Treating PTSD and depression

photo of Psychiatrist Aliza Wingo

Psychiatrist Aliza Wingo translates her research on molecular mechanisms underlying PTSD and depression into concrete recommendations to increase emotional well-being for the many veterans she treats every year.


Atlanta Veterans Affairs Medical Center

 

Emory and the Atlanta VA Medical Center have been partners since 1946. Emory provides physician care at the facility and has made it one of the nation’s most successful VA centers for research to improve care for veterans. Emory investigators attracted more than $15 million in VA funding and $10 million in non-VA funding for such research last year.

Like many of the veterans whom psychiatrist Aliza Wingo sees at her clinic at the Atlanta Veterans Affairs Medical Center, Joe Ritchie had symptoms of both Post-Traumatic Stress Disorder (PTSD) and depression. Wingo wants to understand how the two conditions interact. Why are some people resilient in the face of traumatic events, while others, like Ritchie, struggle to cope and sink into depression?

Some of the reasons may be genetic. Wingo and her colleagues have discovered that among genes regulating the stress response, one is significantly less active in patients with simultaneous PTSD and depression than in people without this double diagnosis. Another genetic variant discovered by her team, a gene in the brain’s reward circuitry, is connected to positive emotions. Wingo hopes understanding these mechanisms will point to treatments that will increase the 35% improvement rate now seen with medication and psychotherapy for patients like Ritchie.

Ritchie’s PTSD and depression can be traced to his experiences in the battlefield. These include three years of mortar and rockets, having to bag bodies after IED explosions, and the unexpected suicide of his best friend. When Wingo first examined him, she looked for anxiety and mood disorders, suicidal thoughts, substance abuse, and other risk factors. She also assessed protective factors like a supportive family, belonging to a religious community, strong social networks, even having someone to talk to.

In addition to state-of-the-art treatment, she recommended that Ritchie develop hobbies and activities he enjoys, helping him set goals and make social connections. “Get sufficient sleep, exercise frequently, set small goals for yourself,” she advised, “all of which will help you cope with stress.”

It’s working. And Wingo’s research continues on psychological well-being (having positive emotions, inner peace, life satisfaction, a sense of purpose and meaning in life), its genetic and molecular mechanisms, and its ability to mitigate risks not only of PTSD and depression but also of cardiovascular disease, diabetes, stroke, and dementia.