Grief-enhanced Trauma-informed Care process(GTC)Grief-enhanced Trauma-informed Care process(GTC)

Development and progress of traumatic stress disorder from reversible to irreversible stages

Traumatic stress, such as PTSD, initiates complex physiological and psychological processes that have both reversible and irreversible effects on the body-mind. These changes involve psychoneuroimmunology inflammation, endothelial dysfunction, oxidative stress and autonomic nervous system impairment, atherosclerosis, persistent neuro-inflammation, development and progress of disorders and poor clinical outcomes.

Reversible Stages

  • Acute Stress Phase:
    • Heightened activation of the hypothalamic-pituitary-adrenal (HPA)axis, impairment of endothelial-dependent neurovascular function, neuromuscular dysfunction, sympathetic nervous system (SNS). Brief body-mind and psychological interventions can normalize physiological responses to such distress. For example, Short-term endothelial dysfunction caused by acute stress can reverse after resolution of the stressor.
  • Subacute Stress Phase:

    • Prolonged stress leads to sustained sympathetic activation, neuroendothelial inflammation, oxidative stress and dysregulation of social transcriptional gene expression. Recovery is possible with timely intervention, including therapy and pharmacological treatments.

Irreversible Stages

  • Chronic Stress Phase:

    • Chronic activation of the HPA axis, persistent neuroendeothelial and neuromuscular dysfunction, advanced oxidative stress damage, and sustained autonomic dysregulation leads to irreversible body-mind structural damage in response to traumatic stress. Long-term stress can cause cardiovascular diseases, neurodegeneration, metabolic dysfunctions, neuroinflammation, suicidality, comorbid psychiatric disorders and major adverse life events. Chronic PTSD patients often exhibit reduced nitric oxide bioavailability, impaired neurovascular function, increased neuroinflammation, contributing to irreversible cardiovascular disorders including coronary artery calcification, and major adverse cardiovascular events.