Prevention Is the Best Medicine—for all Medical Issues, Including PTSD

[Dr. Michael Roy] Everybody should be hypervigilant and so forth after a life-threatening event. But the resilient person— those symptoms go away after a week or two. Those who have persistance of the symptoms over time have PTSD. In the military, we often see a little different picture than that kind of classic pattern we see in civilians. I think that is because for military they have to be hypervigilant for like the whole time they're deployed. There's just no escape from that life-threatening environment. It's protective for them to kind of sleep with one eye open. Then when they leave the combat theater, they come back home— there are a lot of positive things. They're back with family. They're back with loved ones. Even if they got injured and they're in the hospital— there's are a lot of other positive things. There are people coming around. They're being taken good care of. They're safe. So often they don't report symptoms when they first come back. I think in many cases—even if they kind of notice that they have some symptoms— they tend to under report them. They say, "Yeah. Well I have that, but it's going to get better. I feel like it's going to go away. I'm back home. Everything's going to be okay." So they don't really report all their symptoms. But then two, three months or more down the road, they say, "Gee. Things are not getting better. I need some help." That's when they come in. That's when they acknowledge the symptoms. But what if we could do these physiology measures or do the imaging or something when they first come back? We could catch them when they're in that honeymoon period where they're not really acknowledging all the symptoms. But if we can identify them at that point, then we could intervene early, before they develop full PTSD— prevent it from ever occurring. That's probably going to be much better than waiting for it to happen and try to treat it after the fact. Well that's what we do with other things. We treat high cholesterol. We treat high blood pressure. We treat diabetes. We don't wait for somebody to develop heart disease and then try to treat them because that doesn't work as well. Some people die of heart attacks. It's just much harder to deal with when you already have all that atherosclerosis built up in the arteries. You can think of this as the same way. If we can prevent them from going onto all the features of PTSD, that's probably going to be the best thing. That old saying, "Prevention is the best medicine." I think it's true.

Like treating heart disease before a heart attack, says Michael Roy, MD, Col. (Ret.), treating symptoms like anxiety and hypervigilance before they may become part of a full PTSD diagnosis makes the most sense.

Michael Roy

Michael Roy, MD, Col. (Ret.) is professor of Medicine and director of the Division of Military Internal Medicine at Uniformed Services University and director of Recruitment for USU's Center for Neuroscience and Regenerative Medicine.

Posted on BrainLine May 28, 2013.

Produced by Victoria Tilney McDonough, Justin Rhodes, and Erica Queen, BrainLine.