While many of us think of trauma as the lasting emotional impact of a highly stressful experience, we sometimes overlook the fact that trauma also impacts the brain itself on a physical level.
When we experience traumatic stress, the chemistry and makeup of our brain actually changes, leaving a lasting impact on our behavior and the way we experience the world. Luckily, with proper care and attention, this impact can be lessened over time.
This article will explore how trauma changes the brain, what those changes mean for our everyday lives, and how proper treatment can help heal the impact of trauma on the brain.
How Does Trauma Affect the Brain
When we experience a traumatic event, our brain chemistry and functioning changes in response to the emotional and physical consequences of that event.
Traumatic events include a wide range of experiences, including:
- Physical or sexual abuse
- Violence or physical attacks
- Emotional or psychological stress
- Death of a loved one
- Financial, professional, or personal loss
There is no standard definition of a traumatic experience for everyone, and each of these experiences takes a unique toll on us as individuals. While all of us experience traumatic stress in different ways, our brains process stress in mostly predictable patterns. In general, there are three major areas of our brain that are shaped by stressful experiences. These are:
- The hippocampus, which helps control memory, learning, and interpretation of information. This area of the brain may become less active under stress and, in fact, may actually shrink. This shrinkage reduces the amount of information and memories we can effectively process at one time. In addition, a smaller and less active hippocampus means we are less likely to be able to process any new information when we are experiencing traumatic stress.
- The amygdala, which helps us process our emotions. During periods of intense stress, the amygdala’s role in the brain is to serve as an alarm system, alerting the rest of the brain to potential risk. While this is useful in life-or-death situations, the amygdala can be triggered by traumatic stress, too, causing the brain to enter fight-or-flight mode over and over again.
- The prefrontal cortex, which acts as the brain’s center of higher-level critical thinking. When our brain enters fight-or-flight mode, however, the prefrontal cortex becomes mostly inactive. Instead, other areas of the brain respond automatically by increasing adrenaline and other chemicals that stimulate the nervous system. As Dr. Gail Gross notes, this “moves our thinking into reactivity and away from a slower, more thoughtful, and critical approach” during stressful periods.
In conditions of chronic traumatic stress, such as an abusive household or a region in conflict, these responses to stress begin to alter the way the brain works, creating a cycle of anxiety and fear that can greatly impact an individual’s quality of life long after the trauma has ended.
Post Trauma Behavior and the Brain
Because the brains of people struggling with traumatic stress or post traumatic stress disorder (PTSD) have physically changed, they may exhibit an overactive stress response in their everyday lives even when there is no direct stressor present.
This means that they may have difficulty feeling comfortable, struggle with intrusive thoughts or memories, or turn to addictive substances to cope with past trauma.
These stress responses can include:
- Memory-related challenges, particularly difficulty in understanding or remembering words and language
- Higher than average levels of fear, anxiety, and substance abuse
- Difficulty relaxing or feeling at ease, as well as a higher likelihood of feeling tense or “on edge” even in normal situations
- Intense flashbacks, emotional triggers, or relived memories that are also accompanied by strong feelings of anxiety
- Difficulty talking about, thinking about, or analyzing past traumatic events, or sharing them with family, friends, or mental health professionals
- Related mental health challenges such as depression, suicidal thinking, compulsions, or intense and irrational fears
Continual stress can impact the body, too, as organs like the heart and lungs gradually wear down from recurring traumatic responses.
Physical impacts of traumatic stress can include:
- Elevated blood pressure and heart rate
- “Stress eating” which can lead to weight gain and heart-related ailments
- Substance abuse to cope with intrusive thoughts
- Risk-taking behavior such as impaired driving or unsafe sex
- Self-harm or suicidal ideation
Ultimately, traumatic stress not only reshapes the brain but also reshapes daily life for millions of Americans throughout their lifetimes.
Can a Brain Scan Show Post Traumatic Stress Disorder?
There is currently no brain scan that can detect and diagnose post traumatic stress on its own. Instead, doctors and clinicians use tools like brain mapping and other brain scanning technology to inform their diagnoses and plan out appropriate treatments. This typically takes place as a part of a comprehensive assessment process that includes a medical evaluation and a series of questions designed to help diagnose post-traumatic stress.
Brain scanning technology can help doctors and therapists see the physical impact of trauma on the brain and can help confirm a post-traumatic stress disorder (PTSD) diagnosis. Researchers often use brain scanning technology like magnetic resonance imaging, or MRI, to see how an individual’s brain has been altered by stress.
For example, in one 2011 study published in the journal Frontiers in Psychiatry, researchers conducted MRI scans on Iraq War veterans who had been diagnosed with PTSD. They found changes present within the amygdala region of their brains that were not present in a group of veterans who had not been diagnosed with PTSD. These changes may have led to “an exaggerated, pervasive state of arousal that exists outside the presence of an overt actual threat,” as the researchers wrote.
In another study of survivors of a 2008 earthquake in China, researchers found that they could identify 91% of the survivors with post-traumatic stress disorder based on clear changes to the gray and white matter in their brains that showed up in brain scans.
While brain scanning can provide useful insights into the way the brain has been changed by post-traumatic stress, mental health providers typically rely on a mix of in-person assessments, questioning tools, and neurological information to make a diagnosis. This allows a provider to have a clearer picture of the impact that post-traumatic stress has had on an individual and those around them.
Often when an individual seeks help for post-traumatic stress, mental health providers will also look for related conditions, or dual diagnoses, that may be worsening or impacting the individual’s mental health. These conditions can include a substance use disorder, depression, or even an injury to the brain caused by physical trauma. They may also explore the causes behind the post-traumatic stress, as well as how the stress has shaped the individual’s everyday life. Providers may also ask an individual if they have ever thought about or attempted suicide, or if post-traumatic stress has led them to engage in risk-taking behaviors like driving while intoxicated.
Together with insights from brain scans and other tools, a medical provider can then provide an accurate diagnosis of post-traumatic stress and help individuals access the help they need to recover.
Proper Treatment for Post Traumatic Stress
Treatment for traumatic stress is possible. While reaching sufferers as soon after the trauma occurs is preferable, that’s not always possible for individuals who are struggling with trauma from early childhood incidents or post traumatic stress from combat or other experiences.
Luckily, physicians and psychotherapists continue to develop new techniques for managing and processing traumatic stress. These typically include a combination of psychotherapy and medical intervention.
Often, a typical trauma treatment plan will include elements of the following therapeutic techniques:
- Cognitive-Behavioral Therapy (CBT): Cognitive-Behavioral Therapy uses a conversation-based approach with a therapist to explore patterns of challenging behavior or traumatic memories. Unpacking these behaviors with a therapist can help individuals find new, healthier ways of coping with stress.
- Dialectical Behavior Therapy (DBT): Dialectical Behavior Therapy helps individuals who are struggling with impulsive emotional responses. Guided by a therapist, individuals can better understand their emotional triggers and common responses, then use a series of strategies to manage them in healthy ways.
- Eye Movement Desensitization and Reprocessing (EMDR): EMDR uses eye movements guided by a therapist to process emotional trauma and traumatic memories. Using the eye movement technique allows the brain to better access and process traumatic memories that may be causing flashbacks, nightmares, or panic attacks within individuals.
Trauma treatment may also include other components, such as:
- Medication-assisted treatment: If needed, physicians or psychiatrists may prescribe antidepressant or anti-anxiety medications while individuals undergo psychotherapy. This can help reduce depression and symptoms of PTSD that individuals may experience due to traumatic stress. Typically, medication is used in conjunction with psychotherapy, not as a replacement.
- Dual Diagnosis treatment: Often individuals struggling with trauma may also grapple with addiction and substance use disorders. In these cases, it’s important that treatment providers also diagnose and treat any addictive behaviors that may be worsening the body’s response to traumatic stress. Most reputable addiction treatment providers can provide support for co-occurring disorders.
What Happens if Post Traumatic Stress Disorder Goes Untreated?
While post traumatic stress has become more visible and discussed in recent years, especially in the aftermath of the Iraq War, thousands of people still struggle with undiagnosed and untreated post-traumatic stress disorder.
The consequences of untreated post traumatic stress disorder can be severe and can impact an individual’s mental, emotional, behavioral, and physical health. The risks of untreated post-traumatic stress disorder include:
Ongoing stress and anxiety
- Individuals with untreated post-traumatic stress disorder may suffer from chronic episodes of traumatic stress, anxiety, or flashbacks, often triggered by sights, sounds, or sensations associated with the traumatic event. Over time, this stress response can lead to a deterioration of physical health, as well.
Difficulty managing personal and professional relationships
- Post-traumatic stress disorder can often lead individuals to isolate themselves away from family, friends, and colleagues as a way of coping with intrusive thoughts and feelings. When left untreated over a long period of time, the disorder can cause rifts within families and lead to lost jobs, missed school, and other complications.
- Post-traumatic stress disorder has been linked to other health issues, including difficulty sleeping, long-term pain, challenges with blood flow or the heart, and muscular or skeletal injuries. Psychologically, PTSD sufferers are more likely to struggle with anxiety and panic disorders.
Dual diagnosis risks
- Individuals with untreated post-traumatic stress disorder frequently suffer from dual diagnosis conditions, including substance use disorder, depression, anxiety disorder, panic disorder, and eating disorders. In many cases, the individual may turn to addictive substances to manage post-traumatic stress, and, in other cases, their post-traumatic stress may increase the severity of anxiety and depression.
Greater health care needs
- Because post-traumatic stress can contribute to a variety of health complications, individuals with untreated PTSD may need to turn to the health care system more often. Without treatment, it is often difficult for individuals to realize that many of their health challenges are linked to, or made worse by, their post-traumatic stress.
Seeking Professional Help
Luckily, there is a growing awareness among physicians and mental health professionals about the long-term impact of post-traumatic stress. If you or a loved one are concerned about coping with a traumatic event (or series of events) that you have experienced, please seek out support from a medical or mental health professional.
While many people in treatment continue to experience some elements of post-traumatic stress throughout their lives, proper treatment can help individuals learn coping mechanisms and better understand and manage their mental health. There is no shame in seeking help. Avoid long-term risks to your health and the health of others by seeking care.
It may feel like traumatic stress will be a part of your life forever. But with proper treatment and care, you can heal and learn healthier behavior patterns for a more fulfilling life.
At StoneRidge Centers, we work closely with our patients to develop personalized treatment plans that focus on mental and physical health. Our brain-focused approach combines evidence-based therapy with innovative brain science to heal your mind and body. We’re here to help when you’re ready to heal.
Innovative, Evidence-Based Therapies
Because mental health and addiction concerns are so often interconnected, we utilize research-based approaches with evidence-based outcomes that promote overall healing and recovery.