How Trauma Affects the Brain

Many of us are familiar with the word trauma. But what do we know about the science behind it? The answer to how trauma affects the brain is a complex one. Although there is evidence of trauma's effect on the brain, scientists continue to look for more answers. But for now, what we know so far about the neurobiology of trauma will be discussed.

Can Emotional Trauma Cause Brain Damage?

Unfortunately, it is true that emotional trauma can cause damage to the brain. But there is a more fascinating explanation as to why trauma can cause brain damage.

Brain damage due to emotional trauma occurs because of the brain's neuroplasticity. Neuroplasticity means that the brain is able to rewire itself and form new pathways [*]. So, when a person experiences a traumatic event, this will naturally change the way they think, feel, and perceive.

According to researchers, early stress such as childhood trauma can cause a change in the hypothalamic–pituitary–adrenal (HPA) axis—a system in the body that is involved in the stress response [*]. It can also affect a chemical known as norepinephrine. This neurotransmitter plays a role in coping with threat and is thus associated with hypervigilance, one of the symptoms of posttraumatic stress disorder (PTSD) [*].

Trauma’s effect on the brain is more sophisticated than just impacting the HPA axis and norepinephrine. It is on this note that the question of how trauma affects the brain will now be answered.

How Does Trauma Affect the Brain?

To understand the relationship between emotional trauma and the brain, it is important to outline the three brain structures involved in trauma. The following are the parts of the brain that are primarily affected by trauma:

• Amygdala: The amygdala is responsible for our emotional responses to life events. For example, when people perceive something as threatening, the amygdala responds with fear. So, if a trauma survivor encounters anything that reminds them of their trauma, the amygdala goes on overdrive. In other words, it becomes overactive [*].
• Hippocampus: The hippocampus is heavily involved in remembering events that occurred. It also allows us to distinguish past events from present events. After trauma, the hippocampus becomes underactive. This means that survivors may find it hard to recall certain memories. And because the hippocampus is underactive, they may fail to perceive that their trauma from the past is no longer happening in the present [*].
• Prefrontal cortex: Finally, the prefrontal cortex primarily plays a role in regulating emotions. If the amygdala is the emotional state, the prefrontal cortex is the executive state. So, if the amygdala senses fear, the prefrontal cortex will respond rationally. However, the brain's ability to regulate emotions changes after trauma. As a result, trauma survivors become constantly fearful. This fear can pervade their everyday lives.

Is this body of information difficult to absorb all at once? If so, then this wall art about how trauma affects the brain might help you to better remember what you just learned.

As our discussion on trauma broadens in scope, keep in mind that the impact of emotional trauma on the brain is wide and varied. For instance, many people with PTSD have a smaller hippocampal volume than those without PTSD [*]. However, this research finding does not apply to everyone with PTSD. As you will see, the effects of trauma on the brain have different manifestations.

How Does Trauma Affect You Mentally?

Trauma can lead to serious negative mental health outcomes. For instance, studies show that exposure to traumatic events is likely to lead to psychiatric difficulties [*]. However, it is worth noting that not everyone who experiences trauma goes on to develop a mental disorder such as PTSD. In fact, despite the fact that many of us have been exposed to traumas, only a few people suffer from PTSD [*].

Trauma also affects people differently depending on what stage they are in life. For example, children who suffer from childhood trauma can experience depression, anxiety, and changes in behavior. They may find it difficult to regulate their emotions and behaviors. They may also lose their ability to focus, and as a result, their academic performance may start to suffer. It is also possible for these children to lose the capacity to form connections with others. Finally, in older children with childhood trauma, alcohol and substance abuse tend to be their go-to coping mechanism [*].

The effects and signs of childhood trauma in adults may manifest differently but share some similarities with those in children. For example, adults who were exposed to trauma in childhood may suffer from poor self-esteem. They may also find it difficult to trust others. Finally, illness is not uncommon among adults with childhood trauma; in fact, they may even be more susceptible to developing diseases, such as cardiovascular disease and diabetes [*].

It is important to note that repressed childhood trauma has its own psychological consequences compared to unrepressed trauma. In other words, adults who unconsciously forget their traumatic experiences may exhibit different signs and symptoms of distress. Some signs of repressed childhood trauma in adults include a display of childish reactions, issues in relating with others, and an inability to cope with change, to name a few.

Can the Brain Heal From Trauma?

To combat these mental health consequences of trauma, psychiatrists and psychologists advocate treatment to trauma survivors. Thus, it can be said that trauma survivors can move on from their terrible experiences. But does that mean that the brain can heal from trauma?

The answer is both yes and no. For the most part, the human brain has the ability to recover from emotional trauma. This is possible because of the brain’s feature of neuroplasticity, which—as mentioned earlier—allows the brain to reconfigure itself.

However, we cannot deny that experiencing a traumatic event can have long-lasting effects on the brain. Thus, while it is very possible for the brain to recover from emotional trauma, it may take some time and effort from the survivor to take steps toward healing. Moreover, although the brain can heal from trauma, it is also true that it may not ever be the same again, especially if the trauma survivor does not receive treatment.

Another factor influencing the likelihood of recovery is time. Because the odds of the brain healing from emotional trauma become smaller the longer it is left untreated, survivors are encouraged to seek treatment sooner rather than later [*]. Otherwise, they may become more resistant to treatment and their brains may never fully recover.

How to Heal the Brain After Trauma

While there are numerous avenues for healing from emotional trauma, one noteworthy path toward recovery is to undergo psychotherapy with a mental health professional. Regardless of whether the trauma survivor is more comfortable with seeing a psychologist or a psychiatrist, any mental health professional is likely to treat their clients suffering from trauma with intensive psychotherapy. The following are some psychotherapy modalities that mental health professionals may use in the treatment process [*]:

• Cognitive behavioral therapy (CBT): CBT is based on the premise that changes in one aspect of functioning can result in changes in another aspect. With that said, cognitive behavioral therapists target symptoms of trauma by facilitating changes in the pattern of thoughts, feelings, and behaviors of the trauma survivor.
• Prolonged exposure therapy: In prolonged exposure therapy, the main goal is for the trauma survivor to learn that their memories of the trauma, as well as trauma-related reminders, are not inherently harmful. This approach in psychotherapy guides clients toward that realization by gradually exposing them to trauma-related cues until they are desensitized and no longer fearful.
• Eye movement desensitization and reprocessing (EMDR) therapy: EMDR therapy involves both imaginal exposure and bilateral stimulation. In other words, as the client is instructed to visualize and focus on images related to their traumatic experiences, they may also be asked to follow the movement of their therapist’s finger with their eyes.This is said to decrease the intensity of feelings linked to memories of the trauma.

No matter which treatment approach is used, survivors are often encouraged to talk about their feelings to process their trauma. And more often than not, clients may be instructed to work on assignments to be done in between therapy sessions. This is done to promote healing in the client even outside of therapy. Alternatively, therapists may request clients to engage in other activities, such as using trauma worksheets, to facilitate the process of recovery. Overall, all of these tools and approaches are geared toward managing the client’s distress and problem symptoms.

The Bottom Line

Although it is possible to reverse the damaging impact of trauma on the brain, research findings also indicate that the chances of a full recovery are slim if symptoms are left untreated, especially over time. Thus, action in the form of seeking professional help is crucial among survivors who want to begin down their road to recovery. However, even in resistance of treatment, it is still possible for the brain to heal from the neurobiological effects of trauma.

That being said, there is ultimately one point to highlight after this in-depth discussion on how trauma affects the brain. And it is that even though experiencing something traumatic can change your neurobiology, so can healing through processing your trauma.

References:

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6. Kessler RC, Aguilar-Gaxiola S, Alonso J, and others. Trauma and PTSD in the WHO world mental health surveys. 27 October 2017.
7. The National Child Traumatic Stress Network. About child trauma.
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9. American Psychological Association. Treatments for PTSD. June 2020.