Post-Traumatic Stress Disorder and the Brain

Post-traumatic stress disorder is a life-altering condition that, according to the National Center for PTSD, affects approximately 8 out of every 100 people at some point in their lives.

This article will uncover how, like complex post-traumatic stress disorder, the trauma that causes PTSD changes brain structures and how that affects the lives of those unfortunate enough to form it.

A Brief Recap of Post-Traumatic Stress Disorder

Our body cascades many chemical reactions during a frightening event that set off the fight/flight/freeze response readying us to react quickly to the danger. Most people’s chemical responses will return to baseline, but others will maintain the chemical reactions long enough to cause damage.

Although most people believe PTSD to be a diagnosis that only forms in adults, t this is not true. Children also suffer incredibly traumatic events and will form the diagnosis of post-traumatic stress disorder.

According to Amen Clinics, the causes of post-traumatic stress disorder are too numerous and varied to list in this piece; however, they may include:

  • Military combat
  • Childhood abuse
  • Repeated exposure to violence
  • Being held at gunpoint
  • Natural disasters
  • Mass shootings
  • Automobile accidents
  • Rape or other assault
  • Witnessing someone getting hurt or killed
  • Witnessing the death of a loved one
  • Kidnapping
  • Pandemic

You may have noticed that pandemic made the list. With the onslaught of COVID-19, it is predicted the number of people affected by complex post-traumatic stress disorder and post-traumatic stress disorder will increase dramatically.

How Common Is Post-Traumatic Stress Disorder?

Experiencing trauma is not rare as approximately 6 of every 10 men (60%), and 5 of every 10 women (50%) 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.

The Brain Changes Caused by Trauma

While alterations in behavior are the hallmarks of PTSD, the causes for these changes involve changes to significant brain structures. One study using function magnetic resonance imaging (fMRI) showed that brain structure and function might underlie the symptoms of post-traumatic stress disorder.

The brain areas that seem to have been consistently implicated in PTSD have included the hippocampus (a region responsible for memory consolidation and retrieval) and the prefrontal cortex (the area responsible for reasoning and thought). Also involved in the changes seen in those living with PTSD is the amygdala (the fight/flight/freeze response center) (Bremner, 1999).

Several studies have shown that PTSD is associated with a reduction in the hippocampus volume during fMRI and MRI examinations. This volume change can mean that the person experiencing post-traumatic stress disorder will experience memory disturbances and difficulty learning.  

The amygdala volume in people with PTSD decreased, leaving the person living with PTSD easily triggered by events it perceives as dangerous, whether this perception is correct or not. As a result, the person lives in a state of constant alertness and fear and can be easily triggered into a flashback of the event that caused their post-traumatic stress disorder (Morey et al., 2012).

Memory and Post-Traumatic Stress Disorder

One would like to believe that memory is forever, that everything we have experienced is stored somewhere in our marvelous brains. And while this belief is somewhat true, it is not for those who have experienced trauma.

During a traumatic event, the victim focuses only on the event, not on the peripheral details such as when, where, or why the traumatic event is taking place. In fact, memories of the event may completely disappear from conscious retrieval by the victim until weeks or even decades later when they are triggered back to life.

The reason behind this memory conundrum is because memory is processed in three stages:

  • Encoding- adding and embedding information to memory
  • Storage- retaining and encoding information into memory
  • Retrieval- accessing and recalling formation from memory      

When one experiences a traumatic event, it typically becomes encoded into your memory, where it is stored for later retrieval. As a result, some people only remember that the event took place, and others experience flashbacks, the involuntary, recurring thoughts, and images of the traumatic event.  

The other details, such as location, date, and other information you would think would never be forgotten, are not stored in the memory and aren’t available for immediate recall.

Epigenetics and Post-Traumatic Stress Disorder

Epigenetics is the study of inherited genetic changes that involve changes to the DNA by common mutations and the effects of traumatic stress on our parents. Yes, you can inherit the propensity to form post-traumatic stress disorder from your parents.

PTSD is a stress-related disorder; it is entirely possible that complex interactions between the traumatic events our parents have experienced have changed the very core of their being, DNA, and thus altered the course for their children (Zannas et al., 2015).

Because of obvious ethical concerns (one does not want to induce PTSD in a human), animal studies are conducted to further the research of epigenetics and post-traumatic stress disorder.

So, the idea of epigenetics playing a role in the formation of PTSD in the children of those who formed PTSD themselves is supported by further studies examining fear conditioning in rodents. 

Future research offers an exciting understanding of epigenetics and how our genetic makeup is affected by trauma and its partner PTSD.

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 person’s 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

“Even in times of trauma, we try to maintain a sense of normality until we no longer can. That, my friends, is called surviving. Not healing. We never become whole again … we are survivors. If you are here today… you are a survivor. But those of us who have made it thru hell and are still standing? We bare a different name: warriors.” ~ Lori Goodwin

References

Bremner JD. Alterations in brain structure and function associated with post-traumatic stress disorder. Semin Clin Neuropsychiatry. 1999 Oct;4(4):249-55. DOI: 10.153/SCNP00400249. PMID: 10553030.

Epigenetics. Wikipedia. Retrieved from: https://en.wikipedia.org/wiki/Epigenetics

Morey, R. A., Gold, A. L., LaBar, K. S., Beall, S. K., Brown, V. M., Haswell, C. C., … & McCarthy, G. (2012). Amygdala volume changes in post-traumatic stress disorder in a large case-controlled veterans group. Archives of general psychiatry69(11), 1169-1178.

Zannas, A. S., Provençal, N., & Binder, E. B. (2015). Epigenetics of post-traumatic stress disorder: current evidence, challenges, and future directions. Biological psychiatry78(5), 327-335.

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