and loss of the normal ability to shut down the body’s “fight-or-flight” reaction. Roughly one in five women exposed to life-threatening trauma will develop PTSD; about 8 percent of men exposed to such trauma will develop the disorder.
Mini-Strokes Linked to Onset of PTSD
Most people associate the onset of post-traumatic stress disorder with exposure to sources of trauma such as combat or rape or other forms of sexual assault. In the study published in Stroke, researchers from Germany’s Friedrich-Alexander University Erlangen-Nuremberg and the United Kingdom’s University of Liverpool investigated the connection between transient ischemic attacks and PTSD with the help of 108 German adults. The researchers undertook this project, in part, because few researchers have analyzed the post-traumatic stress disorder rate in people who experience TIAs. The researchers concluded that roughly one-third of the study participants who experienced a transient ischemic attack subsequently developed diagnosable PTSD symptoms. This PTSD rate is approximately 900 percent higher than the rate found among all German adults. The researchers also concluded that more than one out of every 10 TIA-affected individuals experienced a significant downturn in mental well-being; in addition, roughly 7 percent of the TIA survivors experienced a significant downturn in their physical well-being. Specific additional mental health problems found in those individuals diagnosed with PTSD included potentially diagnosable anxiety symptoms and potentially diagnosable depression symptoms. The study’s authors largely attribute the increased PTSD rate in transient ischemic attack victims to three main factors: an outsized fear of progressing from a TIA to a stroke, lack of effective methods of dealing with the stress of TIA-related changes in physical health and relatively young age at the onset of a transient ischemic attack. They believe that doctors can take several steps to reduce the stress levels of people who experience transient ischemic attacks. These steps include improved doctor-to-patient explanation of the stroke risks in people who go through a TIA and improvement of the stress coping skills in people who experience these attacks.