Mental Wounds: The world after Lister

VANDENBERG AIR FORCE BASE, Calif. -- One hundred and thirty years ago, almost 50 percent of the patients undergoing major surgery died from infection. Dr. Joseph Lister was the first to treat wounds with dressings soaked in carbolic acid. Dr. Lister and Dr. Louis Pasteur suggested surgeons wash their hands and sterilize their instruments before operating. The medical community in Britain and the United States initially shunned them. Drs. Lister and Pasteur were personal friends. When his medical peers publicly honored Dr. Pasteur at age 70, he turned and bowed his head towards Dr. Lister, saying: "The future belongs to him who has done the most for suffering humanity."

Sufferers of mental wounds
Today we all understand the importance of keeping wounds clean. Unfortunately our views on "mental illness" are much like those of the peers of Drs. Lister and Pasteur 130 years ago. Recently, startling advances have been made in understanding "mental disease."

J. Douglas Bremner, M.D. of Yale University School of Medicine, Departments of Diagnostic Radiology and Psychiatry was commissioned by a number of organizations including the National Institute of Health to study the long-term effect of trauma on the brain. Dr. Bremner concluded, "Individuals with a history of exposure to childhood abuse or combat had a reduction in volume of a brain area involved in learning and memory called the hippocampus, which is felt to be related to stress, with associated deficits in hippocampal-based learning and memory." In plain English, extreme stressors can have lasting effects on the areas of the brain that are used for memory and emotional control. 

These are not chemical changes, but actual reductions the in size of the brain. Dr. Bremner used magnetic resonance imaging, or MRI, on combat veterans diagnosed with Post Traumatic Stress Disorder and found them to have an 8-percent reduction in right hippocampal volume and a 12-percent reduction in left hippocampal volume. Two subsequent studies confirmed Dr. Bremner's original findings.

In other studies, patients were provided a stimulus or cue that provoked traumatic memories. Using positron emission tomography, or PET, these studies revealed dysfunction of the medial prefrontal cortex and hippocampus portions of the brain when traumatic memories were evoked.

Sympathy for those in pain
Forty million women and about one-third that number of men in the United States report rape, attempted rape, or molestation prior to their 18th birthday. Add a myriad of other traumas and it is no wonder we are experiencing an avalanche of problem in today's society, and our military services. 

Much of what in the past has been attributed to the lack of ability to "suck it up" is in fact caused by a physical alteration of the brain. Telling a person who has experienced repeated trauma to "get over it" is the equivalent of telling a blind person you could see if you just really tried. 

It is time for 21st century people to begin to understand that what has been labeled "mental illness" is in fact often a physical illness, just like diabetes, cancer, or pneumonia.