01 Mar P.T.S.D – Not All Wounds Are Visable
Trauma can affect people in so many ways and this blog talks about how it affects the brain
Extensive neuroimaging studies on the brains of PTSD patients have shown 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 signs of PTSD. Together these regions of the brain have an impact on the flight and fight mechanism in our brain. So even long after the trauma the PTSD victim has experienced, they will perceive and respond to stress differently than someone who is not suffering from the aftermath of the trauma
What does the effect of trauma have on the Hippocampus?
The hippocampus is part of the brain’s limbic system. The limbic system has a place in how our memory functions, our motivation and how we experience emotions such as fear and anger. It is theorised that it can be damaged by excess cortisol being released into the body in those who suffer severe chronic stress (cortisol is a hormone released into the body under conditions of extreme stress and perceived threat to help mobilise the body and prepare it for survival through fight or flight
People who experience PTSD show a considerable reduction in the volume of the hippocampus. Although studies have shown a smaller Hippocampus in people experiencing PTSD it cannot be sure that this caused by prolonged exposure to extreme stress, there is a possibility it could be that people have a smaller Hippocampi from birth, which can be a vulnerability to adverse effects of stress
PTSD patients with a reduction in the Hippocampus volume lose the ability to recognise the differences between the then (experiencing the trauma when it happened) and now. This leads to incorrectly interpreting the threat and remaining in the trauma experience.
The neural mechanisms involved, triggers extreme stress responses when confronted with situations that resemble to something from their traumatic past. This can be experienced through a smell for example if someone had been trapped in a fire. Their extreme stress response could going out for a walk and smelling a bonfire same goes for sound and touch. A soldier being unable to watch any films on war as this would remind him of the times he was in Iraq. The hippocampus cannot Minimise the interference of memories that have happened in the past
Damage done to the hippocampus by trauma can result in:
- Susceptibility to extreme fear responses in relation to ‘triggers’ (i.e. anything that reminds the person with PTSD of the traumatic situation)
- extreme and persistent fearfulness
- problems recalling the traumatic event/s or parts of the traumatic event/s. Leading to a fragmented memory
- Continuing to experience intruding, unwanted, distressing and vivid memories of the traumatic event/s
How is Trauma connected to the Ventromedial prefrontal cortex?
The ventromedial prefrontal cortex is located at the front of the brain and is responsible for emotional regulation, that has been triggered by the amygdala and severe emotional trauma can cause changes to this region of the brain
PTSD patients show a marked decrease in the volume of the ventromedial prefrontal cortex as does the Hippocampus and the functional ability of this region. This explains why people suffering from PTSD tend to experience fear, anxiety and extreme stress responses and this happen even when faced with stimuli not connected to the trauma
The prefrontal cortex is part of the brain’s outer layer called the cortex. In adults, the prefrontal cortex takes up nearly a third of this outer layer.
There are competing theories about how best to categorize the parts of the prefrontal cortex. The brain is very interconnected, both physically and functionally. It is difficult to point to a specific part of the brain and say that this section alone controls a certain ability.
In general, though, the prefrontal cortex can be divided into three parts according to which functions they serve.
- The medial prefrontal cortex contributes to attention and motivation. If this region of the brain is damaged then this can cause, trouble acting spontaneously or initiating speech. They could also have trouble concentrating on a task they have started.
- The orbital prefrontal cortex helps people control their impulses and ignore distractions. It helps them keep strong emotions in check in order to follow social rules.
- Lastly, the lateral prefrontal cortex allows people to create and execute plans. Injuries to this region can interfere with people’s abilities to switch between tasks, recall where an instruction came from, or adapt to changes in rules.
How does the Amygdala and anxiety link – the brains emotional computer and alarm system?
The amygdala is in the medial temporal lobes of the brain. It is a part of the limbic system and is primarily responsible for processing and recording emotional responses, such as anxiety.
The amygdala is responsible for determining the appropriate emotional response to external stimuli. For example, if a person is attacked by a mugger, the amygdala recognise the event as threatening. It then sends a message to the rest of the body, preparing it for fight or flight. The fight or flight response is essential to human survival and dates back to when humans lived in caves and were constantly under threat from wild animals It sends a message to the muscles and nervous system, preparing the body to fight, run away, or freeze.
The fundamental connection between the Amygdala and anxiety is that the Amygdala produces anxiety responses. This organ tells the body when it is in a dangerous situation and triggers an anxiety response. Anxiety disorders often develop when the amygdala is over-stimulated. Together, the amygdala and anxiety are responsible for responses to perceived threat, emotional memory, and fear conditioning.
What treatment is available for PTSD?
The main treatments available for people with PTSD are Psychotherapy, medication or a combination of them both. Everyone is different, and treatment that is effective for one person may not be for another. Some people might need to try different treatments to find the one that works in reducing the symptoms.
No matter what option you choose, it is important for anyone experiencing PTSD to be treated by a Mental Health Professional and is experienced with working with people with PTSD.
Cognitive Behavioural Therapy is evidence-based therapy that has been found to be the most effective treatment for PTSD. CBT for PTSD is trauma focused, it focuses on identifying, understanding, and challenging thinking and behavioural patterns. The skills learnt through the weekly CBT sessions are encouraged to be practiced repeatedly outside of the therapy times. This helps to support symptom improvement
BraintrainersUK are experienced in mental health as Nurses and Accredited Cognitive Behavioural Therapists
The EMDR therapy uses Bilateral stimulation, right/left eye movement, or tactile stimulation, which repeatedly activated the opposite sides of the brain, releasing emotional experiences that are trapped in the nervous system. This assists the neurophysiological system, the basis of mind and body connection, to then let go of blockages and be able to reconnect itself
Antidepressants such as Paroxetine, Sertraline, Mirtazapine or amitriptyline are sometimes used to treat PTSD in adults. Of these medications, only Paroxetine and Sertraline are licensed specifically for the treatment of PTSD. But mirtazapine and amitriptyline have also been found to be effective and may be recommended as well.
BraintrainersUK can help you process the trauma …. Let us help you get your life back with Trauma focused Cognitive Behavioural Therapy
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 reassuring to know that the brain also has the amazing capacity to regenerate.
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