Trauma on the Brain: The Neurobiological Effects of PTSD - Daisy Payton (Transcript)

Here is the full transcript of Daisy Payton’s talk titled “Trauma on the Brain: The Neurobiological Effects of PTSD” at TEDxMeritAcademy 2023 conference.

Listen to the audio version here:

TRANSCRIPT:

A Journey Through Trauma and Recovery

In my early 20s, I was in an abusive relationship. It was unsafe, emotionally and physically, but it was all that I knew. After about two years, I started to disconnect from myself and I lost touch with who I was. The only thing that kept me going was my desire to transfer to the University of San Francisco to study psychology and neuroscience.

I thought that if I could just escape to a new city, start a new life, that I would be okay and I could just leave the past behind. Thankfully, I was accepted, so I packed up and I moved 70 miles into a new city with my dog, Toddy, into an adorable apartment. I found the courage to cut off all contact with my abuser and Toddy and I started our new life. I remember wondering, when would the feelings of freedom start to sink in?

As a freshly single woman in a new city, a new school, when would I start to feel like myself again? As the weeks and months went on, I continued to wonder. I started experiencing high levels of physical and emotional stress. My brain felt like a static ball of loose ends, everything firing at once.

My body rebelled as I wasn’t eating or sleeping and I replayed the abuse over and over and over again. Everything felt wrong and I spent the next year in this state progressively getting worse, constantly in fight or flight, and I didn’t know what to do. This level of suffering became intolerable. So much for my fresh start.

The Turning Point

So then one day, I’m in one of my psychology courses and we’re going over the DSM-5, the Diagnostic and Statistical Manual for Mental Disorders. And we have an assignment on post-traumatic stress disorder. So I’m looking over the diagnostic criteria for PTSD and I come across a few case studies that seem to tell my story, to mimic my experience. So at the end of class that day, I nervously approached my professor and I asked for help.

And this was the moment that my healing began and also where my interest in the neurobiology of trauma and PTSD blossomed. So today, I’m speaking to you as a survivor of abuse and PTSD. The neurobiological effects of PTSD cannot be underestimated. And I hope to bring light to the prevalence of PTSD in women who have experienced abuse, how this impacts the brain, and how we as a community can better support those who are struggling.

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Understanding PTSD

So I hope that my story and this research can help you or someone that you love. So let’s start by understanding what PTSD is. So PTSD is developed in people who have experienced or witnessed a severe trauma, like threat of death, serious injury, sexual violation. This can be a single event, like a major car crash, or the exposure to repeated traumatic events, like having an abusive parent, partner, or being a first responder.

So this can happen to anyone. So let’s now talk about some of the symptoms associated with PTSD. So people will experience heightened arousal. This can present as anxiety, exaggerated startle response.

And this will often be accompanied by physical symptoms, such as trembling, excessive sweating, rapid heart rate. People will re-experience their trauma in intrusive thoughts, negative flashbacks, and nightmares. There are significant negative mood changes that occur, as well as avoidance of anything reminiscent of the trauma. So to be clinically diagnosed with PTSD, these symptoms need to be present for longer than a month and need to be severe enough to interfere with daily life.

So women are two to three times more likely to develop PTSD, and this is because of the types of traumas that women face. One in three women will experience intimate partner violence and or sexual abuse at some point in their life, and 50% of these survivors develop PTSD. So now let’s start by understanding some of the brain structures involved in PTSD.

The Neurobiology of PTSD

So the prefrontal cortex is in our frontal lobe. This is considered our personality center. It is critical in our complex thinking, our self-control, and initiation of behavior. It has a top-down control of other brain regions, and it is crucial in regulating our response to fear.

The amygdala is in our limbic system, in our temporal lobe. This is crucial in processing emotion and linking emotion to memory. Its major job is to sense threat and initiate survival instincts like fight or flight.

The hippocampus is also in our limbic system, in our temporal lobe. It is crucial in processing emotion, learning, and storing memory. It encodes and consolidates new information and will move short-term memory into long-term retrievable memory.

Brain Function in Action

So now that we understand some of the functions of these structures, let’s talk about what they look like in action. So the prefrontal cortex in a normal functioning brain exerts a top-down control of the amygdala. This means that when we experience fear, its job is to regulate the amygdala’s response depending on how it perceives the level of threat.

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For example, when we see a spider, our amygdala senses the threat, and either our prefrontal cortex will realize that it’s harmless and inhibit the amygdala’s response, or it will realize that it’s very scary. The prefrontal cortex will tell the amygdala to get to work. The amygdala contacts other brain regions to release hormones like adrenaline and cortisol, and this is our fight or flight. The hippocampus will encode and organize these memories, and then once the spider is gone, we can return to baseline.

PTSD and Brain Function

This is a normal response to fear. So what does this look like in PTSD? Researchers have found that people with PTSD, their prefrontal cortex is hypoactive, meaning it is lacking activity, whereas the amygdala is hyperactive, it is overactive.

So why does this happen?

When a trauma is disruptive enough, the amygdala can get stuck in fight or flight, rhythmically alerting the body to stay on guard, even when there is no threat present. This constant flood of stress hormones eventually weakens the prefrontal cortex, and it loses that top-down control, so the amygdala is now dominant. This is also known as amygdala hijack, it’s like putting pedal to the metal in your car’s accelerator when you don’t have to, to then realize you have no brakes, it’s a pure state of panic.

So meanwhile, the hippocampus is working on overdrive, trying to log all of the memories associated with the trauma, while also being flooded with these stress hormones. Researchers have found that the constant flood of these stress hormones cause volume changes and remodeling in the hippocampus. So the cells in our brains are called neurons, they send and receive signals. The structure of these neurons include dendritic branches and dendritic spines. These are essential in neuronal functioning and connectivity.

The Impact and Hope for Healing

So in this overdrive in the hippocampus, they found that the excess stress causes an actual reduction in the length of the branches, complete loss of the dendritic spine, and an impairment in neurogenesis, which is our ability to grow new neurons. So PTSD is a disruption of the entire system, it remodels and rewires the brain. And this can become chronic, this can be a silent killer, but I wouldn’t be up here today if this was it. Our brains are amazing organs, they’re vulnerable, yet resilient.

So plasticity is our brain’s ability to grow and reorganize neural networks. So these impaired systems, they can heal, but not without a lot of work. So they found that the most effective way to treat PTSD is by treating the entire system, which is brain and body. So this looks like a combination of medication, like antidepressants, to help reground the body, with intensive therapies, like cognitive behavioral therapy to help modify our thoughts and behaviors.

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EMDR, eye movement desensitization reprocessing, is the use of lights and our eye movement with intensive therapy to reframe the way that our brains process the trauma and help us process it differently. So each one of these treatments had a crucial role in my recovery, but one of the most important things during my recovery, and the most helpful, was understanding what my brain was going through. It helped release the shame and the confusion. If it weren’t for my education in psychology, I wouldn’t have known what I was going through.

A Call to Action

I didn’t know that I could get PTSD. There’s a stigma that PTSD happens to people who are in war, in combat, not in our mothers or our friends or our teachers, but it does, and we need to start talking about it. So as a community, we can raise awareness to the prevalence of PTSD, who it affects and how it impacts the brain. We can educate each other to be more trauma-informed and normalize asking for help.

This is not something to be ashamed of, this is something to be taken really seriously. We can help reduce the stigma by bringing awareness to the prevalence of abuse and PTSD in women, and we can continue to advocate for better access to mental health care and resources like support groups for survivors of abuse. So I encourage you to donate or volunteer at your local women’s shelter. You can educate yourself on the signs of abuse, and if you see something, say something.

Pay attention to your people. You might know someone who is suffering from abuse or PTSD, and if this feels relatable to you, I hope you now know that this does not have to be a life sentence, and you can do this. Thank you.

Trauma on the Brain: The Neurobiological Effects of PTSD – Daisy Payton (Transcript)