What Area Of The Brain Does Ptsd Affect
Stress results in acute and chronic changes in neurochemical systems and specific brain regions, which result in longterm changes in brain circuits, involved in the stress response. Brain regions that are felt to play an important role in PTSD include hippocampus, amygdala, and medial prefrontal cortex.
Ensure That Specific Cognitive Difficulties Are Addressed Directly
It seems likely that children in out-of-home care will experience some degree of cognitive difficulty and discrete trauma symptoms, depending on their unique experiences. Although safe and consistent caregiving will create the necessary conditions for recovery, it may not be sufficient to meet the needs of many children. Studies of children in care and related populations – including children with neurodevelopmental issues or acquired head injury , children affected by fetal alcohol spectrum disorders , and children with PTSD – all suggest that cognitive skills can be improved with specific and targeted interventions, delivered in the context of a safe and nurturing relationship. Caregivers also need to provide a structured and predictable environment in order to accommodate children with cognitive vulnerabilities.
What Happens To The Brain In Ptsd
In 1937, James Papez proposed in his now-classic article, based on his anatomical research, emotions have an anatomical mechanism and location in the brain : 38).
Dr. MacLean, the leading authority in limbic neurology, in general championed Papez`s findings. He insisted that in the process of evolution from reptiles to mammals, the mammalian sub-cortex evolved in complexity, developing an anatomical cyto-architecture identical to that of neocortex.
For those students who have a special interest, I refer you to The Limbic Brain by Andrew Lautin, M.D .
Fear conditioning causes an array of stress induced behaviors such as freezing and acoustic startle, even in rodents .
But integrating intelligence into limbic functions allowed stimulus response reactions to support more complex responses to threat, including hesitation and response selection .
MacLeans findings led to the additional proposal that the cingulate subdivision of the limbic system was also involved in early bonding behaviors such as playfulness and sound communications, allowing for a more complex set of survival skills that characterize the evolutionary transition from reptiles to mammals.
Once the limbic brain acquired advanced neocortex, mechanisms of survival evolved beyond visceral and simple reflective behaviors, such as freezing, towards more complex behaviors that serve communal attachment and parental bonding.
In contrast, the hippocampus functions as a switch and control center .
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How Ptsd Affects The Brain
If youre experiencing post-traumatic stress disorder , its important to understand how the different parts of your brain function. Post-traumatic stress is a normal response to traumatic events. However, PTSD is a more serious condition that impacts brain function, and it often results from traumas experienced during combat, disasters, or violence.
Your brain is equipped with an alarm system that normally helps ensure your survival. With PTSD, this system becomes overly sensitive and triggers easily. In turn, the parts of your brain responsible for thinking and memory stop functioning properly. When this occurs, its hard 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 PTSD causes distinct biological changes in your brain. Not everybody with PTSD has exactly the same symptoms or the same brain changes, but there are observable patterns that can be understood and treated.
The diagram shows a cross-section of the brain parts discussed here.
Visual Attention And Working Memory
Additional visual discrimination paradigms pair emotional, neutral, and/or trauma images with an active task requirement that involves making a choice based on other irrelevant features of the images . Trauma experience more generally is associated with larger P2, P3, and LPP amplitudes to trauma as opposed to neutral images as well as larger LPP amplitude to negative than neutral images the latter pattern also predicts higher future externalizing symptoms in those reporting the most severe trauma symptoms . Clinical studies, on the other hand, provide inconsistent results, with PTSD+ showing no difference in P3 amplitude to emotional or neutral images than PTSD without a history of trauma, but displaying heightened LPP to positive images or no group differences in LPP amplitude to threat . In contrast, PTSD+ display greater P3 and LPP amplitudes to food, neutral, and trauma images than PTSD who share a history of combat-related trauma as both studies possessed small sample sizes, it is unclear how to reconcile these results.
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Normal Development Of The Brain Across The Lifespan
To understand how traumatic stress occurring at different stages of the life cycle interacts with the developing brain, it is useful to review normal brain development. The normal human brain undergoes changes in structure and function across the lifespan from early childhood to late life. Understanding these normal developmental changes is critical for determining the difference between normal development and pathology, and how normal development and pathology interact.
Although the bulk of brain development occurs in utero, the brain continues to develop after birth. In the first 5 years of life there is an overall expansion of brain volume related to development of both gray matter and white matter structures however, from 7 to 17 years of age there is a progressive increase in white matter and decrease in gray matter while overall brain size stays the same.13–16 Gray matter areas that undergo the greatest increases throughout this latter developmental epoch include frontal cortex and parietal cortex.17,18 Basal ganglia decrease in size, while corpus callosum,19,20 hippocampus, and amygdala21–23 appear to increase in size during childhood, although there may be developmental sex-laterality effects for some of these structures.24 Overall brain size is 10% larger in boys than girls during childhood.24
Six Principles For Supporting Children In Care Who Have Been Traumatised
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Treating Trauma Through Exposure With Response Prevention
Research indicates that, in most cases, the best treatment for resolving trauma-related psychiatric issues is Exposure with Response Prevention . ERP involves flooding a person with the trauma. Flooding is a term used to describe repeating the traumatic experience over and over until the emotional valence of the trauma the connection between the trauma and the persons pain becomes muted through repetition.
People with PTSD or trauma may avoid situations or relationships as a protective coping strategy. The goal of ERP is to empower trauma survivors to face those triggering situations and fully engage in their communities without experiencing debilitating fear or pain.
Flooding through ERP can be approached in a variety of ways. Through Imaginal Exposure, clients repeat their traumatic experience by repeatedly imagining themselves in the same situation while under the care and supervision of a mental health professional. Through In Vivo Exposure, clients visit the place where the trauma occurred and directly confront their fears and emotions with the support of their therapist or mental health care provider.
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Clinically Relevant Issues To Explore
A primary aim of clinical neuroscience research is to identify brain circuitry and/or processes that differentiate individuals with and without a particular illness or condition of interest. Three biomarker types are especially relevant to trauma neuroscience: 1) diagnostic, identifying people with a specific disorder diagnosis 2) predictive, identifying people who will improve or worsen as a result of treatment and 3) prognostic, identifying people who relapse or experience changes in clinical severity . Traditionally, researchers advocated for diagnostic metrics of disorder that were specific and sensitive biomarkers could also be conceptualized as state-like or trait-like . However, in line with the dimensional Research Domain Criteria framework, biomarkers may index clinical symptoms that transcend diagnostic boundaries and that may predict illness course and treatment outcome . Biomarker strength may also vary as a function of biological differences such as sex or age. Comparing patterns of brain activity between individuals diagnosed with PTSD and healthy individuals who have experienced similar traumatic events may help to identify what brain mechanisms capture clinically heightened responses to trauma . Moreover, it is useful to identify whether patterns of electrical signals are a result of a particular type of trauma or are present across various types of trauma .
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The Nature Of Trauma And Its Effect On The Ptsd Brain
Trauma is a tricky subject. The word trauma gets thrown around quite a bit and there seems to be a subjective nature to its definition. With the mentioning of trauma often comes the phrase Post Traumatic Stress Disorder , which is a legitimate mental disorder listed within the Diagnostic and Statistical Manual of Mental Disorders . What makes PTSD unique from other mental disorders is that it requires a traumatic or stressful event as a diagnostic criterion.
However, what makes trauma tricky is defining what a traumatic or stressful event actually is. This is where trauma can get a bit subjective. What may be considered stressful to one person may simply be routine to another. Thats why most definitions dealing with trauma generally focus on traumatic events that are widely accepted to be traumatic, such as natural disasters, rape, domestic violence, severe illness or injury, death of a loved one, and witnessing or experiencing an act of violence.
So, what exactly, defines trauma and constitutes a traumatic event? And, how does this event lead to the possible development of PTSD? What, exactly, is PTSD and how does it affect the brain? Finally, how do individuals with suspected cases of PTSD come to terms with the traumatic event that has changed them? This article aims to provide answers to all these questions and clarify some of the confusion surrounding trauma and PTSD.
The Thirteen Steps To Managing Emotional Flashbacks
Say to yourself: I am having a flashback.
Flashbacks take us into a timeless part of the psyche that feels as helpless, hopeless, and surrounded by danger as we were in childhood. The feelings and sensations you are experiencing are memories that cannot hurt you now.
Remind yourself: I feel afraid, but I am not in danger!
I am safe now, here in the present. Remember, you are now in the safety of the present, far from the danger of the past.
Own your right/need to have boundaries.
Remind yourself that you do not have to allow anyone to mistreat you you are free to leave dangerous situations and protest unfair behavior.
Speak reassuringly to the Inner Child.
The child needs to know that you love her unconditionally- that she can come to you for comfort and protection when she feels lost and scared.
Remember, the flashback will pass as it has many times before.
Remind yourself that you are in an adult body with allies, skills, and resources to protect you that you never had as a child.
Feeling small and little is a sure sign of a flashback.
Ease back into your body. Fear launches us into heady worrying or numbing and spacing out.
Gently ask your body to Relax: feel each of your major muscle groups and softly encourage them to relax. Breathe deeply, find a safe place to soothe yourself, and allow yourself to feel the fear without reacting to it.
Resist the Inner Critics Catastrophizing.
Allow yourself to grieve.
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Cognitive Behavioral Therapy And Ptsd:
Cognitive behavioral therapy works to explore the relationship between thoughts, feelings, and behaviors, and then make changes to these areas that promote a better quality of life. It is believed that cognitive behavioral therapy can help individuals with PTSD by changing negative associations into positive ones and by coping with unhealthy understandings of their experience.
Another thing cognitive behavioral therapy can help PTSD patients with is unhelpful thought patterns, or distortions, such as overgeneralizing bad outcomes, negative thinking, and catastrophic thinking. This is especially important for individuals with PTSD, as they tend to get stuck in these negative thought patterns. Creating awareness to their negative thought patterns is one of the first steps to helping them conceptualize their experience.
What Are The 17 Symptoms Of Ptsd
What are the 17 Symptoms of PTSD?
- Intrusive Thoughts. Intrusive thoughts are perhaps the best-known symptom of PTSD. …
- Nightmares. …
- Avoiding Reminders of the Event. …
- Memory Loss. …
- Negative Thoughts About Self and the World. …
- Self-Isolation Feeling Distant. …
- Reduced Interest in Favorite Activities.
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Neural Circuits In Ptsd
In summary, dysfunction of a circuit involving the medial prefrontal cortex, dorsolateral prefrontal cortex, and possibly hippocampus and amygdala during exposure to traumatic reminders may underlie symptoms of PTSD. These studies have primarily assessed neural correlates of traumatic remembrance, while little has been done in the way of utilizing cognitive tasks as probes of specific regions, such as memory tasks as probes of hippocampal function.
Emotional Trauma And The Amygdala
The amygdala is a section of nervous tissue in the brain that is responsible for emotions, survival instincts, and memory.
A major role of the amygdala is to detect fear. It recognizes and gathers information around us to determine threats. By using our senses, such as sight and sound, the amygdala will respond with the feeling of fear if it perceives a threat. This all happens unconsciously, deep in our brains.
When affected by PTSD, the amygdala becomes hyperactive.
Those who suffer from emotional trauma on the brain will often exhibit more fear of traumatic stressors than others. Often, stimuli can trigger overactivity in the amygdala if somehow connected to the traumatic event a person suffered from.
How trauma affects the brain might lead to chronic stress, heightened fear, and increased irritation. This might also make it harder for those suffering to calm down or even sleep.
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How Do You Fix Ptsd Memory Loss
PTSD treatment options often include taking medications and engaging in psychotherapy. Complementary and alternative therapies exist, as well, and include options like yoga and acupuncture. These might be helpful along with traditional treatments. You don’t have to live with memory loss when you have PTSD.
How Common Is Post
Experiencing trauma is not rare as approximately 6 of every 10 men , and 5 of every 10 women will experience at least one traumatic event in their lifetime. Men are more likely to experience trauma in the form of accidents, physical assault, combat, or witness death or injury. Women are more likely to experience sexual assault and child sexual abuse.
Some people have inherited a gene from a parent who had PTSD, making them more susceptible to forming it themselves.
However, post-traumatic stress disorder can strike anyone at any time regardless of age or other demographics. No one is immune from PTSD, and as the world changes, it becomes more likely for one to experience a traumatic event that causes it.
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Ending Our Time Together
Traumatic events cause many chemical reactions and initiate the fight/flight/freeze response, but for some, these chemicals never return to baseline, causing damage to some regions of the brain.
60% of men and 50% of women will experience one or more traumatic events in their lifetime. These statistics mean that more research must happen to increase our knowledge and thus treatments for PTSD.
The brain areas affected by PTSD control memory, reasoning, and thought, causing the victim to experience difficulties remembering events, thinking, and learning new information.
Epigenetics, a new kid on the block of neuro-research about PTSD, has found that a persons genes are changed by trauma and that these changes can be passed to their progeny.
The next stage of research and learning about post-traumatic stress disorder will involve those who formed PTSD due to the COVID-19 pandemic as people emerge from isolation and face a new world.
Trauma is personal. It does not disappear if it is not validated. When it is ignored or invalidated, the silent screams continue internally heard only by the one held captive. When someone enters the pain and hears the screams, healing can begin. ~ Danielle Bernock
References
Bremner JD. Alterations in brain structure and function associated with post-traumatic stress disorder. Semin Clin Neuropsychiatry. 1999 Oct 4:249-55. DOI: 10.153/SCNP00400249. PMID: 10553030.
Epigenetics. Wikipedia. Retrieved from:
Changes In Brain Structure And Functioning
Most brain imaging studies investigating the relationship between trauma and changes in the development, regulation and responsiveness of a child’s brain over time are based on studies of adults who report a history of childhood abuse, rather than on studies that track children’s development over time .
In contrast, neuropsychological studies generally provide solid evidence for a link between trauma and brain function. Neuropsychological studies are more useful than neuroimaging studies in assessing children’s everyday functioning because they provide us with more direct insight into the difficulties that children experience. On the whole, neuropsychological studies tend to show that children who have experienced or witnessed violence, trauma, abuse or neglect do experience cognitive difficulties in one or more areas, when compared to children who haven’t experienced these adversities . Some of the main cognitive difficulties are summarised in the following sections.
General cognitive and language delay
On the whole, children exposed to neglect may be more vulnerable to general delays in cognitive and language development . Neglected children and those raised in poverty may be more at risk of general cognitive delay than those exposed to abuse .
Problems with memory
Bias in the processing of social/emotional information
Executive functioning
Metacognitive skills
Behavioural regulation
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