Post-Traumatic Stress Disorder (PTSD) has become more widely acknowledged during the past 10 years. PTSD has long been associated with only those who have served in the military, but, thanks to social media and greater mental health awareness since the COVID pandemic, people are becoming more insightful about how it can develop from other life experiences and cause a fear response. Symptoms of PTSD occur on a continuum, based on the severity of the traumatic experience(s), how an individual perceives these events, the amount of social support in the individual’s life, and the subsequent life events which may add to or perpetuate the brain’s faulty wiring system caused by PTSD.
What many people do not understand is that PTSD is very difficult to treat, because the brain’s ability to process memories and emotions has been pervasively debilitated in several crucial areas. Neuroscientists are still in the infancy stage of understanding the specific long-term effects of PTSD upon important brain structures, particularly the hippocampus, prefrontal cortex, and amygdala.
HOW PTSD CHANGES THE BRAIN’S STRUCTURE
Neuroscience research studies are still pursuing greater knowledge about how trauma stays within one’s subconscious and conscious memory systems, as well as how to reverse the effects of trauma. I will briefly explain how three key brain structures are heavily influenced by traumatic events.
The first brain structure affected by traumatic events is the amygdala. The amygdala triggers an individual’s natural alarm system. When one experiences a disturbing event, the amygdala sends a signal which causes a fear response. PTSD creates an overreactive fear response within the amygdala, and this damage stays within the brain throughout one’s life if untreated. Even with therapy, triggers will occur throughout a person’s life. These triggers affect the amygdala, causing overreactive fear and anxiety responses. These triggers can cause one’s brain to react in a survival mode, which results in a sense of intense panic and irrational thought patterns. Those with PTSD can learn cognitive and behavioral skills which can be applied toward acknowledging and managing these triggers.
The second brain structure affected by traumatic events is the prefrontal cortex. The prefrontal cortex regulates one’s emotional responses to external events, as well as one’s overall decision-making, coping, and goal-setting processes. PTSD causes the prefrontal cortex to have extreme difficulty in managing threats which are sent from the amygdala. To sum up this defect, PTSD causes an individual to have an overactive amygdala and an underactive prefrontal cortex.
The third brain structure affected by traumatic events is the hippocampus. The hippocampus is the brain’s memory structure and receives the most severe damage from traumatic events, in that it loses the ability to store and process information correctly. After experiencing a traumatic event or even ongoing emotional abuse, a person’s hippocampus often cannot separate safe events from the dangerous or painful events which have occurred.
LEARNING HOW TO TRANSFORM YOUR SYMPTOMS INTO STRENGTHS
The first crucial step in creating strength from PTSD symptoms is to gain information about how the brain is greatly affected by trauma and fear. When an individual truly educates oneself about how the brain changes from trauma, the process of identifying and working through these changes can begin. A second crucial step is to understand the four main types of PTSD reactions, which can occur separately or in combined forms, and to learn how to transform these negative reactions into personal strengths.
The Fight response includes the following main effects: hypervigilance, anxiety, overreaction to daily life events, and an unhealthy need for control. Fight-based reactions, through educating oneself and/or through therapy, can be transformed into the following personal strengths: assertiveness in pursuing one’s career, academic, and/or relationship goals, ability to maintain healthy boundaries in all interpersonal relationships, a perpetual sense of unwavering courage and resilience which can be used when confronting future fearful and traumatic events, and well-trained crisis management skills in all life situations.
The Flight response includes the following main effects: panic attacks, generalized anxiety, insecurity, social isolation, low motivation, difficulty with concentration, difficulty with identifying and pursuing life goals, ADHD, and mood disorders. Flight-based reactions, through educating oneself and/or through therapy, can be transformed into the following personal strengths: healthy emotional distancing from stressful situations, perseverance, and effective self-preservation of one’s independent identity.
The Freeze response includes the following main effects: dissociation, social isolation, a pattern of being in emotionally abusive relationships, phobias related to achievement, ADHD, and a perception of oneself as inadequate and flawed. Freeze-based reactions, through educating oneself and/or through therapy, can be transformed into the following personal strengths: mindfulness ability, strong self-awareness, introspective skills, patience, and self-discipline.
The Fawn response includes the following main effects: a weak sense of self, persistent identity confusion, a pattern of codependent relationships, low self-esteem, and a tendency to allow gaslighting in relationships. Fawn-based reactions, through educating oneself and/or through therapy, can be transformed into the following personal strengths: compassion, a humble view of life circumstances, a strong compromising ability, effective problem-solving and mediation skills, and a nurturing, sensitive, and caring nature toward loved ones.
These four main types of responses can keep someone with PTSD in a lifestyle of victimization and a sense of powerlessness over one’s trauma. However, any individual with PTSD can educate oneself about the treatment options and can devote one’s life toward flipping these symptoms into strengths. The most effective therapeutic strategies for transforming PTSD symptoms into strengths include Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), Psychodynamic Therapy, Psychoeducation, Mindfulness Training, and Resilience Training. I am not elaborating on these therapeutic strategies in this blog post, but each can be researched and utilized by those with PTSD if motivated to put forth the effort toward change.
CASE STUDY: HOW A PTSD VICTIM FLIPPED HER SYMPTOMS INTO STRENGTHS
This case study briefly describes a girl who endured ongoing emotional abuse from ages 10 to 16. At age 15, this girl was put into a situation of giving CPR to her father who had stopped breathing due to an accidental prescription pill and alcohol overdose. Her father died. She suffered continual guilt and shame for not being able to save her father’s life, and these feelings were multiplied by her mother’s minimization of her feelings and refusal to discuss this incident. This girl was treated as overly emotional and was blamed and rejected when she sought support or help from any of her family members.
This girl grew into an adult, but she was an extremely damaged adult. Although she went to college, she was still mentally shell-shocked from her experience with parental death and subsequent mistreatment by literally all of her family members for years. During her young adult and middle adult years, she ended up pursuing a satisfying career and created strong bonds with her friends and her children, but she continued to struggle with the triggers which do not ever stop when you have PTSD.
Without validation for her thoughts and feelings, she never knew how to live a different life and remained on autopilot until she was in her late 40’s. This was a very long time and consisted of a pattern of dysfunctional romantic relationships, persistent self-doubt, shame resulting from her inability to control the painful flashbacks, and severe difficulty with daily coping skills. She eventually chose to commit to a path of much effortful and focused cognitive awareness of her PTSD symptoms. She gradually learned how to identify the ruminating and past-oriented thoughts which were triggering the negative and disturbing emotions caused by her PTSD.
She realized that accepting PTSD as a valuable learning path in her life was the catalyst for the rewriting of this path free from fear. When she decided to take action and to just do her best to transform her symptoms into strengths, she was able to derive great freedom and power from her symptoms. She learned to concentrate, during each moment, on her thoughts and their effects upon her moods and behaviors. Although PTSD symptoms will always be a part of her life’s path, she no longer fears them or allows them to interfere with her daily actions, decision-making and problem-solving skills, goal achievement, and relationships. Most importantly, she revised her self-perception as damaged and inadequate to focused and resilient.
Written by: Rebecca Wang-Harris PhD
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