The Brain, Brain Chemistry, and PTSD W.E.Krill, Jr. L.P.C.
PTSD is all about brain chemistry and what happens to the brain during and immediately after the critical, traumatic incident. Essentially, the chemicals that flood the brain during the trauma do so in order to help the person to survive the event, either by running away, or fighting furiously. A third option, to submit to the trauma also has brain chemistry implications. In some individuals, once the brain goes through this chemical ‘rewiring’ to survive the trauma, the wiring stays that way.
When a person has experienced a traumatic event, and depending on their unique brain chemistry, they may or may not have after effects of PTSD symptoms and behavioral signs. This means that two people can experience the same trauma, and one may come out with PTSD, and the other will not. Science may be getting close to predicting who may and who may not develop symptoms, since recent research and study in this area is gaining more information on just how the brain and brain chemicals are involved, and how the process that creates symptoms works.
The parts of the brain that are most involved in PTSD are the amygdala, hippocampus, medial front cortex, thalamus, hypothalamus and the hypothalamic-pituitary-adrenal axis. Along with these, chemicals in the brain such as noradreneline, dopamine, serotonin, the opiod systems, insulin, and cortisol all play complex roles in the PTSD symptom producing process. This complexity is why there has not yet been developed an effective medication to help those who suffer from PTSD to gain relief from all of their symptoms.
Recent research shows that chronic stress of the traumatic type may shrink the hippocampus, and actually kill neurons there, as well as drastically slow down the growth of new neurons. In addition to this startling finding, the ‘wiring’ of the brain’s neurochemical systems become over sensitized, and this results in the symptoms commonly seen in PTSD. The complex chemical-neurological reactivity affects parts of the brain that are all about learning, memory, and fear conditioning. This is why child PTSD victims (as well as adults), for example, may have difficulty with learning as easily after the trauma. They also may have fragmented memories of the trauma, or even new events, as well as problems recalling facts. They may even have dissociative memory problems, meaning they have gaps of moments or even days in their memory.
One important chemical that is being debated in research right now is cortisol. The debate is over its role in producing symptoms in those with PTSD, as the role is not yet fully understood. Cortisol is a hormone that is produced in the adrenal gland. It is sometimes called the ‘stress hormone’ because it tends to increase blood pressure, blood sugar levels, and has an immunosupressive effect. For people who are not PTSD, it actually helps restore homeostasis (calmness) after stress. But in some people who have PTSD, there seems to be a lower base level of cortisol production to begin with, and when cortisol is released, their bodies have a hyper-sensitive reaction to it; that is, the cortisol does not work in them like people without PTSD.
When a person is under chronic stress, such as in battle, or a child who is experiencing serial abuse, or a victim of a hostage situation, there is a prolonged cortisol secretion, that over time, may drastically alter what is considered ‘normal’ cortisol levels. In the average person, cortisol levels are highest in the morning, and lowest a few hours after sleep begins. These facts have broad reaching implications regarding behaviors like sleep, getting a PTSD child up and out the door for school, or being calm enough or alert enough to carry out every day tasks.
Since cortisol acts to increase the blood sugar level, insulin production may increase as well, and go into an overdrive situation along with the other chemicals rushing into the PTSD victim’s body. The extra insulin can then crash the blood sugar, signaling the hypothalamus that glucose (the brain’s only source of energy) is being starved from the brain, which in turn triggers a message to the adrenal glands to increase adrenaline, and the cycle of high stress symptoms begins again. The whole bio-chemical process, once begun, travels at lightening speed.
There may be in fact substantial differences of the chemical reactivity between people who have PTSD or the sources of the PTSD symptoms, as there may also be specific brain chemicals that effect specific symptoms from the PTSD symptom cluster. Though there is no research to directly support the supposition that the more often and longer that this bio-chemical process cycles and repeats the more static and less treatable PTSD becomes, the development of co-morbid mental health conditions and persistence of PTSD symptoms over time is well documented.
The good news is that research on how PTSD works in the brain is moving forward, there is hope that the rewired bio-chemical system can be rewired one more time through therapy to help people regain the life they had before their traumatic event.
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Top notch research on PTSD.
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Ellison Hartley from Maryland, USA on October 04, 2018:
This is a great article. I think that it is important for people to understand PTSD. We need to be supporting our veterans who come home it and need help, it should not have a stigma attached to it.
FLNJGal on October 29, 2015:
Thank you. I am a firm believer in mind over matter; I know the body regenerates and has the ability to heal itself - hopefully my 'normal' is a return to the happy, pain-free person I once was....it has been quite an effort.
William E Krill Jr (author) from Hollidaysburg, PA on October 29, 2015:
My feeling is that in most cases, anti-depressants are not in order, as the source and 'pathways' causing the sad symptoms are not the same in say, dysthymia and PTSD. Though, of course, these can be comorbid, or the depression situational to the PTSD effects. Learning your 'new normal' and finding your unique path to your unique balance and healing is the best route to date, and it sounds like you are doing that. Blessings.
FLNJGal on October 28, 2015:
Thank you for your response. I've done so much reading (as you can probably imagine). I've read about getting stuck in 'fight or flight' and the body producing too much neuroepinepherine. In my hopeful imagination I was wishing that a doctor might be able to pinpoint what chemical (anti-depressant) I needed to be given to counter-balance my hormones. My situation does leave me grasping at straws. I'm at the point where I will take an antidepressant if it would resolve my issues. I have been seeing a new Neurologist (as I recently moved from NJ to FL); he works with a Neuro-Psychologist who I am also scheduled to see (met once, prefers no drugs). I've lost close family members within a relatively short time period; these compounded losses left me with PTSD. Yet when I think about my situation I am reminded of how others developed PTSD and I am saddened to know our struggles are 'just that' - struggles. I will share your wonderful article w/my new Neurologist (who I see Friday for results of my 3 Tesla MRI; 1.5 Tesla was done 2 years ago and did show 2 white spots - which a PA Neuro said were due to migraines - ugh). As I can pinpoint precisely when my PTSD was retriggered (I even told docs it felt like my metabolism shut-down, intuitively I felt this) I doubt (and I am praying) I have MS. I believe your article is exactly what happened to me! What is unbelievable is how long it took me to find your publication and how little there is on the Internet about our changing brain chemistry:( Thank you again!
William E Krill Jr (author) from Hollidaysburg, PA on October 28, 2015:
Unfortunately, I know of no medical doctor who has any miracle fixes; there is no approved and accepted medication to treat PTSD. In my clinical opinion, medication is not the route for treatment. As Michele Rosenthal on healmyptsd.com often cites, healing is a uniquely personal journey.
FLNJGal on October 28, 2015:
This is the best article I've read on PTSD as it pertains to what I believe are my personal health issues anyway. I've had many physical symptoms for 2.5 yrs. now. I lost my sister 6 yrs. ago and an event retriggered my PTSD (which I was dx. w/6m. following her death) spring, 2013. My body chemistry (endocrine, bloodwork) is so off; I have debilitating symptoms (severe edema, nerve pain, rash, incontinence, orthostatic intolerance, etc.) - my Autonomic Nervous System creates a huge problem for me! I've been to 'top docs' at the 'so-called' best hospitals; most are at a loss for dx visual symptoms they do see. I've told them that when this happened it felt as though my metabolism shut-down/crashed. I do believe (as other illnesses are ruled-out) that my brain chemistry changed. While I've been to Functional/Integrative docs and have purchased $$$$ supplements (for leaky gut, vitamin deficiency, etc.) I am ready to take real drugs...as in antidepressants or whatever can reverse, treat or cure my condition. I cannot even work like this. I've spent time on healmyptsd months ago; she has great videos! I'm wondering is there a particular doctor you might know of that is experienced with what you wrote about and can prescribe meds.? This situation is killing me; it has taken a toll on my health and my life;( Thank you so much for all your valuable info. - very appreciated!
William E Krill Jr (author) from Hollidaysburg, PA on January 13, 2015:
I'm glad it was helpful to you, anitaa. You might check out the site of a friend of mine, she has the largest PTSD site on the web: healmyptsd.com
anitaa424 on January 13, 2015:
Brilliant. I would absolutely love a list of books that outline this further. Google hasn't offered much assistance in my search... I mostly find resources for therapists to use when treating patients.
This is an older post, but if anyone knows of any books or articles that are based more toward the trauma survivors POV I would much appreciate the info.
Emilynn Kasinger from Bremerton, Washington on September 16, 2012:
I have suffered from PTSD since I was a teen. I have done years of counseling and therapy. I was greatful to have had counselors that explained this topic to me. I found that understanding what is going on not only on an emotional level but on a physical level is very helpful in the healing process. Understanding what is going on is half the battle.
GayleF on September 06, 2012:
For years I have felt that I had a physical wound to my body that made me react emotionally different, or more extreme than others. I too have learned that I have PTSD from sexual abuse from my father. It's nice to know that most of my heightened emotions are caused by a physical, unhealed wound. Thank you.
cjdecraig on July 12, 2012:
Great article. I have a child with RAD and PTSD, its been a challenge foe us to find the right care. This info will be mentioned to ped.
Jan Dils LC from West Virgina on July 26, 2011:
PTSD is very serious and it is great that the research is leading to new and effective treatment methods.
It is important for people to be informed about this condition.
medor from Michigan, USA on December 03, 2010:
great article... impressive... just watched Dr. Frank Ochberg YouTube on this topic... excellent as well. you rock.
Zothika on September 18, 2010:
This is so useful as my daughter is suffering with this because of sexual abuse. I have trouble getting her up & out of the door for school just like it says here along with a lot of other things it mentions here.
I will be printing this off & taking it into her school, what a brilliant article.
briansbabymoma on July 24, 2009:
i have ptsd myself from my father abuseing me and from one rape and molestation when i was 7-10 years old my safe point is in a bathroom in a corner so i can prosess my thoughts
Daniel Carter from Salt Lake City, Utah on July 09, 2009:
This is an excellent and informative hub. While most people focus on the emotionality of the events causing PTSD, it's actually very good to finally start getting information regarding the actual biochemical reactions associated with them.
Since I am a survivor of serial abuse, and have had extensive counseling and therapy, and done my own research about brain and body balancing, I appreciate your writing this for an audience other than the medical/professional counseling community.