Transcription:

RadioMD Presents:HER Radio | Original Air Date: March 19, 2015
Host: Michelle King Robson & Pam Peeke, MD

Dr. Pam Peeke, New York Times best-selling author and founder of the Peeke Performance Center, and Michelle King Robson, leading women's advocate, entrepreneur and founder of EmpowHER.com host the show everyone's talking about. It's time for HER Radio.

PAM: PTSD is all over the news. Everywhere. You know, this whole issue of PTSD especially when it comes to our wonderful veterans coming from their military duty and their tours. There's a lot written about men and PTSD. We've heard about suicide rates absolutely escalating because of this condition.

MICHELLE: Off the charts now.

PAM: Oh, yes. But, what about women?

MICHELLE: I know. Who would have thought, right? Who would have thought?

PAM: Yes.

MICHELLE: You know, everybody suffers.

PAM: Well, you know, there's now been written a lot of new information, especially appearing in the headlines about women, who, coming back especially from military duty, and their struggles with PTSD. There's no one on the planet better to discuss this with us and help guide us and advise us than Norman Rosenthal. Dr. Rosenthal is one of our dearest "go to" people when it comes to all things understanding the mental health conditions that we see, especially in women.

So, Dr. Rosenthal, welcome back to HER Radio. So, tell us, first. What is PTSD? And, is there a difference between how it's experienced between and men?

ROSENTHAL: Yes. Yes. PTSD is a cluster of symptoms that people have—some people—after they have experienced severe trauma. It's as though many people can get over the trauma, but when you have PTSD, you just can't. So, it can either go underground and you can withdraw and be zoned out, spaced out and just not there. Or, it can manifest in a more flagrant way in terms of flashbacks, nightmares, vigilance, jumpiness and you can end up using drugs or drinking to try and quash the symptoms, but it really interferes with a person's life and that's when that person needs to go and seek some help because they're not naturally metabolizing the trauma.

MICHELLE: So, what causes the PTSD? I mean, I think that you've explained it as trauma. It's suppression of things that have happened in our lives. Are women more likely than men to experience PTSD, Norm?

ROSENTHAL: Absolutely. It's more than twice as common in women than in men.

PAM: Oh, wow.

ROSENTHAL: In women, it's 10% and in men it's just about 4%. Now, some of that might be a reporting difference in that men don't like to talk. Men don't like to complain. But, I think it's a real difference and large proportion of that may be due to sexual assault to which women are, unfortunately, much more commonly the victim. That is such a huge invasion that it's really hard to get over it, as they say.

PAM: Hmm. When I'm listening to this, I want to make sure that HER Radioland knows that we are talking to Dr. Norman Rosenthal who is a world-renowned psychiatrist and New York Times best-selling author. He wrote one particular book which I just love. I mean, lord knows he's written a number of them, but The Gift of Adversity really speaks to a lot of what we're talking about today with his own manifestations of trauma in his life and how he's dealt with it. So, I want to make sure everyone knows about his book as well as his website, NormanRosenthal.com.

So, getting back to the PTSD issue, women are more vulnerable. You know, I'm sitting back and Michelle and I both—our jaws hit the floor. We didn't realize it was that much more prevalent. Now, you've mentioned some caveats and maybe some reasons why, but innately, in terms of women's mental health, aren't we much more likely to experience anxiety, for instance, Norm?

ROSENTHAL: Yes. Anxiety and depression are more common in women and a history of any kind of mental health issues makes you more likely to get PTSD if you are traumatized. So, that could be an important link. The serotonin system in the brain where vulnerabilities can cause anxietal depression is thought, sometimes, to be less robust in women as compared with men. But, I think the sexual assault business has to be remembered, more likely than other injuries, to cause PTSD.

MICHELLE: I so agree with you because I've got a friend who's actually a therapist and she was sexually assaulted when she was a little girl and it didn't come out until she was in her 40's. She suppressed it. She suffered from PTSD for all those years and didn't know it. So, she's become a psychologist because of it. When would a person suspect? Like, in her case, she suppressed it, so she didn't remember it. When should a person, if they're suffering from PTSD, when do they suspect that they're suffering?

ROSENTHAL: You know, that's a great question because when it's so obvious, it's out there for all to see. When you've got a veteran who's gone over an IAD in Iraq and he comes home and he's jumping every time there's a loud noise or a Vietnam vet. I recall a story. He was having his wedding photo with his wife and a car drove by and there was a loud explosion from the car, maybe it backfired or something. The guy dove flat down in the mud in a tuxedo. So, when you see that kind of thing, that's very florid, but I think what PTSD often does is it shuts you down. So, what may happen, for example, just take women. They may just not be interested in sex or not be interested in intimacy. There may be avoidance. It may be this matrix of associations with an injury, this sexual injury, that just makes them want to avoid that whole area. So, I would say to people listening out there, don't just wait for these florid symptoms that are more obvious. Wait for symptoms facing out, what's called dissociation. It's very common with PTSD. People who just zone out because they have learned that that's one way of comforting themselves. They learn to go into these spacey states. That gets them away from the pain, but interferes with intimacy and relationships. So, whenever there are problems with intimacy, with relationships, with physical intimacy, always consider that as a possibility.

PAM: I think that that is so valuable.

MICHELLE: Good advice.

PAM: It's so funny. I had just seen American Sniper and, lord knows, PTSD was all over that one and I saw its manifestations. But really trying to go back to the woman piece of this, women, I think. would get lost in care-giving and everything else. Also, they would also self-soothe with self-destructive behaviors. So, very briefly, in just a minute, tell us the treatments for PTSD for a woman.

ROSENTHAL: Well, treatments out there involve cognitive behavior treatments as being widely used. Helping a woman think--because she might have gotten assaulted in a car-- desensitize her to getting back in a car and driving, but only in safe areas. Not in the dangerous part of town. So, somehow helping the person. Cognitive behavioral interventions can be very helpful. Medicines can help to some degree for anxiety and depression that's often associated with PTSD, but one thing that has impressed me is the potential role of meditation.

PAM: Oh. Meditation. There you go. It's going to be a big one. This is why, Dr. Rosenthal, I want to make sure everyone out there knows that Dr. Norman Rosenthal, our "go to" person has written, Transcendence, which is all about meditation and anxiety. One, in particular, and that's transcendental meditation. It's a New York Times best seller, in addition to The Gift of Adversity.

Dr. Rosenthal, thank you so much for helping us understand PTSD in women's health. I'm Dr. Pam Peeke with Michelle King Robson.

MICHELLE: You're listening to HER Radio on RadioMD. Follow us on Twitter. Like us on Facebook. Stay well.