Therapy Can Help You Overcome Flashbacks
Understanding whats happening in your brain during a PTSD flashback can help you learn strategies to cope. You can work with a therapist to identify triggers for your flashbacks, such as certain objects, people, or places. Then, you can work with them to identify ways to respond calmly to these triggers through relaxation techniques as well as exposure and cognitive behavioral therapies..While PTSD can be a debilitating condition in some cases taking years for the survivor to be stable and healthy enough to process the trauma with appropriate treatment it can be successfully overcome.
How Does Ptsd Affect The Brain
PTSD is a disordered relationship to stress originally triggered by an overwhelmingly stressful event in the past. And stress is a physical and chemical response that happens automatically in the face of certain triggers. In an original biological sense, our heightened state under stress is a positive coping mechanism when we are in danger and need to protect ourselves. When personal protection is on the line, surges in the hormones cortisol and norepinephrine can give us a survival edge. But were not meant to have the stress-related regions of our brain firing overtime on a regular, daily basis. This can lead to serious neurochemical and biological dysregulation.
On top of the general levels of pain and suffering that happen under so much stress, a person with post-traumatic stress disorder may also experience other psychological disturbances, including:
- Depression
Treating Trauma Through Exposure With Response Prevention
Research indicates that, in most cases, the best treatment for resolving trauma-related psychiatric issues is Exposure with Response Prevention . ERP involves flooding a person with the trauma. Flooding is a term used to describe repeating the traumatic experience over and over until the emotional valence of the trauma the connection between the trauma and the persons pain becomes muted through repetition.
People with PTSD or trauma may avoid situations or relationships as a protective coping strategy. The goal of ERP is to empower trauma survivors to face those triggering situations and fully engage in their communities without experiencing debilitating fear or pain.
Flooding through ERP can be approached in a variety of ways. Through Imaginal Exposure, clients repeat their traumatic experience by repeatedly imagining themselves in the same situation while under the care and supervision of a mental health professional. Through In Vivo Exposure, clients visit the place where the trauma occurred and directly confront their fears and emotions with the support of their therapist or mental health care provider.
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What Causes Ptsd Here’s What Happens To The Brain After Trauma
There’s no threshold for whether something is traumatic enough to cause the disorder, but common triggers include natural disasters and violent assaults.
A violent act, natural disasters, military combat: These are all life events that can prompt post-traumatic stress disorder , which affects 8 million Americans, according to the National Alliance on Mental Illness.
The list of triggers for this anxiety disorder is quite long and includes natural disasters such as floods, earthquakes and tsunamis, a serious accident and witnessing a death, especially a violent one.
In addition, the PTSD causes we are all familiar with include military combat, terrorist attacks and violent personal assaults such as sexual assault, mugging, or robbery, says Vonnie Nealon, clinical director of Warriors Heart, an accredited treatment program for military, veterans and first responders, in Bandera, Texas.
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The Thirteen Steps To Managing Emotional Flashbacks
Say to yourself: I am having a flashback.
Flashbacks take us into a timeless part of the psyche that feels as helpless, hopeless, and surrounded by danger as we were in childhood. The feelings and sensations you are experiencing are memories that cannot hurt you now.
Remind yourself: I feel afraid, but I am not in danger!
I am safe now, here in the present. Remember, you are now in the safety of the present, far from the danger of the past.
Own your right/need to have boundaries.
Remind yourself that you do not have to allow anyone to mistreat you you are free to leave dangerous situations and protest unfair behavior.
Speak reassuringly to the Inner Child.
The child needs to know that you love her unconditionally- that she can come to you for comfort and protection when she feels lost and scared.
Remember, the flashback will pass as it has many times before.
Remind yourself that you are in an adult body with allies, skills, and resources to protect you that you never had as a child.
Feeling small and little is a sure sign of a flashback.
Ease back into your body. Fear launches us into heady worrying or numbing and spacing out.
Gently ask your body to Relax: feel each of your major muscle groups and softly encourage them to relax. Breathe deeply, find a safe place to soothe yourself, and allow yourself to feel the fear without reacting to it.
Resist the Inner Critics Catastrophizing.
Allow yourself to grieve.
Cultivate safe relationships and seek support.
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What Does Ptsd Do To A Person
People with PTSD have intense, disturbing thoughts and feelings related to their experience that last long after the traumatic event has ended. They may relive the event through flashbacks or nightmares they may feel sadness, fear or anger and they may feel detached or estranged from other people.
The Brain’s Response To Trauma
When your brain identifies some type of threat, the amygdala is responsible for initiating a fast, automatic reaction known as the fight-or-flight response. Think of the amygdala as the alarm that sounds when something poses a danger. This alarm prepares your body to respond, either by dealing with or getting away from the threat.
The amygdala also communicates with other areas of the brain, including the hypothalamus, which then releases the stress hormone cortisol. It is the brain’s prefrontal cortex that must then assess the source of the threat and determine if the body needs to stay on high alert to deal with the threat or if the brain needs to begin calming down the body.
The prefrontal cortex acts as a braking system that helps return your body to a normal state when you realize that the threat doesn’t pose a danger or after the threat has passed.
When people have symptoms of post-traumatic stress disorder, the amygdala becomes hyperactive while the medial prefrontal cortex becomes hypoactive.
In other words, the part of the brain that triggers a fight-or-flight response responds too strongly, often in a way that is disproportionate to the danger posed by the threat. At the same time, the part of the brain responsible for calming this reaction does not work well enough.
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Trauma: Brain And Body
Harmful or life-threatening events cause the brain to trigger the release of adrenaline, activating the fight or flight response so that you can prepare to run or defend yourself. If your brain perceives you are in danger, it works hard to get you out. At times like this, a lot of energy courses through you.
The Effects Of Trauma On The Brain
People often talk about how the effects of childhood trauma can carry over into adulthood, and it is true.
Traumatic events and experiences can have a lasting impact on people. For some people, effects will include the development of post-traumatic stress disorder symptoms that can vary in severity and sometimes hinder their lives, especially if they never receive formal PTSD treatment. For others, trauma can lead to more subtle changes in their behavior, actions, or thinking. Either way, trauma can impact people in more ways than they may realize.
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What Parts Of The Brain Are Involved In Ptsd
We believe that the amygdala is involved in perceiving something as threatening and that this activation initiates activity in other parts of the brain such as the hippocampus and the orbital frontal cortex .
When a person suffers from PTSD, the normal systems that balance the amygdala activation become impaired. Because the amygdala is activated, more stimuli and less threatening stimuli, are seen as threatening and produce a fearful reaction.
What Happens To The Brain In Ptsd
In 1937, James Papez proposed in his now-classic article, based on his anatomical research, emotions have an anatomical mechanism and location in the brain : 38).
Dr. MacLean, the leading authority in limbic neurology, in general championed Papez`s findings. He insisted that in the process of evolution from reptiles to mammals, the mammalian sub-cortex evolved in complexity, developing an anatomical cyto-architecture identical to that of neocortex.
For those students who have a special interest, I refer you to The Limbic Brain by Andrew Lautin, M.D .
Fear conditioning causes an array of stress induced behaviors such as freezing and acoustic startle, even in rodents .
But integrating intelligence into limbic functions allowed stimulus response reactions to support more complex responses to threat, including hesitation and response selection .
MacLeans findings led to the additional proposal that the cingulate subdivision of the limbic system was also involved in early bonding behaviors such as playfulness and sound communications, allowing for a more complex set of survival skills that characterize the evolutionary transition from reptiles to mammals.
Once the limbic brain acquired advanced neocortex, mechanisms of survival evolved beyond visceral and simple reflective behaviors, such as freezing, towards more complex behaviors that serve communal attachment and parental bonding.
In contrast, the hippocampus functions as a switch and control center .
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How Trauma Changes The Brain
After experiencing trauma, both the brain and the body react and change. Dr. Arkadiy Stolyar, Assistant Professor of Psychiatry, Harvard Medical School and Principal Investigator in Psychiatry at Boston Clinical Trials shares with us an article on how physical changes in the brain lead to symptoms of PTSD:
What Brain Areas Are Implicated In Ptsd
PTSD symptoms develop due to dysfunction in two key regions:
The Amygdala
This is a small almond-shaped structure located deep in the middle of the temporal lobe. The amygdala is designed to:
- Detect threats in the environment and activate the fight or flight response
- Activate the sympathetic nervous system to help you deal with the threat
- Help you store new emotional or threat-related memories
The Prefrontal Cortex
The Prefrontal Cortex is located in the frontal lobe just behind your forehead. The PFC is designed to:
- Regulate attention and awareness
- Determine the meaning and emotional significance of events
- Regulate emotions
- Inhibit or correct dysfunctional reactions
When your brain detects a threat, the amygdala initiates a quick, automatic defensive response involving the release of adrenaline, norepinephrine, and glucose to rev up your brain and body. Should the threat continue, the amygdala communicates with the hypothalamus and pituitary gland to release cortisol. Meanwhile, the medial part of the prefrontal cortex consciously assesses the threat and either accentuates or calms down the fight or flight response.
Studies of response to threat in people with PTSD show:
- A hyper reactive amygdala
- A less activated medial PFC
In other words, the amygdala reacts too strongly to a potential threat while the medial PFC is impaired in its ability to regulate the threat response.
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How To Know If You Need Help
Though theres no cure for PTSD, you should seek help from a health-care professional if you cant socialize, function at work, concentrate or sleep at night. A PTSD diagnosis is usually made if youve had symptoms for more than one month.
Current PTSD treatments include medications, mindfulness, service animals , and individual and group therapy, Cummins says. It could be that your predominant symptoms are anxiety or depression, Dr. Saltz says. Your treatment should be aimed directly at the symptoms youre experiencing.
Having a solid relationship with your health-care professional can be pivotal, too.
Decreased symptoms are typically seen over time when patients establish relationships with their clinicians and feel less alone in handling the challenges that come from PTSD, Cummins says. Additionally, increased support from friends and family can help reduce the feeling of social isolation that can result from PTSD.
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Each Ptsd Brain Varies
While these are the main brain regions that Dr. Liberzon says tend to be implicated in a vast majority of PTSD individuals, he notes that each PTSD individual can have brain variations. In other words, there isnt a one-size-fits-all image for everyone with the condition. He says that for each person, there are different combinations regarding the deficiencies in each brain area.
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The Science Behind Ptsd Symptoms: How Trauma Changes The Brain
By Michele Rosenthal
After any type of trauma , the brain and body change. Every cell records memories and every embedded, trauma-related neuropathway has the opportunity to repeatedly reactivate.
Sometimes the alterations these imprints create are transitory, the small glitch of disruptive dreams and moods that subside in a few weeks. In other situations the changes evolve into readily apparent symptoms that impair function and present in ways that interfere with jobs, friendships and relationships.
One of the most difficult aspects for survivors in the aftermath of trauma is understanding the changes that occur, plus integrating what they mean, how they affect a life and what can be done to ameliorate them. Launching the recovery process begins with normalizing post-trauma symptoms by investigating how trauma affects that brain and what symptoms these effects create.
Ptsd Changes How The Brain Works
Beyond those three areas, PTSD has broader effects on overall functioning. “In some studies, individuals with the condition have been found to have depletions in the brain’s gray matter, along with changes to connections between sections of the brain,” says Clouston. “These things are critical to your ability to learn, remember, and make new connections between ideas.” You need gray matter as an essential part of cognitive health.
The other area that shows physical signs of PTSD is our neurochemistry, or the balance of chemicals, including hormones, that interact with neural tissue.Cortisol levels in people with the disorder are often lower than in others, Dr. Jain explains, while other chemicals, such as noradrenaline and adrenaline, are spiking. “These are released by the body when goes into fight or flight mode. We know that in people with PTSD, those chemicals are just floating around in their bodies, at much higher rates than they should be and for a lot longer,” says Dr. Jain.
The neurotransmitter serotonin, which is so often the focus of mood disorder treatment, is also impacted by the condition. A study published in Molecular Psychiatry in 2016 found that people with PTSD often appear to have serotonin imbalances. This, says Dr. Jain, probably accounts for some of the mood symptoms that accompany post-traumatic stress, like depression, irritability and anger.
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How Common Is Post
Experiencing trauma is not rare as approximately 6 of every 10 men , and 5 of every 10 women will experience at least one traumatic event in their lifetime. Men are more likely to experience trauma in the form of accidents, physical assault, combat, or witness death or injury. Women are more likely to experience sexual assault and child sexual abuse.
Some people have inherited a gene from a parent who had PTSD, making them more susceptible to forming it themselves.
However, post-traumatic stress disorder can strike anyone at any time regardless of age or other demographics. No one is immune from PTSD, and as the world changes, it becomes more likely for one to experience a traumatic event that causes it.
Effects Of Pharmacotherapy On Brain Function And Structure In Ptsd
We have begun to assess the effects of pharmacotherapy on brain structure and function in PTSD. We recently assessed the effects of phenytoin on brain structure and function. Studies in animals show that phenytoin, which is used in the treatment of epilepsy and is known to modulate glutamatergic function, blocks the effects of stress on the hippocampus. We studied nine patients with PTSD in an open-label function before and after treatment with phenytoin. Phenytoin resulted in a significant improvement in PTSD symptoms. Phenytoin also resulted in increases in both right hippocampal volume and right hemisphere volume. These findings indicate that phenytoin has an effects on PTSD symptoms as well as brain structure in PTSD patients.
We have assessed the effects of open4abel paroxetine on memory and the hippocampus in PTSD. Male and female patients with symptoms of PTSD were medication-free for at least 4 weeks before participation in the study. Twenty-eight patients were found to be eligible and started the medication phase. Of the total patient sample five patients did not finish due to noncompliance 23 patients completed the study.
Before patients started the medication phase, neuropsychological tests were administered, including the Wechsler Adult Intelligence Scale – Revised, WAISR , two subtests of the Wechsler Memory ScaleRevised.WMS-R, including logical memory and figural memory and the verbal and visual components of the Selective Reminding Test, SRT.
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Emotional Trauma And The Hippocampus
The hippocampus is part of the limbic system in the brain. It is mostly responsible for storing and retrieving memories, while also differentiating between past and present experiences.
How trauma affects the brain, the hippocampus may be physically affected studies have shown that in people suffering from PTSD, the volume of their hippocampus may be smaller than others.
Mainly how trauma affects the brain, the hippocampus will affect the ability to recall some memories for trauma survivors.
Other memories may be extremely vivid and constantly on the mind of survivors. Environments that remind the survivor of their trauma in even small ways can cause fear, stress, and panic.
This is because the victim cannot differentiate their past trauma and the present situation. The fight-or-flight response is then activated due to the brains perception of a threat.