Explaining the brain with PTSD

14 April 2023

Due to the unique nature of military life, post-traumatic stress disorder (PTSD) commonly affects veterans, but what’s going on inside the brain when people are experiencing PTSD?

PTSD develops when someone experiences a singular or multiple events which overwhelms their ability to effectively process the event and recover from it. The events and their meaning result in changes to how the brain and nervous system function, resulting in the symptoms of PTSD. 
 
There are four main categories of symptoms for PTSD, and individuals may experience these symptoms slightly differently. These symptoms include:
 
  • Re-experiencing the event: Memories, images, feelings and thoughts of the traumatic event will involuntarily come back to the person’s mind. This includes intrusive memories or nightmares. Dissociative flashbacks can occur where a person believes and acts as if they were in the event again.
  • Hyper-aroused state: This refers to increased activity in the nervous system and may include feeling on edge, ready to defend or hyper-alert. It can include hyper-vigilance to any threat in the environment, poor concentration, and elevated heart rate.
  • Avoidance behaviours: Due to the distressing nature of the memories, a person with PTSD will actively avoid triggers that remind them of the event. These can include external reminders, such as large crowds and noises, environments and people that bear similarity to the traumatic situation. It also includes internal triggers, such as thoughts of the event and avoiding talking about the event. 
  • Negative changes to thoughts and mood: This includes persistent changes to a person's mood, such as low mood, low motivation, anhedonia (loss of joy), and thoughts of worthlessness or shame about oneself. It also includes negative changes in an individual’s beliefs about themselves, other people or the world.

So, what’s happening inside the brain?

Understanding what is going on inside the brain when a person is experiencing PTSD is a very complex and detailed question to answer. 

To understand this in basic terms, we can use the analogy of the head coach and players in a sports team. 

The “head coach” refers to our higher order brain regions, the pre-frontal cortex. This structure has executive control over the lower order brain regions and the nervous system, the “players”. 

The “‘players”’ often react to events and situations with strong emotions, and the “head coach” guides them to make responses that are calculated and considered. In someone who has PTSD, this system reverses and whilst players are experiencing big emotions, the head coach is unable to regulate them effectively and this impacts on their ability to perform effectively.

After traumatic experiences, the brain fails to process the memory of the event. The part of the brain responsible for the processing of memories is called the hippocampus. When this structure fails to process the event and file it away effectively the memory of the traumatic event is basically playing on a loop in the brain.

In response, another brain structure called the amygdala constantly fires a “warning siren” which results in the person being in a near-constant state of elevated “fight/flight/freeze”, which is a signal to the rest of the body to be ready to defend or run away.

Essentially, the nervous system, or the "players”, experience elevated levels of stress hormones like cortisol and epinephrine (adrenalin) and are on edge, and the head coach is unable to settle and control them. 

Understanding the brain to treat PTSD

PTSD is treatable, however, it's important for people to first understand the biological mechanics of PTSD and why the brain may function this way in response to trauma.

There are a few methods to treat PTSD, but they all follow some similar principles of needing to safely process memories of the traumatic event. This means taking careful steps to improve awareness of internal state and nervous system arousal, learn skills in calming one's internal state/nervous system, and then process the traumatic memories under careful supervision from a trained professional using a trauma focused intervention such as Eye Movement Desensitisation and Reprocessing Therapy (EMDR). 

Processing means helping the hippocampus to “file away” the traumatic memories properly. Through confronting the trauma, safely and gradually, the “fight/flight/freeze” system is “switched off” and symptoms are reduced to normal levels.

Support at Mates4Mates

If you’re a veteran or family member and want to find out more about seeing a psychologist at Mates4Mates to treat PTSD, reach out to us on 1300 4 MATES for a confidential chat. 

To book an appointment, you will need a Medicare or DVA referral from your GP. You do not need to be registered with Mates4Mates. 

Mates4Mates is also running the Explaining the Brain Program multiple times throughout 2023 to help veterans and family members to better understand the symptoms and experiences of PTSD. The next round of expressions of interest will open in mid-June.

Written by Jonathan Moscrop, Mates4Mates Clinical Lead – Psychological Services and Psychologist

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