UNDERSTANDING TRAUMA AND ITS IMPACT ON THE BRAIN

Trauma takes various forms. An example of physical trauma, for example, is a concussion, a type of traumatic brain injury (TBI). TBI describes an injury to the head that disrupts healthy brain functioning. Those who have experienced head trauma, including a mild traumatic brain injury, or mTBI, can experience long-term cognitive, psychological, or behavioral issues.

Emotional trauma, on the other hand, occurs in response to distressing events. In many cases, the trauma is processed and does not create long-lasting effects. But in vulnerable populations, or as a result of ongoing trauma, post-traumatic stress disorder (PTSD) may occur. PTSD leads to persistent symptoms that can interfere with daily life and impact mental health.

Those with a high number of adverse childhood experiences (ACEs) comprise one population that is more vulnerable to emotional trauma. Children who have faced multiple hardships—such as abuse, neglect, or household issues like mental illness, suicidal behavior, and/or incarceration—can face lasting consequences in their later years.

The symptoms of trauma can be emotional, cognitive, and physical. Trauma affects multiple regions of the brain, including the amygdala, prefrontal cortex, and hippocampus.

Emotional trauma symptoms include anxiety, depression, PTSD, trouble sleeping, and hypervigilance, among other possible side effects. Meanwhile, TBIs can also raise the risk of depression, anxiety, and PTSD, as well as ADD/ADHD, psychosis, dementia, and suicide.

SPECT BRAIN IMAGING AND TRAUMA

The brain imaging diagnostic tool called SPECT (single photon emission computed tomography) can help accurately identify any underlying brain issues that may be contributing to mental health symptoms. Therefore, SPECT scans help determine how trauma is affecting the brain. Other types of brain imaging, such as MRIs, can reveal the brain’s anatomy but do not indicate how well it functions.

And because SPECT is a functional brain imaging tool that evaluates brain activity and blood flow patterns, it helps differentiate between TBI and PTSD, which can have many of the same symptoms. In fact, one study found that brain SPECT imaging was able to differentiate a PTSD group from a TBI group with 89% accuracy.

Can trauma change brain function? SPECT scans indicate that it can. Amen Clinics clinicians have found a diamond pattern in the brain of those with emotional trauma. This pattern reflects increased activity in the anterior cingulate gyrus, basal ganglia/amygdala, and thalamus. Similarly, those with PTSD show overactivity in the deep limbic area, basal ganglia, and anterior cingulate gyrus.

Because SPECT shows which areas of the brain are working too hard, not working hard enough, and working well, this type of brain scan is especially important to help guide treatment strategies. A 2012 study found that adding SPECT scans to a standard mental health evaluation changed psychiatrists’ recommended diagnosis and/or treatment eight times out of 10. 

This study also highlighted how SPECT can reveal previously undetected trauma. More than one in five cases showed an undiagnosed brain injury, while another one in five cases indicated unexpected toxicity. In 60% of cases, consulting SPECT scans led to a change in the medications or supplements recommended by medical experts.

A BRAIN-BASED APPROACH TO HEALING TRAUMA

In instances of trauma, the entire body is affected. Facing an acute stressor activates the sympathetic nervous system, creating a chain reaction that leads to the stress response known as fight or flight. As a result, the hormones cortisol and adrenaline flow through the body.

Frequent or long-term stressors can lead to this stress response getting stuck in place. Chronic stress may then create a variety of physical, psychological, cognitive, and behavioral symptoms. It can even weaken the body’s immune response.

In other words, chronic trauma dysregulates the brain-body connection. That’s one reason why it’s so important to address both the brain and body when healing trauma. Amen Clinics advocates a “whole body” approach to recovery, looking at the entire person to treat problems at the root causes—rather than prescribing a medication designed to merely mask symptoms in the short term.

Evaluating the entire person is important when dealing with trauma, which can contribute to or aggravate multiple mental health conditions, including:

• PTSD and complex PTSD
• Depression
• Anxiety
• Addictions and other trauma-related coping mechanisms

A brain-based approach to healing trauma also allows for personalized treatment plans. Because each person is unique, and each mental health condition is never a single or straightforward issue, a helpful treatment for one individual may be ineffective or even harmful to another.

Others may experience mental health issues that do not respond to traditional treatments like antidepressants. Using brain imaging to identify trauma-related dysfunction helps create personalized treatment plans that target the exact areas of the brain in need of help.

The individual can then take the proper steps to rebuild their brain health—because brain health is mental health. Since there are many natural ways to heal trauma in the brain, medications are never considered the first or only strategy for recovery. Tactics like dietary changes, exercise, meditation, and supplements can make a major impact without any damaging side effects.

THERAPEUTIC INTERVENTIONS FOR TRAUMA

Many victims of trauma will experience mental health improvements through lifestyle interventions. But there are numerous additional evidence-based therapies available to tackle PTSD brain recovery and other trauma-related symptoms or conditions. These include:

• Eye movement desensitization and reprocessing (EMDR). This interactive psychotherapeutic technique uses bilateral hemispheric brain stimulation. During a session, the individual processes traumatic memories in a healthy way and is able to reduce or eliminate the strong emotions they evoke.
• Cognitive behavioral therapy (CBT). In this form of psychotherapy, clients learn to identify and then replace their negative or harmful patterns of thinking and behaving. Patients learn more helpful ways of thinking and acting, as well as better coping skills to handle challenging situations in the future.
• Neurofeedback. This treatment helps people retrain their brain. Those with stress, anxiety, and behavioral issues can learn healthier forms of self-control, emotional self-regulation, responses, and behavior. Thanks to its neuroplasticity, the brain learns a more efficient way of functioning and, with practice, reinforces new pathways for better mental health.
• Hyperbaric oxygen therapy (HBOT). This innovative, noninvasive treatment involves breathing 100% pure oxygen in a pressurized chamber. The client’s lungs take in up to three times more oxygen than usual, which is transported by the bloodstream to damaged tissues. This process facilitates improvements in mental health conditions, TBIs, and cognitive or memory problems.
• Mindfulness and meditation. A study at Harvard showed that eight weeks of mindfulness-based training not only led to enhanced psychological well-being and reduced mental health symptoms. Participants also demonstrated “changes in gray matter concentration in brain regions involved in learning and memory processes, emotion regulation, self-referential processing, and perspective taking.”

In addition, numerous lifestyle choices will support trauma healing. For example, adopting a brain-healthy diet fuels the entire body with proper nutrition. We know that the Standard American Diet (SAD) deteriorates brain function. But consuming vegetables, fruits, lean proteins, and healthy fats (including omega-3s, which improve brain blood flow) contributes to better mental health.

Sleep is another key factor in the process of recovering from emotional trauma. Unfortunately, there is an association between exposure to traumatic events and reduced sleep quality. As one study notes, sleep problems often accompany PTSD and “may interfere with recovery from elevated post-traumatic stress levels.”

Finally, physical activity helps the brain recover from trauma—both physical and emotional. Exercise has been shown to reduce symptoms of anxiety and depression as well as feelings of stress and anger. Studies have noted numerous positive brain changes, increased neuroplasticity, and better moods as a result of exercise. It also releases feel-good endorphins and promotes better sleep.

TRAUMA AND RELATIONSHIPS

Implementing brain-based trauma treatment using the above tactics is not only important for the individual suffering from the effects of emotional trauma. We know that childhood trauma impacts adult relationships in a multitude of ways. Therefore, many lives can be affected by just one person’s unaddressed trauma.

For example, the brain changes associated with trauma can lead to:

• Trouble forming secure attachments in relationships
• Issues with trust and interpersonal communication
• Behavioral issues
• Poor emotional regulation
• Problems with learning
• Difficulties in social interactions
• Aggression
• Risky behaviors

These issues may then contribute to larger effects over a lifetime, such as chronic physical health conditions, unemployment, and poor performance at school and work. Ultimately, those who do not receive help are unable to fulfill their true potential

And, as the effects of trauma are being treated, rebuilding relationships is instrumental for healing. Healthy relationships have been called the single most important factor in long-term health and longevity.

Connecting with others—support groups, therapists, mental health organizations, family, and friends—can transform both physical and mental health outcomes. Conversely, a lack of quality relationships can be detrimental to health over the long term.

SUCCESS STORIES IN USING A BRAIN-BASED APPROACH

Clearly, trauma and mental health (which is inextricably linked with brain health) go hand in hand. That means using a brain-based approach is the most effective way to treat trauma, as seen in numerous success stories at Amen Clinics.

Seeing before-and-after SPECT scans of these clients verifies the progress they’re making—and highlights when and what different interventions may be needed. By examining issues like trauma as brain health issues, individuals shed stigma and shame. Meanwhile, their loved ones can better understand their behavior and avoid moral judgments.