In last week's post describing Post Traumatic Stress Disorder (PTSD) and your general well being, I noted that you do not have to be a combat veteran to experience PTSD. Unfortunately, there are many occasions in daily life for traumatic events to be experienced or witnessed. Among others, these can include physical/sexual abuse, terrorist attacks, natural disasters, accidents, violent crimes.
What happens in the brains of people with PTSD? Suffice it to say, there is no use telling them to get over it because PTSD changes the brain's structure.
Extensive neuroimaging studies on the brains of PTSD patients show that several regions differ structurally and functionally from those of healthy individuals. The amygdala, the hippocampus, and the ventromedial prefrontal cortex play roles in triggering the symptoms of PTSD. Together, these regions impact the stress response mechanism in humans. Consequently, the PTSD victim, long after their experiences, continues to perceive and respond to stress differently than someone who does not suffer the results of trauma.
The most significant neurological impact of trauma is seen in the hippocampus. PTSD patients show a significant reduction in the volume of the hippocampus. This area of the brain is responsible for memory functions. It helps us record new memories and retrieve them later. The hippocampus also helps us distinguish between past and present memories.
PTSD patients with reduced hippocampal volumes lose the ability to discriminate between past and present experiences. They have extreme stress responses when facing situations that only slightly resemble something from their traumatic past. I have treated numerous patients who were victimized by physical and/or sexual abuse whose responses were overdetermined to current situations, often benign, as though the current situation was the one which had traumatized them initially. This can occur decades after the initial traumatic event.
Severe emotional trauma causes lasting changes in the ventromedial prefrontal cortical region of the brain. This area is responsible for regulating emotional responses triggered by the amygdala. Specifically, this region regulates negative emotions like fear. PTSD patients show a marked decrease in the volume of ventromedial prefrontal cortex. This explains why people suffering from PTSD tend to exhibit fear, anxiety, and extreme stress responses even when faced with situations not connected, or only remotely so, to their experiences from the past.
Traumatic events appear to increase activity in the amygdala. This region of the brain helps us process emotions and is also linked to fear responses. PTSD patients show hyperactivity in the amygdala in response to stimuli that are somehow connected to their traumatic experiences. Sometimes, they show hyperactivity even to stimuli not associated with their trauma.
Hyperactivity of the amygdala is positively related to the severity of PTSD symptoms. To a large extent, this is a result of the hypoactivity of the hippocampus and the dysfunction in the ventromedial prefrontal cortex in controlling the amygdala. The excessive reactivity of the amygdala helps explain some of the major signs of PTSD - startle responses to the most harmless of stimuli and frequent flashbacks or intrusive recollections.
However, there are promising treatments for PTSD and these treatments have been shown in some studies to correlate with brain changes. We certainly now know that the brain can regenerate more than we thought in the past. Some drugs and behavioral therapies have been shown to increase the volume of the hippocampus in PTSD patients.
So, if you or a loved one suffer from PTSD, or if you work with someone who appears to suffer from such a stress related disorder, get help as it is available. There is no reason to suffer needlessly. There is hope and you can change. However, as usual, change starts with a mindset which recognizes that change is possible.
For other posts on this and related subjects, see my website at www.successandmindset.com