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Post-Traumatic Stress Disorder

Post-Traumatic Stress Disorder (PTSD) is a complex disorder that develops in people who have experienced or witnessed trauma. Most individuals who go through a traumatic experience will not develop PTSD, and many people who have PTSD recover and no longer meet the diagnostic criteria for diagnosis after treatment. This is a disorder that is relatively common but does not look the same for each individual. About 6% of the US population will have PTSD at some point in their life. Symptoms may impact cognition, mood, bodily experiences, and behavior. 


The Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria for diagnosis includes exposure, persistently re-experiencing the event (nightmares, flashbacks, memories, etc), avoidance, negative thoughts, trauma related arousal and reactivity (irritability, heightened startle reaction, hypervigilance, etc), symptoms that last for more than one month, distress or functional impairment, symptoms that are not due to medication, supplements or other illnesses.


Initially, the response to trauma begins with an adrenaline surge from sympathetic nervous system activation. This can result in symptoms such as hypertension, tachycardia, shortness of breath, dilated pupils, sweating, etc. With a repeated or prolonged stimulus, there is a conditioned behavioral response that occurs. 


There are a few different areas of the central nervous system that are affected by PTSD. Brain imaging studies have shown alterations in a circuit including the medial prefrontal cortex (responsible for executive functioning, problem solving, decision making, etc.), hippocampus (responsible for memory), and amygdala (involved in emotion processing). 


Other findings in studies that consist of traumatic reminder exposure include decreased hippocampus function, visual association cortex (visual imagery and processes visual information), parietal cortex (spatial perception, body awareness, learned movements, sensory integration), and inferior frontal gyrus (language comprehension and production, social cognition, executive function). Consequently, there was increased function in the amygdala, posterior cingulate (memory, spatial navigation, self-reflexion, attention, decision making, arousal and awareness) and parahippocampal gyrus (memory, interpreting spatial information, emotional processing). The midbrain (top part of our brain stem responsible for sympathetic output) has also been linked to PTSD. Due to the multitude of areas that are affected, we can see why PTSD is so complex.


At Carolina Functional Neurology Center, we aim to find the root cause of our patient’s symptoms and strive for optimal neurological well being. While co-managing with your mental health providers we can work to identify objectively, if there are specific areas of dysfunction in the nervous system as a result of the trauma and subsequent PTSD. We use specific neuro therapies intended to target the affected areas so that we can make positive neuroplastic changes.


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