Post-traumatic stress disorder and accelerated ageing – is there a connection?

It has long been no secret that stress in its various manifestations can negatively affect the human body. According to research, a lot of stress in life is associated with the acceleration of biological ageing, even in young, healthy people. At the same time, the connection between ageing and such a disease as post-traumatic stress disorder (PTSD), a widespread but underdiagnosed phenomenon whose impact on the ageing process is much higher, remains poorly researched. Therefore, we will consider what PTSD is and how to reduce its negative effect on the body.

What is PTSD?

Posttraumatic stress disorder (PTSD) is a type of anxiety, a syndrome that results from exposure to real or threatened death, serious injury, or sexual assault (1). Following the traumatic event, PTSD is common and is one of the serious health concerns that is associated with comorbidity, functional impairment, and increased mortality with suicidal ideations and attempts. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has included PTSD in the new category of Trauma- and Stress-related Disorders.

The symptoms of PTSD include persistently re-experiencing the traumatic event, intrusive thoughts, nightmares, flashbacks, dissociation (detachment from oneself or reality), intense negative emotions (sadness, guilt), and physiological reaction to being exposed to the traumatic reminder (2). Furthermore, problems with sleep and concentration, irritability, increased reactivity, increased startle response, hypervigilance, and avoidance of traumatic triggers also occur. There is a significant impairment in social, occupational, and other areas of functioning. However, the symptoms of PTSD overlap with acute stress disorder (3). For a patient to be diagnosed with PTSD, the duration of the symptoms must be more than one month.

PTSD is the highest level of stress?

At a first sight, it seems that PTSD is a severe version of stress but there are a lot of differences between these two disorders. Even acute stress disorder refers to the initial traumatic symptoms that arise immediately after a traumatic event, while PTSD refers to the long-term aftermath of trauma. Secondly, they differ in the body’s chemical reactions and the hormones released. During stress our organism is guided by the “fight or flight” rule, especially in the first stages of stress, there is a burst of stress hormones – cortisol, adrenalin, etc. While during PTSD people mostly feel apathy, and the level of stress hormones is critically low.

Although medical professionals previously categorized PTSD to originate from one traumatic event, they now recognize that continuous exposure to stressful situations, or cumulative stress, can also cause symptoms of PTSD. This is referred to as complex PTSD, prolonged duress stress disorder (PDSD), or rolling PTSD.

According to the National Center for PTSD, posttraumatic stress disorder, about 8 million Americans have PTSD during any given year. And for example, in Ukraine due to war this amount is much higher! While the signs of PTSD in women don’t differ greatly from signs of PTSD in men, women are more likely to develop PTSD, with a lifetime incidence of 1 in 10. For men, it’s 1 in 25.

Dr. Chad Wetterneck, PhD, clinical supervisor for Rogers Behavioral Health (4) claims that PTSD is a mental health diagnosis characterized by five events or symptoms:

1. A life-threatening event. This includes a perceived-to-be life-threatening event. Whether or not it is, it’s really about the perception of the person who experienced or witnessed the event that it could happen to them again.
2. Internal reminders of a traumatic event. These signs of trauma typically present as nightmares or flashbacks. It’s important to realize that these are not simply memories. They are unwanted, intrusive episodes in which a person feels as though they are in a life-threatening situation again – like they’re watching a movie or seeing it unfold in front of them. It feels very real to them.
3. Avoidance of external reminders. Those with PTSD often do whatever they can to not think about their traumatic event, to suppress the feelings associated with it. They might avoid alleys if they were assaulted in one, or they might refuse to drive if they were in a car accident.
4. Altered anxiety state. PTSD can leave people feeling on edge and looking out for danger (hypervigilance). What it boils down to is that people feel more anxious. Their startle response is exaggerated. They’re jumpy or looking over their shoulder more often. It’s a physical sign of PTSD and a reaction to the body’s increased anxiety and the need to be aware of possible threats.
5. Changes in mood or thinking. People with PTSD can see the world as a very dangerous place. And because they focus on protecting themselves from it, it’s often difficult for them to go out in public. The isolation can lead to depression, or sometimes a person may act in an opposite way when they see no future. In that case, they may take more risks or engage in risky behaviours.

Does PTSD accelerate ageing?

A study conducted by American experts at the University of California showed that stress disorder that occurs after injury provokes accelerated ageing (5). Post-traumatic stress disorder (PTSD) includes disorders such as insomnia, depression, loss of appetite or bulimia, and irritability. After analyzing data from many studies since 2000, scientists have found a link between PTSD and ageing. From this, scientists concluded that PTSD is a much more serious problem than was previously believed.

According to another research, there may be a need to re-conceptualize PTSD beyond the boundaries of mental illness, and instead as a full systemic disorder and premature ageing (6). They confirmed that PTSD is associated with biomarkers of senescence appearance (leukocyte telomere length and pro-inflammatory markers), the prevalence of senescence-associated medical conditions, and high mortality rates. The majority of reviewed studies also indicated increased medical comorbidity among several targeted conditions known to be associated with normal ageing, including cardiovascular disease, type 2 diabetes mellitus, gastrointestinal ulcer disease, and dementia. In short, evidence from multiple lines of investigation suggests that PTSD may be associated with a phenotype of accelerated senescence.

What is the key to ageing?

Recently scientists at the Boston University School of Medicine in the United States have proven that PTSD can cause accelerated brain ageing in humans. This happens if a person has a special variant of the klotho gene associated with longevity (7). The klotho gene is well known as a biomarker for cellular ageing and age-related health problems. The association of this gene with Alzheimer’s disease, cognitive impairment, and the health of brain tissue is now being actively studied. Increased klotho activity is known to have a protective effect against cognitive decline in the elderly. On the other hand, traumatic stresses promote cellular ageing and increase the biological (epigenetic) age of a person. Also, it was shown that PTSD affected inflammation, cardiometabolic disease, and neurodegeneration, including that characteristic of Alzheimer’s disease.

Other widely researched items connected to senescence are the telomer’s shortening, inflammatory disorders, raised the level of oxidative stress, changes in macrophage state (M1/M2), disturbances in the apoptosis process and immune disorders, and appearance of so-called senescence cells.

How fight PTSD and prolong youthfulness?

Recently scientists claimed that there is no cure for PTSD. But not long-ago scientists claimed sertraline and paroxetine are the only medications approved by the FDA for PTSD. While these medicaments have a long list of side effects and can cause even a severe state in patients (8). So, they are prescribed with caution.

In different studies, it has been proved that senolytic therapy is one of the most prospective approaches for age-related pathology control and longevity, and PTSD prevention and treatment. The most known senolitycs are natural speeches like Q10 (9), NADH (10), Quercetin (11), Fisetin (12), Luteolin (13), Curcumin (14), Piperlongumine (15), cardiac glycosides: Ouabain,  Digoxin, and others (16; 17).

There is information that klotho gene expression can be regulated by vitamin D (18). Regulation occurs in cell lines from the kidney proximal, distal, and collecting tubules. This way adequate doses of vitamin D counter-regulatory actions in the kidney, possibly exerting anti-ageing effects.

This way senolytics appear to restore pro-genitor dysfunction, attenuate tissue inflammation and alleviate age- and disease-related metabolic dysfunction across cell types and tissues (19). Today most of them are presented as different supplements: Multi EM Ferment®, NADH Original Instant Power®, Neotosil®, and many others. These products appear to delay, prevent or alleviate multiple age-related conditions and chronic diseases and enhance health span and lifespan in experimental animals. Therefore, these agents could lead to interventions for humans that delay, prevent or treat senescence- and age-related conditions, and help in stress and PTSD conditions.

Reference

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