Posttraumatic Stress Disorder (PTSD) & Emotional Trauma

Unlike traditional psychiatry, which rarely looks at the brain, Amen Clinics uses brain imaging technology to help distinguish the symptoms of posttraumatic stress disorder (PTSD) and emotional trauma from other conditions, such as traumatic brain injury (TBI).

What is Posttraumatic Stress Disorder?

Many people are exposed to trauma during their lives, whether they experience it themselves, personally witness it happen to someone else, or discover that a loved one had a traumatic event. Afterwards, it is normal for anyone to have several distressing symptoms in the days and weeks that follow, which in most cases, subside naturally over time. However, when symptoms persist and interfere with academic, occupational, relational, and social functioning it may be a sign of posttraumatic stress disorder (PTSD), a potentially debilitating condition that can significantly disrupt a person’s life. PTSD can affect anyone—even young children. Being abused, physical and sexual assault, military combat, and motor vehicle accidents are common reasons an individual might develop posttraumatic stress disorder. This condition is also seen in first responders—firefighters, police, and EMTs—who are routinely on the front lines attending to emergencies, severe or fatal injuries, and crisis situations. The repeated exposure to traumatic circumstances and critical incidence stress have been shown to significantly impact mental health and can be devastating to the personal and professional lives of first responders. It is important to understand that posttraumatic stress disorder is not a character flaw or a sign of personal weakness, rather it develops as a response to traumatic events. However, if it is left untreated, PTSD can cause a wide array of serious symptoms and even lead to suicide.

Who is Affected by PTSD?

Approximately 3.5% of U.S. adults suffer from posttraumatic stress disorder, and an estimated 1 in 11 will be diagnosed with the condition at some point during their lifetime. It is believed to affect a higher proportion of veterans—between 11 and 15%—especially those who served in combat areas. However, for Vietnam vets, the lifetime rate of those who develop PTSD is closer to 30%, which is similar to the rate seen in first responders. Recently published research has also found that a notable number of health care professionals working in hospitals during the peaks of the COVID-19 pandemic developed symptoms of posttraumatic stress disorder.

PTSD can affect males and females, however, females are 2-3 times more likely than males to develop the condition. In addition, girls tend to suffer trauma at a younger age when it has a greater impact on brain development. Some individuals have a familial risk factor that can increase their chance of developing posttraumatic stress disorder.

What Causes PTSD?

The human brain is wired to alarm us about the presence and threat of danger or death, so having a biological, physiological, or psychological response to a traumatic event is normal. In general, directly experiencing or personally witnessing any frightening, dangerous, or life-threatening situation—or even the perception that a situation is life-threatening—can trigger symptoms of posttraumatic stress disorder. The stress response varies from person to person. An individual can also develop PTSD after learning that something traumatic happened to a loved one.

Common causes of posttraumatic stress disorder include:

  • Military combat
  • Childhood abuse or another traumatic event
  • Rape and other sexual assault
  • Repeated exposure to violence
  • Being stalked
  • Seeing someone get seriously hurt or killed
  • Being held at gunpoint or against your will
  • The sudden death of a parent or other caregiver during one’s childhood
  • Physical assault, psychological trauma, or other traumatic stress
  • Automobile accidents
  • A sudden life-threatening medical event (i.e. anaphylaxis or awakening during major surgery)
  • Trauma survivors of a natural disaster, such as a severe hurricane, tornado, fire, or earthquake
  • Living in a war zone or other environment with chronic stress
  • Terrorist attacks
  • Mass shootings

It is common for PTSD to co-occur with other conditions, including:

Why Choose Amen Clinics for Treating PTSD?

Most psychiatrists in clinical practice never look at the human brain and make their diagnostic assessment based only on a patient’s reported symptoms, which is why many people are misdiagnosed or prescribed the wrong treatment. This is especially important because some individuals have overlapping symptoms with other mental health conditions. Functional neuroimaging studies, such as SPECT (single photon emission computed tomography), are very helpful in determining whether a patient has PTSD, another disorder, or both. A research study conducted at Amen Clinics utilized this brain imaging tool to evaluate the brain blood flow patterns in TBI and PTSD—two conditions that have many overlapping symptoms. The study found that brain SPECT imaging was able to differentiate specific brain regions in the PTSD group compared to the TBI group with 89% accuracy. This research was recognized by Discover Magazine as #19 of the top 100 science stories of 2015. At Amen Clinics, a comprehensive evaluation that includes brain SPECT imaging paves the way for an accurate diagnosis and treating PTSD with a more effective plan that leads to faster healing.

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PTSD Brains Work Differently

People who are suffering with posttraumatic stress disorder often have abnormal brain function that causes overactivity in multiple areas of the brain. On a PTSD brain scan, abnormally high activity is commonly seen in specific brain regions: the deep limbic area, basal ganglia, and anterior cingulate gyrus, a brain region that is involved with shifting attention or getting stuck. In addition to being a very useful tool for determining a correct diagnosis, brain SPECT imaging helps PTSD patients in other ways too, including:

  • Brain imaging shows that PTSD symptoms and behaviors are caused by biological processes in the brain from exposure to a traumatic event, NOT by personal failure, thereby reducing the shame and stigma associated with having a mental health condition.
  • After seeing the brain scans, families have a better understanding that their loved one is not at fault for having PTSD symptoms. This promotes compassion and forgiveness and encourages families to become more involved in the healing process.
  • A PTSD brain scan helps provide important information that leads to a personalized and more effective treatment plan for PTSD patients.
  • Follow-up SPECT scans can show if treatment is working or if it needs to be adjusted to improve the healing process.


Healthy Brain Scan

PTSD Brain Scan

SPECT (single photon emission computed tomography) is a nuclear medicine study that evaluates activity (blood flow) in the brain. Basically, it shows three things: healthy activity, too little activity, or too much activity in brain structures. In a healthy “active” brain scan, blue represents average blood flow and red and white represent increasingly higher levels of blood flow. In the healthy scan on the left, the most active area is the cerebellum, located in the back/bottom part of the brain, and this is normal to see. The PTSD scan on the right reveals high activity in areas of the brain called the deep limbic area, basal ganglia, and anterior cingulate gyrus in a “diamond pattern,” which is a classic finding in cases of posttraumatic stress disorder. There are significant differences in the SPECT scans of PTSD compared to healthy scans. Other types of brain imaging, such as a magnetic resonance imaging study show the anatomy of a brain structure, but not how well it functions.

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Symptoms of Post-Traumatic Stress Disorder

There are significant differences in the onset of symptoms in PTSD patients. Some people may develop PTSD shortly after a traumatic event, or it can take days, weeks, or months for them to emerge. In other cases, symptoms may not develop until years later when traumatic memories are triggered by something in the present. When this happens, it can be difficult for a person to connect their distressing symptoms to a trauma they experienced years before. PTSD severity ranges from person to person.

Posttraumatic stress disorder patients can exhibit a wide range of symptoms including:

  • Intense recollections, such as flashbacks and nightmares of a traumatic event
  • Inability to recall certain aspects of what happened
  • Avoidance of people, places, or things that are reminders of the trauma
  • A refusal to talk about the event
  • Inability to discuss one’s feelings about what happened
  • Distressing memories
  • Dissociation or feeling removed from one’s mind or body
  • Inability to stop thinking about the incident
  • Increased or excessive anxiety
  • Heightened fearfulness
  • Always being on guard or being easily startled
  • Emotional numbness from trauma exposure
  • Feelings of guilt, shame, or self-blame about the traumatic event
  • Sleep disturbances
  • Loss of interest in activities that used to be enjoyed
  • Anger and irritability
  • Social isolation
  • Co-existing mental health conditions, such as major depressive disorder


“With A Better Brain Comes A Better Life”

– Daniel G. Amen, M.D.


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