The human brain and body actually have built-in systems designed to act under traumatic situations.
In cases where someone was physically harmed, the first reaction might be relief that they survived the incident. Broken bones heal and scars fade. But what happens when someone experiences psychological trauma?
Roughly 8 million people in the United States suffer from posttraumatic stress disorder (PTSD) in any given year, according to the Department of Veterans Affairs. These are only the diagnosed cases, however, and only a fraction of people who will experience psychological trauma in their lifetimes. In fact, women experience psychological trauma and PTSD more frequently than men, and some populations, like combat veterans, are more likely than others to develop PTSD. It’s also possible to develop PTSD from serious health problems, childbirth (including the loss of a child), serious accidents or witnessing serious accidents, childhood abuse, or domestic abuse.
It turns out that the human brain and body have built-in systems designed to act under traumatic situations. Those traumatic situations, however, can change both the mind and the body on a chemical and cellular level.
Let’s have a look inside psychological trauma — what it is, how it affects the brain, how “normal” it is, and the help available for those who experience it. You might be surprised — and you just might discover a piece of information that can help you, or someone you love, get the help needed to heal.
What happens when we experience psychological trauma?
Our brains are built with a natural response to any threatening situation. It’s commonly known as “fight or flight.” That response is how humans learn fear, from childhood and beyond.
“When we’re exposed to a single threatening stimulus, our sympathetic nervous system responds right away,” says neuroscientist and medical doctor David Rabin, who is the chief innovation officer, co-founder, and co-inventor of Apollo Neurosciences. “Our breath increases, we start to sweat, blood gets diverted from our digestive system to our muscles. Those responses are super important, as when we’re exposed to a threat, we need to be able to get out of that situation immediately.”
Rabin’s a researcher and clinician working primarily with patients who have suffered psychological trauma. He’s also one of the nation’s leading researchers exploring alternative treatments for those with PTSD using compounds like MDMA. He explains that when threats come along, the human body is doing what it’s designed to do. When psychological trauma occurs, however, the body forgets that it no longer needs to be in that heightened state.
“You want your digestion, creativity, hunger and reproductive systems to shut down when you’re running from a lion,” he says.
During periods of extreme psychological stress, however, the body is bombarded with hormones like cortisol, adrenaline and epinephrine — commonly called stress hormones. Even though the body is doing what it’s supposed to do to help get you to safety, extreme events create extreme reactions in the body.
How does psychological trauma/PTSD affect the brain?
“Trauma can have some very destructive effects on the brain,” says Dr. Ajeet Sodhi, an attending physician in neurology, interventional neuroradiology, and Director of Critical Care at California Institute of Neuroscience. “The fact that trauma could physically impact the brain isn’t something that was known for many years.” He explains that as far back as World War I, soldiers returning from war were said to have “shell shock.” Medical professionals knew something damaging had happened, but they didn’t have an official diagnosis for it yet. PTSD was designated as an official diagnosis by the American Psychiatric Association in 1908.
Now, researchers know that when someone experiences psychological trauma, neural pathways in the brain change under extreme mental stress. The part of the brain where the fight-or-flight response originates, the amygdala, goes on high alert. Since it’s the part of the brain that also helps store memories, it’s well-built to store bad memories as well.
Next, the prefrontal cortex (located in the frontal lobe of the brain) can shrink. Why is this important? “The frontal lobe is the part of the brain where our personalities originate,” says Sodhi. “Trauma also causes this part of the brain that regulates emotion to become dysregulated.”
Following extreme psychological trauma, your body and brain can remain in a constant state of high alert, even though the threat could be long gone. “People can become stressed, they can’t sleep, and often, they become sick because their body isn’t designed to operate in that heightened state constantly," he says. These are some of the leading symptoms of PTSD.
For those suffering from PTSD, daily living can become a burden, thanks to the body’s constant state of overload. It might also seem to those suffering from PTSD that they are isolated, and no one understands what they’re feeling, or for that matter if it’s “real.” After all, it’s easier to dismiss something we can’t see, like feelings, than it is a broken leg, which becomes apparent on an x-ray.
Is PTSD normal?
PTSD is most certainly real. However, in Dr. Sodhi’s work in neurological trauma, he’s no stranger to the public stigma surrounding mental illnesses, including those suffering from PTSD.
“One of the biggest misconceptions is that PTSD is somehow a character fault or personal weakness,” he says. “Those suffering from PTSD are quick to be labeled as ‘crazy,’ and they’re used as a punchline. We treat their condition as a shameful thing when the reality is that PTSD can happen to anyone.”
He breaks PTSD down even further into its most essential parts: “People were normal. Something happened. They couldn’t deal with it.”
Given most everyone has felt overwhelmed every now and then, it’s easier to understand that psychological trauma is the act of the body and brain being overwhelmed by something the mind wasn’t prepared to process. That doesn't make a person weak or abnormal. It makes a person someone who had an extraordinary neurological response to an extraordinary situation.
The good news is that there’s help available and that it’s okay to ask for help.
What help is available for people who have PTSD?
"There’s a misconception that you can’t heal from PTSD because so many people have received inadequate treatment for so long," says Rabin. The reality, he assures, is quite the opposite.
The brain can actually be “re-wired” through a combination of talk therapy and what’s called cognitive behavioral therapy (CBT). If that sounds intimidating, don't sweat it. CBT helps people become aware of their negative thoughts and find more effective and healthy ways of dealing with them.
“Practice makes perfect. Not that there’s an idea of perfection we should achieve, but if you practice being stressed out all the time, you’ll get really good at it,” says Rabin. “If you practice doing something good, you’ll get really good at that, too.”
Rabin points out that those suffering from psychological trauma can teach themselves to become better self-healers through techniques like CBT. Sodhi has also seen the benefits of CBT with patients living with PTSD over his career as well.
“As humans, we think all the time but we’re not aware of what we’re thinking. We think our thoughts are out of our control,” says Sodhi. “CBT teaches us how to gain control over our thoughts and emotions.”
And that’s what many who suffer from PTSD feel that trauma has taken from their grasp: control. Control over their minds, bodies, memories, and health.
But while psychological trauma might have the ability to change the neurological structure of the mind and wreak havoc with the body, those challenges can be overcome. It’s also important to know that you’re not alone. You’re among 8 million others who have suffered psychological trauma. It’s real, it’s not all in your head, and there is help available to point you towards a healthier, more peaceful life.
E. Napoletano is an award-winning journalist and author and the recipient of the 2019 Illinois Women’s Press Association first-place prize for her feature on the traumatic effects of family separation policies at the border.