You’ve almost definitely heard about PTSD somewhere before. It’s a pretty well-known mental illness portrayed in a lot of movies and books. It is also common knowledge that exposure to trauma causes it. But what exactly happens in the brain to bring about the unique long-term response to trauma? Why does it happen that a group of people experience the same trauma, but only some develop PTSD? Say a terrorist group abducted a group of about 200 students from their school. What puts some of these students at risk of developing PTSD after release, and some not?
PTSD, an initialism that stands for Post-Traumatic Stress Disorder, is precisely that — a disordered response to traumatic stress after it has happened. This is not the regular headaches, anxiety, and moodiness during and after a stressful experience. It is quite different. A significant distinction between PTSD and a normal stress response is duration. If you or someone close to you ever experiences something traumatic, symptoms of mental distress should ease up after, at most, eight weeks. Once there’s still a significant level of discomfort after that time has passed, then it has gone beyond a normal trauma response.
What Puts You at Risk of Developing PTSD?
The abducted students I referred to at the beginning will, unfortunately, all likely end up having a form of mental distress. But how long that lasts and whether it becomes Post-Traumatic Stress Disorder depends on a few factors. Those factors range from their genetics to how much support they receive from family and friends.
Here are some of the things that put a person at risk of developing PTSD after experiencing trauma:
- History of substance abuse
- History of mental illness
- Childhood trauma or other past traumatic experiences
- Having no significant social support
- Family history of PTSD or other mental illnesses
- Experiencing further stress after the event
- Having poor coping skills
How The Brain Responds To Trauma
The major parts of the brain that trauma affects are the amygdala, the prefrontal cortex, and the hippocampus. The effects of trauma are widespread throughout the brain, but those three are the main parts affected.
This is the seat of our fight-or-flight response, which also plays a significant role in memory.
In 1994, some American scientists studied a woman with a destroyed amygdala. She had lost the ability to both recognize and experience fear. Nicknamed ‘SM’, she’s the only clinically fearless person ever studied.
Studies have shown that in people with PTSD, the amygdala is overactive. This accounts for some of the symptoms of PTSD, which include:
- Heightened fear
- Difficulty calming down (overwhelming anxiety)
- Disproportionate response to being startled. For example, leaping up when someone taps you on the shoulder.
This is the actual store for memories in the brain. Of course, memories are not “filed away” in the brain, but if they were, this would be the storage cabinet. Studies show that some people who have remarkable memory have a very active hippocampus. It also helps us to distinguish between the past and the present. That is, what we’re experiencing and what we’re remembering. It’s all tied into its memory function. Unfortunately, people with PTSD usually have decreased activity in their hippocampus whenever a traumatic memory is triggered.
It works somewhat like this:
The brain doesn’t adequately process the trauma when it happens. Because of this, the hippocampus affected by PTSD presents the memory as a current event. The person with PTSD feels like it is happening right at that moment. This is what causes the very vivid flashbacks characteristic of the disorder. The brain’s trauma response team (the amygdala being the captain) can’t also tell the difference. It sends the person into fight-or-flight mode when the flashback occurs.
The Prefrontal Cortex
This is where we get our rationality. Every time you tell yourself, “Calm down,” and try to talk yourself through your fear, it’s your prefrontal cortex doing the heavy lifting. It serves as an analytical balance to the emotions the amygdala feeds us. When an event triggers the memory of a traumatic experience, studies have shown that the prefrontal cortex is less active than usual.
This explains another symptom of PTSD, the immense difficulty in managing fear and anxiety. Though the person with post-traumatic stress disorder may know that there is no immediate threat, they still feel like there is. This makes the panic overwhelming and difficult to control.
The understanding of how trauma affects the brain has proven essential in treating the disorder. It can also help us better understand our minds when we experience something traumatic and help us better cope with it.