STRESS AND MENTAL ILLNESS: POST-TRAUMATIC STRESS DISORDER AND DEPRESSION
Early childhood trauma, such as parental loss, physical or sexual abuse, or neglect, increases the risk of later mental disorders, including post-traumatic stress disorder (PTSD) and depression. Post-traumatic stress disorder is mediated in part via HPA-axis dysfunction. It is characterized by "intrusive re-experiencing," autonomic hyperarousal, reduced responsiveness, intense emotional reactions, sleep problems, learning difficulties, memory disturbances, dissociation, aggression against self and others, and psychosomatic reactions. Many of these symptoms are signs of an overactive amygdale which is located in the brain's medial temporal lobe and is believed to play a key role in the emotions.
Acutely, patients feel as though the trauma were recurring. They experience sleep disturbances, increased vigilance, exaggerated startle response, and generalized anxiety or agitation. Chronically, children exhibit detachment, restricted range of affect, dissociative episodes, sadness, somatization (psychological needs expressed as physical symptoms), and feelings of hopelessness. Many of these characteristics have been described in institutionalized and post-institutionalized children. This condition is underrecognized in post-adoption. Sometimes PTSD is complicated by the coexistence of mood, psychotic or other anxiety disorders, suicidal ideation, learning disabilities, or attentional difficulties.