Much of the conventional wisdom surrounding the treatment of PTSD is based upon the presumption that individuals who have PTSD have experienced irreversible neurological changes. However new research suggests otherwise. This important discovery could have far-reaching consequences for the treatment of PTSD.
What is Trauma?
Trauma is an emotional and physiological response to a terrible event. This event could be experiencing combat, rape, a natural disaster or an assault. Other potentially traumatic events, while not as well-known, are no less damaging including any threat to one’s life, body or even moral integrity.
The automatic reaction when we are faced with danger is to go into fight-or-flight mode, which by increasing the release of cortisol and adrenaline enables to one to act quicker, either to fight or to flee.
Trauma inhibits this typical response to danger. Instead of fighting or fleeing, we freeze. This freeze is accompanied by a profound sense of paralysis and helplessness which disables the victim to do anything that results in gaining relief from the situation.
What is PTSD?
Post Traumatic Stress Disorder, or PTSD, is a condition that may evolve after the trauma is experienced. Although there a plethora of symptoms, the most common are:
Experiencing the event again as if it is occurring at the moment
Attempting to avoid any reminder of the event
Feelings of emotional numbness such as the inability to cry
Vulnerability to hyper-arousal from seemingly innocuous events
The Central Role of Neuroplasticity
The neurological implications of PTSD can be best appreciated once neuroplasticity, a new and exciting concept in neuroscience, is explained. Until recently the consensus among scientists was the development of the brain was akin to physical development- that once the brain became mature, it would no longer grow or develop in any way.
But recent brain research has shown quite the opposite to be true. The human brain is in a constant state of change. New experiences impact the circuitry in our brain. So, in the course of one’s life, brain mapping will show new and changing neural pathways. This flexibility in the brain is known as neuroplasticity.
When trauma is experienced, neuroplasticity is responsible for the brain changes in order for the brain to cope and adapt to the particular situation. However, this adaptation, while serving the brain well at the moment as a defense against further trauma, has adverse long-term effects as will be explained.
The Neurology of PTSD
Neuro-imaging has demonstrated that the three areas of the brain that are impacted by trauma are:
The prefrontal cortex (PFC)
The amygdala seated in the brain’s limbic system (the emotional seat of the brain) determines when danger is present, triggering the fight-or-flight response. The problem is that experiencing trauma causes the amygdala to remain hyper-vigilant to other stimuli that are not threatening, thus activating the fight-or-flight response system even when the person is safe.
Consequently, PTSD can cause the sufferer to get caught in a vicious cycle where it seems that danger is practically everywhere due to the activated amygdala.
This hyperactive amygdala is continually interacting with the hippocampus, the area of the brain that plays the critical role in memory function. Brain scans have shown that those with PTSD have a reduced hippocampus which suggests that trauma may be responsible for impaired memory.
Also, the hippocampus organizes memories and helps to give those memories context. PTSD by impairing the function of hippocampus serves to fragment memory resulting in a loss of context, compromised ability to distinguish past from present, and a reduction in integrating memories with factual knowledge and feelings.
The damage to hippocampus functioning seems to be responsible for the flashbacks and intrusive memories so familiar to those who suffer PTSD. But it gets worse. Those painful memories stimulate the amygdala assuring its continued hyper-activity.
The third region of the brain impacted by trauma is the prefrontal cortex or PFC. The PFC regulates emotions, impulses, behaviors, and response to fear. Research has shown that those who have PTSD have reduced activity in the PFC. This means that there is impaired ability to arrest the flashes of memory coming from the hippocampus and the inability to signal the amygdala that the danger is imaginary.
The Neurology of Mindfulness
Research has shown that there is significant data to support mindfulness as a way to relieve PTSD. However, it is only recently that this literature has addressed the neurological changes that occur in the brain during the mindfulness process.
As was explained above, deregulation of the brain areas associated with emotional regulation and memory are vital contributors to the symptoms associated with PTSD, in addition to the overactivity of the fear center, the amygdala.
Mindfulness meditation by way of neuroplasticity changes brain structure and function.
It reverses the patterns of brain deregulation and memory fragmentation by increasing PFC and hippocampus activity in addition to calming down the amygdala.
Brain scans show that mindfulness meditation causes an increase in gray matter in the hippocampus as well as a decrease of gray matter in the amygdala. What’s more, neuroimaging studies have associated mindfulness meditation with increased activation of the PFC.
Neurology and brain research aside, clinical studies have demonstrated that mindfulness assists those with PTSD free themselves from the painful and vicious cycle of negative thinking, often a cornerstone of trauma.
The exciting discovery of neuroplasticity gives new hope to those suffering PTSD through the well-known power of mindfulness.