PTSD: Branded in the Brain

Imagine that you’re in your car, humming along to your favorite tune on the radio while waiting for the traffic signal to change. Suddenly, you see a horrific car accident that leaves some people dead and several others injured. Immediately, your heart starts racing, your breathing gets rapid and shallow, and you feel anxious. These are all typical signs of the human body’s stress response system, also known as the fight-or-flight response.

In most people, after witnessing a traumatic event, your system would eventually return to a normal state of relaxation. In some individuals, however, those feelings of fear, anxiety, and horror linger and develop into posttraumatic stress disorder (PTSD).

That’s what happened to Miles.

PTSD CAUSES AND SYMPTOMS

After the accident, Miles developed PTSD, a condition that will affect an estimated 1 in 11 people during their lifetime. This condition arises in some individuals who experience trauma or witness a traumatic event. Physical, sexual, and emotional abuse are common causes of the condition, as are military combat, natural disasters, mass shootings, and terrorist attacks. For some people, the threat of death, serious injury, or emotional harm—or even a perceived threat—can set the stage for PTSD.

People with PTSD tend to recall traumatic events long afterward with flashbacks, uncontrollable thoughts, or nightmares. They often avoid places, people, and things associated with the trauma. It is common to experience anxiety, depression, fearfulness, emotional numbness, anger, and insomnia. Individuals suffering from PTSD are also likely to be easily startled, hypervigilant, or jumpy. This can interfere with relationships, cause problems in your career, and lead to unhealthy coping behaviors such as substance abuse. In some cases, it can ruin your life.

Like Miles, people who have PTSD may continually re-experience the trauma as if the past were still alive in the present. Miles, for example, had nightmares about the accident every night. In addition, whenever he saw a car similar to the one that caused the accident, it triggered the same horrible feelings he had experienced in that moment.

WHEN THE STRESS RESPONSE GETS STUCK

As humans, we all need to feel safe. When we experience traumas, however, we lose that foundational feeling of safety. The fight-or-flight response that is activated by protective circuitry that strives to keep us safe no longer functions optimally. It gets stuck in overdrive and refuses to calm down.

Miles’ danger detector, his stress response alarm system, was on constant fight-or-flight high alert. He felt like he was under threat at all times. Like Miles, many traumatized individuals have fight-or-flight reactions that continue long after the danger has passed. The feeling of danger never abates. It is why the emotional traumas in PTSD are “branded in the brain.”

PTSD AND THE BRAIN

Brain SPECT imaging studies reveal that people with PTSD who have suffered emotional trauma or physical abuse tend to have too much activity in certain areas of the brain. The regions where overactivity is seen on SPECT scans include the following:

• Deep limbic area (the brain’s emotional center): Overactivity in this region is associated with depression.
• Basal ganglia (the brain’s anxiety center): Too much activity here is linked with increased anxiousness.
• Anterior cingulate gyrus (the brain’s gear shifter): Heightened activity in this area is associated with getting stuck on thoughts and behaviors.

On SPECT, the overactivity takes the shape of a diamond pattern. This pattern tends to keep the brain on overdrive, increasing anxiousness, irritability, fearfulness, and interfering with sleep. Seeing the diamond pattern on SPECT scans is a clue that past emotional trauma may need to be addressed.

PTSD on SPECT – Before and After Treatment

Active View BEFORE Treatment	Active View AFTER Treatment

In a healthy “active” SPECT scan, blue represents average blood flow and red (or white) represents increasingly higher levels of blood flow. In the scan on the left, there is high activity in the deep limbic area, basal ganglia, and anterior cingulate gyrus, which is a classic finding in cases of PTSD. The scan on the right shows that overactivity has been calmed.

TREATING PTSD

The scan on the right shows that if you have PTSD, there is hope for soothing an overactive brain. There are many treatment options that can provide relief. Psychotherapy is a common component of a treatment plan and can be very helpful. Other therapies that can be beneficial include cognitive behavioral therapy (CBT), EMDR (eye movement desensitization and reprocessing), and other trauma-focused therapies. For some people, antidepressant medications may be recommended as part of a treatment plan.

Understanding your brain and any co-existing conditions, such as substance abuse, depression, or past head injuries is key to getting the most effective treatment plan. SPECT can be a powerful tool in this regard. Not only does functional brain imaging help identify co-occurring disorders and target treatments to your brain, but it also provides other important benefits. For example, SPECT helps:

• Demonstrate that symptoms and behaviors are not imaginary, thereby reducing emotional pain and stigma.
• Families gain a better understanding of what is actually going on in the brain of their loved ones, which increases forgiveness.
• Encourage compliance with treatment plans, which improves outcomes.

PTSD and other mental health issues can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, clinical evaluations, and therapy for adults, teens, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.