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People with PTSD May Have Overactive ‘Fight or Flight’ Response

U.S. Air Force photo by Airman 1st Class Joshua Magbanua

Imagine you are in a life-threatening situation. You survey your surroundings and play out various scenarios in your mind. You have seconds to decide how to protect yourself. Do you run away or do you fight your way to safety? How you react to this situation is your intuitive “fight or flight” response.

What is ‘Fight or Flight’?

Your fight or flight response occurs when tough situations or stressors challenge or threaten your mind and body. Although the fight or flight response is “normal”, service members and combat veterans with posttraumatic stress disorder (PTSD) may have an elevated fight or flight response.

Lt. Cmdr. Jorielle Houston, chief of the practice based implementation network for the Deployment Health Clinical Center, said that the fight or flight response is also referred to as acute stress response.

“It is our body’s reaction to determine if we need to fight, or flee,” she said. “A series of neural (brain) and physiological (body) mechanisms rapidly activate the nervous system to release stress hormones (adrenaline) that helps us mobilize and avoid harm.”

Depending on the situation, Houston said, our body can react in two ways: You can either confront the situation or escape it.

“It is an adaptive, instinctive response,” she said.

Impact on People with PTSD

According to Houston, a PTSD diagnosis falls under the category of trauma and stress-related disorders. People diagnosed with PTSD may:

  • Persistently re-experience the traumatic event (nightmares, flashbacks or some other physical or emotional distress)
  • Avoid trauma-related stimuli
  • Experience negative thoughts or feelings that begin or worsen after the trauma
  • Have trauma-related arousal and reactivity

These experiences, and common low-level stressors, can cause additional health concerns for someone with PTSD.

“When a separate stress reaction happens, people with PTSD are likely to have an increased fight or flight response,” Houston said. “Research suggests that combat veterans have overactive fight or flight responses, which means higher adrenaline levels and less control of their heart rate in response to blood pressure changes.”

In simpler terms, a person with PTSD in a state of chronic stress is like an engine that is idling too high for too long – after a while the engine will stop performing properly. According to Houston, potential health issues from long-term acute stress include high blood pressure, heart disease and stroke.

Family Support

Family members and loved ones provide crucial support for a service member coping with PTSD. Houston encourages families to talk openly and discuss ways they can support their service member coping with trauma.

“Learn what their triggers are,” said Houston. “Learn breathing techniques; engage in physical activity; ensure they have somebody to talk to.”

More About PTSD

  • Learn the basics:  PTSD 101 provides an overview of what PTSD is and available treatment options.
  • Hear from others: AfterDeployment shares a video of a Marine veteran who describes his trauma triggers, the "fight-or-flight" response, and the effects it has on him.
  • Take a deep breath: The National Center for Telehealth & Technology Breathe2Relax app can help you learn basic breathing skills to help reduce PTSD symptoms.
  • Manage symptoms: PTSD Coach is a mobile app that helps with coping skills while working with a health care provider.
  • Ask for help: The DCoE Outreach Center is available 24/7 to help service members and their families.

Comments (10)

  • I am having problems for some time now of sleeping, anxiety, depressing and just living with hopes of getting better but they all turns out to be just hopes. Day after day, another hope. I have a friend who I talk with on email, and she brings out the best in me with her concerns. I never think about hurting myself or causing any harm to anyone else. I don't watch the TV news, anymore, to much evilness and wickedness going on in the world today.

    • Samuel, we are so sorry that you are struggling. Life will get better. We suggest that you talk to medical provider about your current concerns. If you need resources in your area, please call the DCoE Outreach Center at 866-966-1020.

  • This article is good general information but suggest we add a few more links with substance for those that need to research more. I myself did my own studies years ago before all this data and info became readily available. Also suggest we add the moral injury portion to the big picture surrounding PTSD. I believe each of us react differently to the same stressor, scenario and memory because of the values we were raised with. The attack on those values and core beliefs can destroy you to the core and cause you to doubt virtually everything you ever believed in. That doubt added to the other PTSD issues creates a very volatile situation and all parts need to be understood and dealt with before any real progress can be made.

    • Thank you for your feedback and providing more information for our audience.

  • The persistence and at times inappropriate "fight or flight" response fails to extinguish over time as you point out. I would direct you to a recent study published in Neurotrauma in January regarding brain volume and connectivity differences in TBI patients with and without PTSD. The first author is Lopez and this study lends support to the theory regarding faulty extinction learning and the role in perpetuating the "fight or flight" response.

    • Thank you for sharing, Dr. Dsurney.

  • I was diagnose with ptsd from the army Service and my blood pressure keep me dizzy most of the time I get pill for this and most of time it don't work

    • Hi Angel, we suggest you speak with your health care provider as soon as possible.

  • Appreciate the article

  • Wonderfully written

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This page was last updated on: September 14, 2017.