PTSD:A Brief Lesson

Neuroimaging

Written by Felix Blumhardt, PhD, LCSW

Post-Traumatic Stress Disorder (PTSD) is a health problem that affects many of our Veterans and their families. Until recently, the science around PTSD was not understood well. As a result, PTSD has been somewhat of a mystery, a mystery that has been enhanced through media and supported through our cultural norms.

Let’s dispel what PTSD is not.

PTSD is not a weakness. It isn’t a shortcoming. PTSD isn’t a bad choice made by someone. PTSD is a mental or psychological injury. In fact, PTSD is the result of brain biology, the brain biology that all humans share and that frequently serves us well.

Let’s explore what we know about that brain biology so that we can gain some clarification about PTSD.

A Brief Science Lesson

Post-traumatic stress (PTS) is a normal response to traumatic events but Post Traumatic Stress Disorder (PTSD)is a more serious condition that impacts brain function, and often results from traumas experienced during combat, disasters, or violence.In other words, PTSD is a response to trauma.

The human brain is equipped with an alarm system that normally helps ensure survival. This alarm system is housed within a little part of the brain called the amygdala. With trauma, the amygdala becomes overly sensitive and the parts of the brain responsible for thinking and memory stop functioning properly, because all of the activation in the brain has been diverted. When this occurs, it can be difficult to separate safe events happening now from dangerous events that happened in the past.Over the past 40 years, scientific methods of “neuroimaging” have enabled scientists to see that trauma causes distinct biological changes in our brain. Not all people have exactly the same symptoms or the same brain changes, but there are observable patterns that can be understood and treated.

Our amygdala triggers our body’s natural alarm system. Our amygdala is a primitive part of our brain that’s wired to ensure survival,so when it’s overactive, it can be difficult to think rationally. People with PTSD tend to have an overactive response, so something as harmless as a car backfiring or a book dropping on a hard floor could instantly trigger a panic response.

Our prefrontal cortex (the front-most part of our neocortex) helps us problem solve, observe how we are thinking, and put on the “brakes” when we realize that the thing we first feared isn’t actually a threat. Our prefrontal cortex helps regulate emotional responses triggered by the amygdala. In people with PTSD, the prefrontal cortex isn’t always capable of doing its job when needed.

An overactive amygdala combined with an underactive prefrontal cortex creates the conditions for PTSD. This helps us to understand why someone with PTSD might: (1) feel anxious around anything even slightly related to the original trauma that led to the PTSD; (2) have strong physical reactions to situations that typically don’t provoke a fear reaction; and (3) avoid situations that might trigger those intense emotions and reactions.

Other common PTSD experiences—such as unexpected emotions or always being hypervigilant (looking out for threats that could lead to more trauma) —seem to be related to the hippocampus, or memory center of our brain. Our hippocampus is a lot like our computer’s memory that writes files to its hard drive. After a trauma, our hippocampus works to remember and make sense of the event. Because trauma is typically overwhelming, all the information doesn’t get coded correctly and this results in memory challenges like recalling important details of the event.

Our amygdala, prefrontal cortex, and hippocampus all contribute to the feelings and actions associated with fear, clear thinking, decision-making, and memory. With PTSD, we can wee physical changes that occur within the brain and these changes contribute to the negative symptoms of PTSD.

The Good News

Our brains are truly extraordinary; our brains can actually receive hardware updates in addition to software updates. Different pathways form and fall dormant, are created and are discarded, according to our experiences. This is neuroplasticity.

When we learn something new, we create new connections throughout our brain, and were wire our brains to adapt to new circumstances. This happens naturally, but it’s also something that we can encourage and stimulate. Research on neuroplasticity has made significant strides from observing changes in the brains of those who suffered serious trauma.This neuroplasticity is how our brain heals itself and it is on which our current treatments for PTSD are based.

Tune in to our next quarterly newsletter to read more about PTSD, additional resources for Veterans with PTSD, and activities that promote well-being for persons living with PTSD, to include those supported by Continuing the Mission!

References

How PTSD affects brain “circuitry”. USU | CHAMP, Human Performance Resource Center, 30 May 2017