How Does PTSD Impact the Brain?

Post-traumatic stress disorder (PTSD) impacts 10% of women and 4% of men in the US at some point in their life. Additionally, 37% of these cases have severe symptoms. PTSD can profoundly impact a person's brain, mood, and behavior in various ways. Many symptoms of PTSD can be attributed to how trauma changes key brain structures. There are three main areas of the brain impacted by trauma or PTSD.

Each area impacted is responsible for a different set of symptoms that can play out in a person's daily life. The good news is that treatment options are available for those who have experienced trauma.

What is PTSD?

Post-traumatic stress disorder is a mental health condition caused by exposure to a traumatic event. This could be related to a sexual offense, physical violence, a near-death experience, watching another person die or have an accident, the unexpected death of a loved one, abuse, bullying, etc. Anything that causes personal trauma can lead to symptoms of PTSD. These symptoms tend to increase with the number of traumatic events a person is exposed to, especially if they are repetitive. Additionally, the age at which these events occurred plays a role in how it affects the person. For example, repetitive sexual childhood trauma increases one’s risk of developing PTSD.

Symptoms of PTSD

In addition to the effects of PTSD mentioned above, a person may also have struggles surrounding:

• Threat perception
• Oversensitivity to perceived threats
• Emotional regulation/functioning
• Self-esteem
• Self-image

Trauma can lead to difficulties in developing and sustaining healthy and satisfying relationships. It can also make it more difficult to cope with unpredictability in life. Rejections or failures can be extremely difficult for a person with PTSD, and they may find emotional regulation to be a struggle. This can lead to emotional outbursts, the activation of the fight or flight response, and exaggerated emotional expressions that do not align with the severity or nature of the triggering event.

Trauma may lead to the development of phobias, mood disorders, anxiety, difficulties focusing, and sleep changes. It can also have a negative impact on a person's academic or career performance and success. Therefore, it's important to treat any symptoms of PTSD as soon as possible, as untreated PTSD can have far-reaching negative impacts.

Additional symptoms of PTSD include:

• Increased fear
• Heightened anger
• Negative or less-than-positive emotions
• Lack of enjoyment in daily activities
• Lack of interest in personal interactions

Research from neuroscientists has linked many of the symptoms of PTSD with impaired brain functioning in the areas most impacted by this disorder.

Areas of the brain impacted by PTSD

Post-traumatic stress disorder impacts the brain in three primary areas. The prefrontal cortex (PFC), amygdala, and hippocampus. This can affect a person’s daily life in a variety of ways. For instance, one’s fear response may be compromised. Additionally, they may feel increased stress, anxiety, or a negative mood and may also have difficulty concentrating, making decisions, or remembering things.

Prefrontal cortex (PFC)

The prefrontal cortex (PFC) is located in the frontal lobe of the brain, directly behind the forehead. It is responsible for a variety of functions, including:

• Attention and awareness.
• Interpreting the emotional significance and meaning of an event.
• Emotional regulation.
• Deciding the appropriate way to react and respond to a situation.
• Conscious, voluntary behaviors.
• Correcting or inhibiting dysfunctional reactions or behaviors.

When a person experiences trauma and symptoms of PTSD, this part of the brain becomes hypoactive, or less active than it was prior to the trauma, which has a direct impact on the functions listed above.

Amygdala

The amygdala is a small, almond-shaped part of the brain located in the center of the temporal lobe. It detects environmental threats and activates the fight or flight response. It also helps activate the sympathetic nervous system in the event of a threat and helps properly store new emotional threat-related memories. When the amygdala is affected by trauma, it becomes overactive. It releases an excess of norepinephrine into the brain, a hormone/neurotransmitter that plays a role in the body’s fight or flight response, which the PFC is unable to regulate appropriately. This leads to hypervigilance, increased wakefulness, sleep changes, and hyperarousal.

Hippocampus

The hippocampus is located in the back of the brain in an area considered the brain’s learning center. This section of the brain is smaller and less active for those who have experienced trauma. Post-traumatic stress disorder or trauma can impact the way that this part of the brain stores memories, solves problems, and distinguishes between events that occurred in the past vs. the present. This is why people with PTSD sometimes have what is referred to as a flashback.

The hippocampus is able to time stamp and store events throughout the day as memories in chronological order. However, when trauma occurs, it freezes the hippocampus. When this happens, the traumatic event is not time-stamped and stored. Therefore, it can come back up at any time and cause a person to feel as if they are reliving the event all over again. This can cause a person to live in a prolonged state of hypervigilance while exhibiting strong emotional reactivity.

Methods for treating PTSD

Eye movement desensitization and reprocessing (EMDR) is an effective form of therapy able to activate the hippocampus and store traumatic events in their proper place while helping a person heal from trauma and PTSD.

In addition to EMDR, which is able to treat symptoms in as few as eight sessions, other forms of treatment that have helped alleviate the symptoms of PTSD include:

• Exposure therapy
• Mindfulness interventions
• Interpersonal skill building
• Antidepressants

While some people with PTSD experience symptoms throughout their life, this does not mean treatment is ineffective. Some cases require ongoing follow-up sessions or a more long-term, consistent treatment plan. Furthermore, not everyone is open to asking for support, engaging in therapy, and/or being consistent with their treatments. Some choose to self-medicate with substances instead of seeking treatment, which can worsen their symptoms.

If you or a loved one have been exposed to trauma, it’s important to seek treatment from a trusted, licensed mental health practitioner.