Can you die from ptsd

Warning Signs of Early Death Found in Veterans with Severe Post-Traumatic Stress Disorder | The Brink

But the risk can be reversed with lifestyle changes

Photo by Viktoriia Miroshnikova/iStock


But the risk can be reversed with lifestyle changes

November 9, 2022

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From the time we’re born to the time we die, a lot may change, but our DNA—the long, double-helix molecule that contains all of a person’s genetic code—stays the same. The instructions for reading that code can shift, however, as the chemical tags on and around a DNA sequence change throughout our lives, depending on our age, environment, and behavior. This outside influence on how our genes are read and expressed by cells is called epigenetics—and researchers studying it have discovered clues that may show why some veterans live longer than others. 

Scientists can interpret epigenetic changes and patterns by looking at DNA methylation (DNAm), a process that turns a gene “on” or “off. ” (For example, smokers tend to have reduced DNAm in a gene shown to have a role in suppressing tumors, making them more susceptible to disease.) DNAm can also indicate a person’s cellular age, which can be different from their numerical age, and point to risk factors associated with early death. 

In a new study of military veterans published in Translational Psychiatry, researchers discovered a connection between DNAm signals of accelerated cellular aging and mental health conditions like post-traumatic stress disorder (PTSD)—findings that suggest former service personnel with PTSD are at greater risk of early death. 

“Our study found that PTSD and comorbid conditions, like substance misuse, are associated with a cellular marker of early death found in DNA methylation patterns,” says Erika Wolf, a Boston University Chobanian & Avedisian School of Medicine professor of psychiatry and senior author on the study. An early death is one that occurs before the average age of death, which in the United States is about 75 years, but differs slightly between men and women.

The study included two samples of veterans that had representative levels of trauma and other psychiatric conditions, like substance use and personality disorders. One group included 434 veterans in their early 30s, who had served in post-9/11 conflicts; the other group included 647 middle-age veterans and their trauma-exposed spouses. Both groups were assessed for a range of psychological conditions, and had blood drawn to obtain genetic information and to test for levels of a variety of inflammatory molecules. 

The data was then put into an existing algorithm called GrimAge—which is designed to predict time to death based on methylation data in a person’s blood and other types of biomarkers—and correlated with a range of psychiatric diagnoses, biomarkers, cognitive tests, and brain morphology. The researchers also accounted for the influence of age. 

According to the paper, the veterans’ DNAm index of time to death was associated with a number of adverse clinical outcomes, including high inflammation levels, oxidative stress, alterations in immune and metabolic molecules, and cognitive decline. The results indicated PTSD symptoms were a factor in faster cellular aging—.36 of a year faster, according to Wolf. So, for every year that the cells of someone without PTSD age, the cells of someone with more severe PTSD symptoms age a year and a third. 

The study is the first to detect associations between a broad range of trauma-related psychiatric symptoms and some of the earliest warning signs of mortality risk via DNAm patterns. But Wolf, a clinical research psychologist for the National Center for PTSD at the VA Boston Healthcare System, says that a person’s fate is not set in stone and there are ways to avoid the risk of early death. She says the research has important clinical implications, since lifestyle interventions may reverse metrics of biological aging and mitigate premature death.

“Collectively, our findings suggest that a number of psychiatric disorders may increase risk for early death and underscore the importance of identification of those at greatest risk,” Wolf says.  

The algorithm isn’t designed to predict a single person’s time of death—if people are worried about their biological health, they’re much better off getting a metabolic panel, says Wolf—but can help identify biological pathways associated with accelerated aging in broader groups. For example, if we know about a particular inflammatory process that is problematic among those with accelerated cellular aging, then scientists can work to develop something to correct that.

“We know of some health behaviors that reduce inflammation, like exercise and stress reduction, good nutrition,” Wolf says. “The ability to detect low levels of these molecules years before they may become clinically significant, and hopefully be able to intervene early on in disease trajectories, is critical for efforts to ultimately slow or reverse the adverse health consequences of traumatic stress.” 

Funding for this study was provided by the US Department of Veterans Affairs, the National Institutes of Health, and the National Institute of Mental Health.  

Explore Related Topics:

  • Aging
  • Disease
  • Health
  • Inflammatory Diseases
  • Microbiology & Molecular Biology
  • Molecular Biology & Genetics
  • Stress
  • Veterans
  • Wellness
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PTSD with depression may significantly increase risk of early death in women | News

For immediate release: December 4, 2020

Boston, MA – Women with post-traumatic stress disorder (PTSD) and depression have an almost fourfold greater risk of early death from cardiovascular disease, respiratory disease, type 2 diabetes, accidents, suicide, and other causes than women without trauma exposure or depression, according to a large long-term study conducted by researchers at Harvard T.H. Chan School of Public Health.

“The study examines longevity—in a way, the ultimate health outcome—and the findings strengthen our understanding that mental and physical health are tightly interconnected,” said Andrea Roberts, lead author of the study and a senior research scientist in the Department of Environmental Health. “This is particularly salient during the pandemic, which is exposing many Americans and others across the world to unusual stress while at the same time reducing social connections, which can be powerfully protective for our mental health.”

The study, which is the first study of co-occurring PTSD and depression in a large population of civilian women, was published online December 4, 2020 in JAMA Network Open. Previous research on PTSD and depression has primarily focused on men in the military.

Roberts and her colleagues studied more than 50,000 women at midlife (ages 43 to 64 years) and found that women with both high levels of PTSD and depression symptoms were nearly four times more likely to die from nearly every major cause of death over the following nine years than women who did not have depression and had not experienced a traumatic event.

The researchers examined whether health risk factors such as smoking, exercise, and obesity might explain the association between PTSD and depression and premature death, but these factors only explained a relatively small part. This finding suggests that other factors, such as the effect of stress hormones on the body, may account for the higher risk of early death in women with the disorders.

Treatment of PTSD and depression in women with symptoms of both disorders may reduce their substantial increased risk of mortality, the researchers said.

“These findings provide further evidence that mental health is fundamental to physical health—and to our very survival. We ignore our emotional well-being at our peril,” said Karestan Koenen, senior author of the study and professor of psychiatric epidemiology in the Department of Epidemiology and Department of Social and Behavioral Sciences.

Other Harvard Chan School authors included Laura Kubzansky, Lori Chibnik, and Eric Rimm.

This study was supported by the National Institutes of Health (NIH R01Mh201269-07 and U01 CA176726).

“Association of posttraumatic stress and depressive symptoms with mortality in women: A 9-year prospective cohort study,” Andrea L. Roberts, Laura D. Kubzansky, Lori Chibnik, Eric B. Rimm, Karestan C. Koenen, JAMA Network Open, online December 4, 2020, DOI: 10.1001/jamanetworkopen.2020.27935

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Nicole Rura
[email protected]


Harvard T.H. Chan School of Public Health brings together dedicated experts from many disciplines to educate new generations of global health leaders and produce powerful ideas that improve the lives and health of people everywhere. As a community of leading scientists, educators, and students, we work together to take innovative ideas from the laboratory to people’s lives—not only making scientific breakthroughs, but also working to change individual behaviors, public policies, and health care practices. Each year, more than 400 faculty members at Harvard Chan School teach 1,000-plus full-time students from around the world and train thousands more through online and executive education courses. Founded in 1913 as the Harvard-MIT School of Health Officers, the School is recognized as America’s oldest professional training program in public health.

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