When subjected to similar types of trauma, women are several times more likely to be diagnosed with post-traumatic stress disorder (PTSD) later on than men. It has been known for quite some time that women have an elevated risk for this chronic life-altering condition, but new research has quantified this risk and found it to be even more significant than had previously been assumed. In a presentation given at the 2015 Conference of the Anxiety and Depression Association of America, researchers from Emory University in Atlanta reported on their research into the incidence of PTSD among recent trauma victims. They recruited more than 100 women who had recently experienced stressful life events with known connections to the disorder, along with a control group of men who had undergone comparable trauma. At intervals of one and three months after the traumatic events, each study participant was examined in a clinical setting to see if a PTSD diagnosis was appropriate. The researchers had little doubt they would find more women reporting symptoms associated with PTSD. But the differences between the two genders were monumental: after one month, female trauma victims were 10 times more likely to receive a PTSD diagnosis than male victims, and after three months they were five times more likely to suffer from the disorder. Even among study participants who did not surpass the diagnosis threshold, troubling symptoms were far more evident, making it crystal clear that women were reacting to trauma much more intensely than their male counterparts. None of this is shocking, since the contention that women are more vulnerable to PTSD than men has been accepted as a medical fact for a long time. But until this study, it was difficult to determine how much greater the risk really was—and this research answers that question and reveals how susceptible traumatized women are to developing a persistent and chronic hyper-stress response.
Biochemistry of Stress in Women
The facts about gender and PTSD cry out for an explanation. Interestingly, some of the best data on the subject comes from research sponsored by the very same institution responsible for the study just discussed. Back in 2011, another team of scientists from Emory University performed biochemical studies on PTSD sufferers, and they uncovered a connection between the disorder and an excess of a brain cell protein called pituitary adenylate cyclase-activating polypeptide, or PACAP for short. However, the association they found only applied to women. Men with an excess of this pituitary gland secretion were no more likely to develop PTSD than anyone else. PACAP is known to mediate the body and brain’s reaction to stress, so this is exactly the sort of biochemical relationship that researchers would expect to find in victims of a stress-related disorder. The Emory researchers involved in this study discovered something else significant in the women they examined. In addition to changes in PACAP levels, they also found variations in a gene that codes for a brain receptor called PAC, which binds with PACAP and helps regulate the intensity of the stress response. It appears this change causes an increase in brain sensitivity to the presence of PACAP, and what is really interesting is that this particular genetic variation is not present at birth but is an evolutionary response to frequent or intense stress exposures. In other words, it represents a learned response, suggesting that those with this variation have trained their brains to respond more quickly and more strongly to stress and the type of anxiety-causing triggers that can lead to the development of PTSD. Once again, the biochemical association discovered applied to women and not to men, whose incidence of PTSD was not determined by either the presence of excess PACAP or altered function in PAC receptors. But in women it seems a negative feedback loop can develop: a specific chemical that intensifies the experience of stress is produced in abundance following exposure to trauma, and in turn the presence of that chemical helps provoke genetic changes that ensure that chemical will have a stronger effect than would normally be the case. In a sense, it is as if the brain—in women—becomes addicted to the chemicals produced by a heightened stress response and makes adjustments to guarantee the brain’s stress cravings can be more readily and easily satisfied.
It’s All in the Mind: Learning to Overcome PTSD
Biochemical imbalances aside, the good news is that victims of PTSD can and do respond well to therapy and treatment. The chances of improvement following a diagnosis of PTSD are quite good, as long as sufferers get the help they need as soon as it becomes clear the symptoms of this disorder are beginning to disrupt their lives. Just as the brain is trained to overreact to potential stressors, so too can it be re-trained to respond in a more appropriate and controllable manner. Eventually a new immunity can be developed, protecting a formerly vulnerable man or woman against the triggers that brought on episodes of PTSD in the past.