How PTSD Affects The Brain

Uniformed Services University of the Health Sciences
Scientists are now able to see that PTSD causes distinct biological changes in your brain. Not everybody with PTSD has exactly the same symptoms or the same brain changes, but there are observable patterns that can be understood and treated.

If you’re experiencing post-traumatic stress disorder (PTSD), it’s important to understand how the different parts of your brain function. Post-traumatic stress is a normal response to traumatic events. However, PTSD is a more serious condition that impacts brain function, and it often results from traumas experienced during combat, disasters, or violence.

Your brain is equipped with an alarm system that normally helps ensure your survival. With PTSD, this system becomes overly sensitive and triggers easily. In turn, the parts of your brain responsible for thinking and memory stop functioning properly. When this occurs, it’s hard to separate safe events happening now from dangerous events that happened in the past.

Over the past 40 years, scientific methods of “neuroimaging” have enabled scientists to see that PTSD causes distinct biological changes in your brain. Not everybody with PTSD has exactly the same symptoms or the same brain changes, but there are observable patterns that can be understood and treated.

The neocortex is located at the front-most part of the brain. The basal ganglia are located at the center of the brain. The hypothalamus is located below the basal ganglia and right above the brain stem. The amygdala is located below the hypothalamus. The hippocampus is located directly to the right of the amygdala.

The diagram shows a cross-section of the brain parts discussed here.

Your alarm system

Your amygdala triggers your natural alarm system. When you experience a disturbing event, it sends a signal that causes a fear response. This makes sense when your alarm bells buzz at the right time and for the right reason: to keep you safe. Those with PTSD tend to have an overactive response, so something as harmless as a car backfiring could instantly trigger panic. Your amygdala is a primitive, animalistic part of your brain that’s wired to ensure survival. So when it’s overactive, it’s hard to think rationally.

Your brake system

Your prefrontal cortex (the front-most part of your neocortex) helps you think through decisions, observe how you’re thinking, and put on the “brakes” when you realize something you first feared isn’t actually a threat after all. Your prefrontal cortex helps regulate emotional responses triggered by the amygdala. In service members with PTSD, the prefrontal cortex doesn’t always manage to do its job when needed.

A bad combination

An overactive amygdala combined with an underactive prefrontal cortex creates a perfect storm. It’s like stomping on your car’s accelerator, even when you don’t need to, only to discover the brakes don’t work. This might help you understand why someone with PTSD might: (1) feel anxious around anything even slightly related to the original trauma that led to the PTSD; (2) have strong physical reactions to situations that shouldn’t provoke a fear reaction; and (3) avoid situations that might trigger those intense emotions and reactions.

System recall errors

Other common PTSD experiences—such as unwanted feelings that pop up out of nowhere or always being on the lookout for threats that could lead to more trauma—seem to be related to the hippocampus, or memory center of your brain. Your hippocampus is a lot like your computer’s memory that writes files to its hard drive. After a trauma, your hippocampus works to remember the event accurately and make sense of it. But because a trauma is typically overwhelming, all the information doesn't get coded correctly. This means that you might have trouble remembering important details of the event, or you might find yourself thinking a lot about what happened because your hippocampus is working so hard to try to make sense of things.

Debrief/Bottom line

Your amygdala, prefrontal cortex, and hippocampus all contribute to the feelings and actions associated with fear, clear thinking, decision-making, and memory. Understanding how they work also might explain why some therapies can help you work through PTSD. For a visual guide to these and other parts of your brain, and more information about them, explore the Center of Excellence for Medical Multimedia’s “Interactive Brain.

Posted on BrainLine May 6, 2019.

How PTSD affects brain “circuitry”. USU | CHAMP, Human Performance Resource Center, 30 May 2017.

Comments (10)

Please remember, we are not able to give medical or legal advice. If you have medical concerns, please consult your doctor. All posted comments are the views and opinions of the poster only.

I am currently 67, and suffered a traumatic injury in 1958. It wasn't until 2018 that I was diagnosed PTSD and Disassociative Amnesia.
I don't recoil at the instrument of my injury or anything, but I definitely see some kinship in the article!
My decision making "skills" have been sketchy, but the very worst is when I think someone is trying to take advantage of me or pull one over on me.

I'm a 53 year old male who has been Diagnosed with PTSD. Another Month and it will be three years of going through some of the craziest times of my life. I have taken multiple types of RRSI's which I just can't handle the side effects, I have had three stellate ganglion blockers, and EMDI which also did not take like it was supposed to.. So the other Day my Med Manager pretty much told me he has nothing left for him to try so I guess what I'm asking with all of this is if this PTSD has effected the parts of my brain is there anything I can do to fix this issue? Or am I going to have to live with this for the rest of my life? Thanks for your time in reading this and if anyone has that answer I truly would like to know.

I am not in the military or have been, but this explained brain injury and PTSD so well and I've endured enough trauma for two lifetimes. My trauma and neglect started at age 4 after my mother died and my dad married a foreign woman by catalog and left us with her in her country. She was nuts and she only hurt me and not my brother. I faced the price of taking my childhood trauma with added abusive relationships the rest of my adult life, then when I thought I was in the clear I spent 13 years locked away from society and suffered psychological abuse by my past husband. For 20 years I was in therapy, had a psychologist for a while, and now am being seen by a renowned psychiatrist. I tried many treatments for PTSD and was hospitalized 7 times for it and have been in outpatient treatment on and off since 2011. I have been on a med I receive as an injection; Invega and finally something that helps, I'm also on the highest dose of Lamotrigine and Lithium, and Adderall to keep me focused on the here and now. I tried EMDR and I got worse, DBT and even though the skills helped after I finished a 2-year stint (once a week), I would relapse. But now my toughest symptom is memory loss for recent things. I do things that either I or someone else notices of which I have no memory of doing or I forget things that don't seem as difficult for others. I started doing some things on my own to treat myself and that is filling my mind with positive memories as a child and young adult, the rest is so horrible there are no finding positive thoughts. As a child, I'll remember laying on a grassy slope watching the clouds and believing my mom is in them, stuff like that. I have very little memory of abuses but do have the emotions and physical scarring. Since therapy, I have bodily aches and pains when I have a repressed trigger with the worst being tremors/shakes. The rage is gone and I'm calmer. I still don't experience true laughter but do giggle on occasion. So, my best reason for settling down is Invega, I really believe this, although I can't help thinking when will the side effects hit? Then I may have to go off of it, or how long will my ins. cover it? It cost more than $1900.00 for each injection once a month! I hope you find the avenues that will work for you before you're much older like me I'm 65.

One of the novel therapies for PTSD involve administration of psychoactive substances during therapy. Authors believe that a controlled administration of substances like NMDA allow the client to talk about the darkest corners of their mind and thus allowing to overcome the trauma by facing it head on. I'm only a medical student, but I would recommend you to see a therapist. Drugs that you are given are supposed to reduce the symptoms for you to get therapy, they will not actually fix the root of the problem itself.

So I suffered long term reoccurring trauma as a child and into my my teen years. Fear so bad that I always felt like I was going to die as that’s maybe because I’ve had my head bashed into walls and physically and sexually and emotionally abused even had a knife held to my throat by my own mother telling me she was going to kill me because I wanted butter on my toast. I’m 34 now doing ok but let me tell you I’ve been through therapy with countless different types of them and the drugs they’ve had me on were such high doses it actually created its own physical health problems with me which were counter productive. I’ve self medicated with these drugs and Then some at both high and low doses. From personal experience with lsd in high doses(only because I had gel tabs and you can’t really alter the dose) .. well let’s just say I saw the universe below me and had outer body experiences.. I can say for a short time until my next trip that I found new appreciation for life itself and I wasn’t so angry or afraid but after a while that wore off. Mushrooms on the other hand in small doses were amazing... I laughed so hard and just was able to be free and live like My past didn’t exist and I wasn’t scared of things like I normally would of been or reacted crazy like I have in the past because I felt threatened in such a small way. In high doses (like eating an eighth) I would melt into myself and found the darkest corners o didn’t want to be at. I even became Cheshire the cat with only my head floating.. MDMA was great tried it twice but the hangover was miserable. It was like I had all my happiness sucked out of me again. Salvia was interesting but more paralyzing for 20 seconds or so.. DMT now that’s another world.. it was like living as I was glass breaking through dimensions all the while everything around me was like a kaleidoscope. Only took one hit lasted for a minute or so. I think mushrooms and lsd in very very low doses as a prescription would do more good than any of the others I’ve had experience with. I wish there were more studies on those. I know it is in some state but it’s only for terminally ill patients. Which is unfortunate because it could do some great healing with proper dose and a good Psychologist... not a therapist or a special hypnosis one (that crap doesn’t work) Psychiatrists just give you meds and don’t really help you through anything.. . the only person who has ever slightly helped me was a psychologist.. some great people there, they are just so extremely expensive! Wish I had the capacity to go to school for it. Studying is hard with Ptsd.. it’s even harder to hold a job to afford good treatment and function “normal” in society. It just sucks

I personally suffer from PTSD. What I found most helpful was therapy. It's very painful and difficult at first but a necessary step for me personally. I took medication to supplement the therapy and make living day to day easier. The mood stabilizer Lamotrigine was very helpful to me. Therapy and mood stabilizers didn't fix everything, but I learned coping skills that have helped me survive flashbacks, anxiety, and depression. You aren't alone, brother. Hang in there.

It would be really helpful to know the author of this piece but I couldn't find one listed anywhere

If any is looking for the author they credited it in the gray box above the comments section. It was ripped straight from that website. Hope this helps :)

I am not a service member, nor a retired veteran but this article has helped me understand a bit more of why I may have inappropriate fear responses to places like waiting rooms. My therapist explained to me that my “trauma brain” may react to generally benign situations. Thanks for elaborating a bit more for me.

I'm glad to see another non-service member here, especially someone who can relate. I too got some good insights.