PTSD and Your Brain
I found an interesting article on PTSD and Memory over at Pandora’s Project. It talked about how PTSD physically changes your brain. In other words, post traumatic symptoms are not just psychological. The article itself talks mainly about childhood sexual abuse, but the effects of PTSD are the same no matter what the causing factor.
I had a pretty bad struggle with PTSD in my early college days. I suffered from panic attacks and hated crowds, which made walking around on a crowded campus extremely hard. I can remember standing outside the classroom building with my heart beating so hard I thought I was going to have a heart attack. It got so bad I couldn’t make myself go in for class. I eventually had to leave school.
After being contacted by my rapist this past spring, I am once again struggling with PTSD. I knew that the panic attacks were part of it and the agoraphobia, but I didn’t realize how many other things were impacted by my rape including memory problems.
A Disease of Memory
Memory problems play a large part in PTSD. PTSD patients report deficits in declarative memory (remembering facts or lists — see below), fragmentation of memory and dissociative amnesia (gaps in memory lasting from minutes to days that are not caused by ordinary forgetting).
Psychiatric Symptoms Associated with Childhood Abuse
* Memory and concentration problems
* Intrusive memories
* Abnormal startle reponses
* Feeling worse when reminded of trauma
* Out-of-body experiences
* Fragmented sense of self and identity
* Panic attacks
* Drug addiction
Many abuse victims report that they remember seemingly random or minor details of the abuse event, while forgetting central events. For instance, one woman who had been locked in a closet had an isolated memory of the smell of old clothes and the sound of a clock ticking. Later, she connected these details with feelings of intense fear; only then was she able to recall the whole picture of what had happened to her. PTSD also causes problems with non-declarative memory (subconscious or motor memory, such as remembering how to ride a bicycle). This can show up as abnormal conditioned responses and the reliving of traumatic experiences when something happens to remind the sufferer of past abuse. These types of memory disturbance may also be related to physical changes in the hippocampus and medial prefrontal cortex.
The trauma from my rape has actually changed my brain!
Childhood abuse and other sources of extreme stress can have lasting effects on the parts of the brain that are involved in memory and emotion. The hippocampus, in particular, seems to be very sensitive to stress. Damage to the hippocampus from stress can not only cause problems in dealing with memories and other effects of past stressful experiences, it can also impair new learning.
Damage to the hippocampus following exposure to the stress brought on by childhood abuse leads to distortion and fragmentation of memories. For instance, in the case of the PTSD sufferer who was locked in a closet as a child, she had a memory of the smell of old clothes but other parts of her memory of the experience, such as a visual memory of being in the closet or a memory of the feeling of fear, are difficult to retrieve or completely lost. In cases like this, psychotherapy or an event that triggers similar emotions may help the patient restore associations and bring all aspects of the memory together.
Besides the hippocampus, abnormalities of other brain areas, including medial prefrontal cortex, are also associated with PTSD. dysfunction in these medial prefrontal regions may underlie pathological emotional responses in patients with PTSD. For example, we sometimes see a failure of extinction of fear responses — a rape victim who was raped in a dark alley will have fear reactions to dark places for years after the original event, even though there is no threat associated with a particular dark place.
Surprisingly, I found this comforting. I know that non-survivors have a hard time understanding why we just can’t seem to get over it. It is because our assailants didn’t just physically harm our bodies, they permanently changed our brains! It is not something we can just shake off.
The article concludes with the following:
Traumatic stress, such as that caused by childhood sexual abuse, can have far-reaching effects on the brain and its functions. Recent studies indicate that extreme stress can cause measurable physical changes in the hippocampus and medial prefrontal cortex, two areas of the brain involved in memory and emotional response. These changes can, in turn, lead not only to classic PTSD symptoms, such as loss and distortion of memory of events surrounding the abuse, but also to ongoing problems with learning and remembering new information. These findings may help explain the controversial phenomenon of “recovered” or delayed memories. They also suggest that how we educate, rehabilitate and treat PTSD sufferers may need to be reconsidered.
I hope they continue to research these differences. It can only lead to a better understanding of what PTSD is and thus better treatment for all of us who suffer from it.
For more great articles for survivors of sexual assault, please visit Pandora’s Project.