Why PTSD is not just a mental problem OR The Physiology of PTSD

Hello everyone! Today I want to talk about Post Traumatic Stress Disorder and why it isn’t “all in your head.” There is SO MUCH STIGMA when it comes to my favorite population- soldiers and first responders- regarding getting help for this issue. It’s seen as emotional weakness. Most people have no idea that it’s a PHYSICAL PROBLEM that also happens to be linked to emotions. Somehow, I think (and hope!) that spreading this information will help everyone realize that getting help for this is critical. There’s no stigma in setting a broken arm so there shouldn’t be here either. I’m going to walk you through how a memory is processed through the body and how this is involved in linking the body with the mental processes that happen in a traumatic situation and why someone can get “stuck” there.

It’s not all in your head, it’s actually all in your body!

This is the VERY short form of things and I’m sure I’ll write more on this later. For now, I’m wriging this out from the somatic (body) therapy perspective but it’s really abbreviated- and still complicated! I didn’t want to overload you and I’m sure I’ll expand on it in future blogs. 

First, let’s talk about the symptoms of PTSD. Any time someone goes through a traumatic or troublesome event, they WILL have symptoms like this. It’s important to leave the diagnosing to the professionals. Post Traumatic Symptoms at the start are NORMAL responses from your body to a dangerous situation. We have a “fight or flight” system in our body for a reason, and, generally, your body does a beautiful job of handling things. Depending on where you are in the healing process, it may not be PTSD. PTSD happens at a certain time period, when the body gets “stuck.” It’s treatable and doesn’t have to be permanent. However, the longer you wait, the harder it is to get rid of the symptoms (but not impossible!) 

So- your brain takes in all kinds of information on a daily basis. Think about what you did at noon last Friday. Do you remember? How much do you remember- where you were, the weather, who was wearing what, etc. Chances are you don't remember much. This is because your brain takes in billions+ pieces of information a day and it has to determine what is valuable and worth keeping, and what can be thrown out. You probably don't need five hundred memories of the process of unlocking your front door.

Any time that we process information we form explicit memories and implicit memories. Explicit memories are the factual information, general knowledge, and autobiographical information. Implicit memories are the emotional responses, body sensations- this is devoid of subjective internal experience or recalling self or time. These two types of memories travel in different pathways in the brain and have to be integrated later to form one unified memory.

 So- when your brain takes in this information there are four key components to memory processing. (There are more, but we're gonna go with the biggies and streamline this a bit.) First, your brain goes through the Thalamus. This is initially the first "filter" of information. The Thalamus says "meh. that's probably worth keeping. This can be thrown away." That way your brain processes only what is valuable to it and doesn't waste time sending worthless information down the pipeline.

After that it goes into the prefrontal cortex. This part of the brain has access to the storage area of the brain (Think of this as the secretary with the only key to the filing cabinet.) This part of the brain categorizes information and connects it to other like types of information. This is also the part of the brain that makes predictions for us ("That brown dog bit me, so I think maybe this grey dog might bite too. I better stay away.") It links our new information to stored information.

Third, the information hits the Amygdala. This part of the brain processes implicit information (sensory memories), tags information for emotional significance and determines whether or not an immediate emotional response is necessary.

*Deer are a good example of a highly active amygdala. They spook at everything! That's the Amygdala doing that.

Finally, it hits the Hippocampus. This area processes explicit info (factual information). It's VERY involved in moving explicit information through the several phases it needs to go through to be processed. (It's our main suspect when it comes to the breakdown of memory with trauma.)

Here comes the traumatic perspective: The Hippocampus is amazingly sensitive to Cortisol. Cortisol is a stress hormone. When you're really stressed out those levels rise. In a traumatic event they can rise so high that the Hippocampus goes offline and leaves the building. At this point, the implicit and explicit information don't get linked and you have all this information just floating about in bits and pieces. They aren't integrated. So, you have this implicit (very emotional) information all over the brain that doesn't know where to go (the traffic lights crashed!) and sticks around until it's processed. Often, it shows up in the form of visual, emotional, or other stimuli. Flashbacks, sometimes hallucinations (example: certain smells connected to a memory), tension in the body, etc. These are all parts of a memory that haven't been processed. Traumatized individuals can tell you all about that.

 Here's the good news: First, our brains are built to heal. We have natural mechanisms that help us process this stuff. Most of the time we do this without even knowing it. "Venting" to others is a form of this processing. Over time, as you vent enough, the memory gets processed and becomes neutral. Some people go to a "happy place" for emotional regulation. We have all these things that we do to regulate it.

Then, here's more good news: We now have therapeutic tools to help integrate these memories. The whole reason the brain is looping is it is trying to put it away and going “I’m missing something. Where does this go?!” Sometimes, you don't even have to do the traditional talk therapy to fix it. If you’re feeling “stuck” consider consulting a mental health professional to help walk you through this. Once the memory is integrated and processed the physical symptoms will decrease and life will be so much richer!