February 18, 2023

Healing PTSD Before Surgery

Medical PTSD is a condition that can impact patients before, during, and after surgery. Some call it surgery PTSD when it occurs before, during, or after the operating room. It is caused by traumatic memories that are not correctly consolidated in the brain, making them more intense and difficult to process. The diagnosis of medical PTSD can be challenging due to anesthesia, sedatives, pain medications, sleep cycle disruptions, and other factors that can interfere with memory formation. Patients are also vulnerable in medical settings, particularly if they lack advocates to speak up for them. It is important to address medical PTSD before surgery to improve outcomes and promote recovery. Symptoms of medical PTSD can include flashbacks, nightmares, and avoidance behaviors.

Here's what we'll discuss:

  • What is PTSD: dysregulated memory consolidation
  • Medical PTSD: sometimes it's harder to diagnose because of medications, sedatives, anesthesia, sleep cycle disruptions that occur in medical settings (meds can interfere with our memories and make it harder to diagnose)
  • Furthermore, we're extra vulnerable in medical settings, especially if we don't have advocates to speak up for us when we're sick.
  • Dissociative states are destructive coping mechanisms when used long term.
  • Trauma focused psychotherapy includes effective treatments like prolonged exposure, cognitive processing therapy, narrative exposure therapy, written exposure therapy, and EMDR. Before surgery, exposure therapy in the pre-op room, operating room, and recovery room/hospital can be powerful when guided with the anesthesiologist or surgeon.
  • Blunting the sympathetic tone associated with each of these exposures is particularly powerful because it can help the memory be less intense and thereby allow for normal consolidation.
  • Fostering certainty, confidence, and control over the surgery outcomes are important to help empower patients.
  • The greater the certainty, confidence, and control we feel, the better we are able to relive triggering events with lower risk of a poor outcome, like a panic attack or anesthesia complications.
  • Fostering curiosity, and speaking to our doctors from a place of inspirational curiosity is critical to fostering the certainty, confidence, and control over our surgery and anesthesia. Speaking to our doctors from a place of curiosity also helps better engage our doctors and relieve tensions that may otherwise arise in the doctor-patient relationship

What is Medical PTSD?

Medical PTSD is a form of PTSD that is caused by traumatic medical experiences. It can result from a wide range of medical procedures, including surgery, intensive care unit stays, and medical emergencies. PTSD is related to traumatic memories that are not correctly consolidated in the brain and not stored like normal, non-traumatic memories. This can make the memory more intense and difficult to process, leading to symptoms such as flashbacks, nightmares, and avoidance behaviors.

Can You Have PTSD From Medical Issues?

You can develop PTSD from medical issues. The experience of a traumatic medical event can lead to the development of PTSD. It is important to recognize the signs of medical PTSD and seek treatment to promote recovery.

What Are the Signs of Medical PTSD and Trauma?

The signs of medical PTSD and trauma can include flashbacks, nightmares, avoidance behaviors, anxiety, depression, and hyperarousal. These symptoms can be triggered by medical settings, surgeries, procedures, or events that are similar to the original traumatic experience. Because of how medical settings and anesthesia interfere with memory formation, symptoms may be delayed and be hard to diagnose.

How Do You Deal with Medical PTSD?

There are several effective treatments for medical PTSD, including trauma-focused psychotherapy, medication, and self-help strategies. Trauma-focused psychotherapy is a powerful tool, and includes tools such as:

  • Prolonged exposure
  • Cognitive processing therapy
  • Narrative exposure therapy
  • Written exposure therapy

These therapies can help patients process traumatic memories and reduce symptoms. Medications such as antidepressants or anti-anxiety medications can also be effective in reducing symptoms. Self-help strategies, such as mindfulness meditation, deep breathing exercises, and exercise, can also be helpful in managing symptoms of medical PTSD.

Watch the video for more detail about how these exposure-based therapies can be safe and powerful to overcome PTSD symptoms in preparation for surgery.

Can You Be Traumatized by Surgery?

Yes, surgery can be a traumatic experience that can lead to the development of PTSD. Patients may experience symptoms such as anxiety, depression, and flashbacks after surgery. It is important to recognize the signs of medical PTSD and seek treatment to promote recovery.

How to Address Medical PTSD Before Surgery

To effectively address medical PTSD before surgery, it is important to understand the condition and its causes. Patients should talk to their healthcare providers about their concerns and discuss their treatment options. Exposure therapy, which involves exposing patients to the feared situation in a safe and controlled environment, can be an effective treatment for medical PTSD. Patients can also foster certainty, confidence, and control over the surgery outcomes to help empower themselves. Additionally, speaking to doctors from a place of curiosity can help engage doctors and relieve tensions in the doctor-patient relationship.

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