Child abuse. Rape. Sexual assault. Brutal physical attack. Being in a
war and witnessing violence, bloodshed, and death from close quarters.
Near death experiences. These are extremely traumatic events, and some
victims bear the scars for life.
The physical scars heal, but some emotional wounds stop the lives of
these people dead in their tracks. They are afraid to get close to
people or form new relationships. Change terrifies them, and they remain
forever hesitant to express their needs or give vent to their creative
potential. It may not be always apparent, but post-traumatic stress
disorder (PTSD)
stifles the life force out of its victims. It is no use telling them to
“get over” it because PTSD fundamentally changes the brain’s structure
and alters its functionalities.
What goes on inside the brains of people with PTSD?
PTSD is painful and frightening. The memories of the event linger and victims often have vivid flashbacks.
Frightened and traumatized, they are almost always on edge and the
slightest of cues sends them hurtling back inside their protective
shells. Usually victims try to avoid people, objects, and situations
that remind them of their hurtful experiences; this behavior is
debilitating and prevents them from living their lives meaningfully.
Many victims forget the details of the incident, obviously in an
attempt to lessen the blow. But this coping mechanism has negative
repercussions as well. Without accepting and reconciling with “reality,”
they turn into fragmented souls.
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 a role in triggering the typical symptoms of
PTSD. These regions collectively impact the stress response mechanism in
humans, so the PTSD victim, even long after his experiences, continues
to perceive and respond to stress differently than someone who is not suffering the aftermaths of trauma.
Effect of trauma on the hippocampus
The most significant neurological impact of trauma is seen in the
hippocampus. PTSD patients show a considerable reduction in the volume
of the hippocampus.
This region of the brain is responsible for memory functions. It helps
an individual to record new memories and retrieve them later in response
to specific and relevant environmental stimuli. 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 or interpret
environmental contexts correctly. Their particular neural mechanisms
trigger extreme stress responses when confronted with environmental
situations that only remotely resemble something from their traumatic
past. This is why a sexual assault victim is terrified of parking lots
because she was once raped in a similar place. A war veteran still
cannot watch violent movies because they remind him of his trench days;
his hippocampus cannot minimize the interference of past memories.
Effect of trauma on the ventromedial prefrontal cortex
Severe emotional trauma causes lasting changes in the ventromedial prefrontal cortex
region of the brain that is responsible for regulating emotional
responses triggered by the amygdala. Specifically, this region regulates
negative emotions like fear that occur when confronted with specific
stimuli. PTSD patients show a marked decrease in the volume of
ventromedial prefrontal cortex and the functional ability of this
region. This explains why people suffering from PTSD tend to exhibit
fear, anxiety, and extreme stress responses even when faced with stimuli
not connected – or only remotely connected – to their experiences from
the past.
Effect of trauma on the amygdala
Trauma appears to increase activity in the amygdala.
This region of the brain helps us process emotions and is also linked
to fear responses. PTSD patients exhibit hyperactivity in the amygdala
in response to stimuli that are somehow connected to their traumatic
experiences. They exhibit anxiety, panic, and extreme stress when they
are shown photographs or presented with narratives of trauma victims
whose experiences match theirs; or made to listen to sounds or words
related to their traumatic encounters.
What is interesting is that the amygdala in PTSD patients may be so
hyperactive that these people exhibit fear and stress responses even
when they are confronted with stimuli not associated with their trauma,
such as when they are simply shown photographs of people exhibiting
fear.
The hippocampus, the ventromedial prefrontal cortex, and the amygdala
complete the neural circuitry of stress. The hippocampus facilitates
appropriate responses to environmental stimuli, so the amygdala does not
go into stress mode. The ventromedial prefrontal cortex regulates
emotional responses by controlling the functions of the amygdala. It is
thus not surprising that when the hypoactive hippocampus and the
functionally-challenged ventromedial prefrontal cortex stop pulling the
chains, the amygdala gets into a tizzy.
Hyperactivity of the amygdala is positively related to the severity
of PTSD symptoms. The aforementioned developments explain the tell-tale
signs of PTSD—startle responses to the most harmless of stimuli and
frequent flashbacks or intrusive recollections.
Researchers believe that the brain changes caused by PTSD increase the likelihood of a person developing other psychotic and mood disorders.
Understanding how PTSD alters brain chemistry is critical to empathize
with the condition of the victims and devise treatment methods that will
enable them to live fully and fulfill their true potential.
But in the midst of such grim findings, scientists also sound a note
of hope for PTSD patients and their loved ones. According to them, by
delving into the pathophysiology of PTSD, they have also realized that
the disorder is reversible. The human brain can be re-wired. In fact,
drugs and behavioral therapies have been shown to increase the volume of
the hippocampus in PTSD patients. The brain is a finely-tuned
instrument. It is fragile, but it is heartening to know that the brain
also has an amazing capacity to regenerate.
http://brainblogger.com/2015/01/24/how-does-post-traumatic-stress-disorder-change-the-brain/
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