The pandemic. Social unrest, natural disasters, war. You don’t have to look very far to see traumatic events that affect large numbers of people. More personal crises include divorce, death, abuse, violence, sexual assault and accidents.
A traumatic event is any experience frightening, shocking or dangerous enough to affect someone physically and emotionally, whether they are part of the event or a witness to it.
Trauma resulting from a distressing event can cause unexpected symptoms that disrupt daily life. For example, after a car accident, you may not be able to drive or ride without anxiety. Your heart may race unexpectedly, even when you’re not actively thinking about the wreck. You may “see” the accident over and over; visiting the scene or even traveling near it may trigger a panic attack.
It’s helpful to realize it’s not you, it’s your brain. Even more helpful is knowing that your brain can heal from trauma.
Four areas of the brain spring into action after a traumatic event:
- The amygdala, a region that scans for threats and connects emotion and memory, telling us what’s safe and what isn’t.
- The hippocampus, essential to learning and processing memory and emotion.
- The prefrontal cortex, the brain’s center for rational thought, higher-order thinking, planning, and language. It helps control the amygdala.
- The hypothalamus and the pituitary gland, which release the stress hormones both during the event and later, during PTSD.
Trauma affects the first three areas of the brain in profound ways. The amygdala becomes more active and hypersensitive, poised to alert you to any threat, actual or perceived. Loud noises or someone or something that reminds you of the trauma become triggers for alarm and panic. You become less able to tolerate stress.
After trauma, stress hormones kill cells in the hippocampus, which actually shrinks. You may experience memory loss or persistent, disturbing memories, along with a limited ability to process emotions. It becomes difficult for your brain to distinguish past from present; a memory of the trauma may feel like it’s happening right now, triggering the amygdala to regard it as a threat and send out a warning. The connection between the hippocampus and amygdala gets stronger, contributing to a state of trauma-driven fear and anxiety.
The functioning of the prefrontal cortex also suffers. We’ve all experienced overwhelming situations in which our thinking brain simply stops working. Trauma interrupts the ability of the prefrontal cortex to do its job. With impaired ability to reason, it becomes difficult for your brain to control or assess the alarms coming from the amygdala; it becomes difficult to identify true threats because everything seems unsafe.
“Individuals who have a mental health condition or who have had traumatic experiences in the past, who face ongoing stress, or who lack support from friends and family may be more likely to develop more severe symptoms and need additional help.”National Institute of Mental Health, Coping with Traumatic Events
In addition, a steady supply of stress hormones keeps you locked in a state of vigilance, hyperarousal, and anxiety. Adrenal overload leaves you on edge, fatigued, and vulnerable to shutdown and feelings of depression.
Trauma Disrupts Daily Life
All this trauma-driven activity in the brain translates to symptoms that change the way you live and behave. PTSD is an often-confusing state driven by survival instincts that take charge and override “normal.”
Post-traumatic symptoms fall into four categories:
- Thinking – Intrusive thoughts and flashbacks related to the trauma; conversely, you may experience memory loss.
- Emotional – Intense emotions and moods, such as anger or sadness accompanied by sudden rage or tears. Negativity and blame are common, as are numbness and anxiety. It can be difficult to find joy in things you once loved.
- Behavioral – Avoiding anything related to the trauma or its memories. For example, going out of your way to avoid the site of a traumatic event or hiding pictures of someone connected with your trauma.
- Physical – Bodily changes such as increased heart rate and shortened breath, feeling jittery or on edge, startling easily, panic attacks, insomnia, and nightmares.
“Brain fog” is a common complaint among trauma victims, who find it difficult to focus, concentrate or take in new information. If you suffered from a mental health disorder before a traumatic event, symptoms of that disorder could worsen. Trauma can affect relationships; you may withdraw from others, especially those who seem insensitive or oblivious to what you’re going through.
“Children who have witnessed traumatic events—such as domestic violence, shootings or even fighting—can develop traumatic stress that in time can impact their physical and emotional health.”Changing Minds, Understanding the Science of Trauma
Symptoms in children can include bed-wetting, forgetting how to talk (or becoming unable to), acting out the traumatic event, becoming extra-clingy, and refusing to go to new places or respond to people they don’t know. Because symptoms make it hard for children to pay attention in school, trauma in children is often confused with ADHD.
Luckily, the brain’s neuroplasticity enables it to heal from trauma. “What fires together, wires together” applies not only to trauma but to trauma release. To restore mental and physical health, we can reroute the neural pathways of trauma with multiple therapies, some of which are still developing an evidence base:
- CBT – cognitive behavioral therapy (“talk therapy”), which helps people recognize and change patterns of thought.
- Antidepressants have been shown to counteract the effects of stress on the hippocampus.
- EMDR – eye movement desensitization and reprocessing therapy, designed to help trauma victims process memories, alleviate distress and reduce hyperarousal.
- Trauma-Focused Cognitive Behavioral Therapy (TF-CBT), designed for children and adolescents.
- Mindfulness-based stress reduction, Somatic Experiencing (a body-centered approach), hypnosis, and neuro-linguistic programming.
Each person is unique; there is no “one size fits all” trauma therapy. In addition to counselor-led therapy, several at-home practices can help you process trauma and reduce symptoms. Journaling allows you to process memory and emotion and “wake up” the prefrontal cortex. Exercise and yoga are good ways to relieve and release stress. In addition, supportive relationships with people you trust, avoiding alcohol and self-medication, keeping regular routines for meals and sleep, and limiting stressful situations can all help reduce symptoms.
Don’t Stay Stuck in the Trauma Loop
Chronic stress from trauma takes a toll. Staying stuck in the brain’s trauma loop can strengthen unhealthy neural pathways and put a strain on the body that may eventually lead to chronic physical illnesses and problems with sleep and digestion.
Healing from trauma requires commitment to seeking help and following a therapeutic program. At Best Day, our counselors are trained to help you with a diagnosis and a treatment plan for PTSD designed to restore you to your best life.