For decades we’ve known that people who have experienced severe trauma can develop a condition called Post-Traumatic Stress Disorder (PTSD), in which their emotions and behaviors are altered after a traumatic event. Further investigation into this disorder shows how PTSD impacts the physiology of the brain. For example, PTSD brain scans show the changes that trauma can create within the brain, which helps explain some of the more problematic behaviors that impact the quality of life in people who live with this disorder.
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Changes in Brain Structure & PTSD
Changes in the hypothalamic-pituitary-adrenal centers of the brain are impacted by increased cortisol levels (stress hormones) and influence a wide variety of biological factors within the mind and body. Neurotransmitters that communicate synapses within the brain increase the arousal system, which impacts the brain’s endogenous opioid systems. This disruption influences the propensity for addiction and even alters the sensations of pain and discomfort. The results of these changes within the brain are often an extreme startle response, hypervigilance and feeling as if you are in danger or risk of harm even in the absence of threat.
Bessel van der Kolk, MD, a leading expert in the impact of trauma, explains the three major changes in the traumatized brain and the ways these changes impact a person’s quality of life. PTSD alters the quality of life for those living with it by impacting the ability to interpret information and new experiences. The three changes to the brain involve threat perception, self-sensing and the filtering system (which helps determine what is relevant and what isn’t in any given situation). These altered systems in the brain impact the relationship people with PTSD have with others, their view of themselves and the perceptions of the world around them. This increased understanding of the mechanics of the brain with PTSD can help guide treatment options.
Scans of a PTSD-impacted brain vs. a normal brain indicate structural changes that occur as a result of certain types of trauma. Brain scans of Vietnam veterans with PTSD indicate ongoing brain injury as a result of the condition, which increases the likelihood of cognitive decline and dementia, similar to the scans of people who have survived the Holocaust.
What Functional Neuroimaging Can Reveal
These assessments raise questions about whether a brain scan can show PTSD. The use of a functional MRI for PTSD is a method in which blood flow is tracked within the brain to determine which areas are receiving more oxygen than others. The increased oxygen level indicates greater activity in those areas of the brain, which can be a useful predictor in determining what treatments may be most effective for an individual.
This exciting finding could be a game-changer in the treatment of people with this condition, enabling them to receive more effective and timely treatment that will improve quality of life and possibly reduce the influence of PTSD on the brain’s health.
Honing in on the right treatment for the unique needs of an individual will reduce the need for experimenting with different medications to find out which one may help. While this research is still emerging, the implications of the results could impact the quality of life for countless people living with PTSD.
Study Identifies PTSD Biomarker
The early search for PTSD biomarkers indicated the need for additional studies. Preliminary results showed the potential for this sort of observable data, justifying the need for large-sample studies to further investigate the possibility of biomarkers.
As additional studies have been completed, the presence of PTSD biomarkers is understood with greater clarity. These markers tell us more about the impact of the symptoms of trauma and why some people experience these symptoms with greater severity than others. If an individual has biomarkers that indicate an increased likelihood of PTSD, this could result in a variety of treatment options that may reduce the negative influence of the disorder.
It is common for people with PTSD to abuse substances in response to their challenging symptoms. In fact, approximately 50% of those with PTSD resort to substance abuse. The use of drugs and alcohol with PTSD worsens the impact of the disorder and creates additional problems that impact relationships with others and social and emotional functioning. The study of the PTSD-affected brain has the potential to guide treatment options for substance use disorder and may help anticipate the ways substances will influence the symptoms of PTSD.
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National institute for Clinical Application of Behavioral Medicine. “Three Ways Trauma Changes the Brain.” Accessed September 29, 2019.
Cardenas, Valerie A.; et al. “Changes in brain anatomy during the course of PTSD.” The National Institutes of Health, June 16, 2011. Accessed September 29, 2019.
Nauert, Rick, Ph.D. “Brain Scans May Tailor Treatment for PTSD.” PsychCentral, August 8, 2018. Accessed September 29, 2019.
Schmidt, Ulrike; Kaltwasser, Sebastian F.; Wotjak, Carsten T. “Biomarkers in Posttraumatic Stress Disorder: Overview and Implications for Future Research.” The National Institutes of Health, July 21, 2013. Accessed September 29, 2019.
The National Institutes of Mental Health. “Brain Biomarkers Could Help Identify Those at Risk of Severe PTSD.” January 30, 2019. Accessed September 29, 2019.
McCauley, Jenna L. Ph.D.; et al. “Posttraumatic Stress Disorder and Co-Occurring Substance Use Disorders: Advances in Assessment and Treatment.” The National Institutes of Health, October 29, 2012. Accessed September 29, 2019.
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