PTSD Scientifically Speaking

My mental illness largely stems from childhood stresses that formed me into a caregiver, peacemaker, and people pleaser – dysfunctional, unhealthy roles which I continued to play to my own demise in adulthood.

There is most likely a genetic component to my mental illness as well, because studies on serotonin and studies on dopamine show that these neurotransmitters have major effects on our emotional brain centers such as the amygdala and hippocampus.

Although, since individuals with no mental illness have also been found to have abnormalities in neurotransmitter levels, researchers speculate that these abnormalities “may represent a classic susceptibility factor for affective disorders by biasing the functional reactivity of the human amygdala in the context of stressful life experiences and/or deficient cortical regulatory input.”

So, back to the environmental stressors… Yes, I most likely have the neurophysiological susceptibility to depression and bipolar, but would these illnesses have manifested if my childhood was one of validation, and unconditional love and support?

Or let’s assume I don’t have the neurophysiological susceptibility, but still grew up in the same abusive environment. Would the environment alone have caused my mental illness?

The answers to these questions I will never know for sure. What I do know is that as a child, the aforementioned roles, or coping skills if you will, helped me survive. However, as an adult they were killing me. You see, if no one validates or takes care of a child in ways that facilitate healthy emotional development then that child is less likely to know how to do these things for her adult-self. And obviously, no one else is going to (or should have to) do this for her because she is an adult…on the outside, that is.

On the inside, I was still that little child, who felt helpless, threatened, scared, and vulnerable. I was still operating in survival mode – “fight or flight” – hence, the PTSD symptoms.

Most therapists I have worked with use CBT (cognitive behavior therapy) techniques (i.e., self-talk, re-directing and grounding.) These techniques didn’t do anything for me, even after years of CBT treatment. In fact, I think they actually perpetuated my childhood coping skills which, as I previously stated, were no longer working for me as an adult.

CBT by its own definition “challenges an individual’s way of thinking and the way that he or she reacts to certain habits or behaviors.” Where is the emotional component to that? Everyone knows that trauma produces an emotional response which ingrains itself so far deep into our brainstem, physical, body, fight-or-flight memory that no amount of cognitive restructuring can truly change it until the emotions are first processed. I am talking limbic system, caveman-instinct stuff here, where as CBT addresses frontal cortex areas (higher brain centers than the limbic system.)

Only speaking from my experience, there are a few things that have made the biggest difference in my healing journey, and these things have to do with emotions which, remember, are recorded in the limbic system.

1. learning how to validate my own feelings
2. learning how to not judge myself for having negative feelings
3. learning how to radically accept myself and my feelings

I learned all of these skills in DBT (dialectical behavioral therapy.) A therapist has to been specially certified in this therapy, not just anyone can do it.

Only after I learned how to recognize and then experience my emotions in a validating, non-judgmental way was I able to learn how to accept and tolerate them long enough to change my thoughts and behaviors (which gets into CBT stuff.) But, the emotional processing had to come first for me, and I will explain why further on in this post.

I have been working with a DBT counselor for less than a year and have completely changed. I still have a lot of work to do, but at my last visit, I was shocked to realize I had nothing to talk to her about because my emotions, thoughts, and behaviors were all balanced; in a state of homeostasis, which is an absolute miracle for me; now on to the scientific aspects of my transformation.

Implicit or “Physical” Memory
                versus
Explicit or “Narrative” Memory

When a person is negatively affected by trauma, information experienced during the traumatic event such as tightening muscles, rapid breathing, increased heart rate, sweating, and increased blood pressure is quickly stored as “physical” memory via the amygdala while information such as where the event happened, when it happened, and whom you were with at the time is slowly stored as “narrative” memory via the hippocampus.

Narrative memory is stored more slowly because excessive catecholamines (epinephrine and norepinephrine) and endogenous opioids that are released during “fight or flight” episodes inhibit narrative memory storage. In other words, your brain says to you, “No time to process, just get the hell out of here!”

Childhood traumas are even more complicated because “the hippocampus is still immature, while the amygdala is already able to record unconscious memories.” Therefore, “early childhood traumas can disturb the mental and behavioural functions of adults by mechanisms that they cannot access consciously.”

To summarize, it is safe to say that we are more apt to retain the negative emotions and physical sensations of the original event (i.e., physical memory), and less likely to have acquired the type of memory needed to verbally and logically recall and analyze our experience of the event (i.e., narrative memory.)

Researchers believe that the amygdala’s general function is for “biologically relevant learning”. It does this by signaling a “baseline level of arousal,” whereas “other parts of the brain such as the prefrontal cortex use that information and elaborate that information in a way that’s relevant for the specific experience of positive or negative emotion.”

In order for the prefrontal cortex to do this, however, it must have a strong connection to the temporal lobe which is where the amygdala resides. This connection is made via a nerve-fiber bundle known as the uncinate fasciculus (UF.) The figure below is from a study entitled, “Volumetric associations between uncinate fasciculus, amygdala, and trait anxiety,” by Baur et al which was published in BMC Neuroscience in January of this year.

A 2009 study in the Journal of Neuroscience reports that higher amygdala activity corresponds to lower prefrontal activity, and vice versa. Researchers, Justin Kim and Paul Whalen explain, “The prefrontal cortex is supposed to keep areas like the amygdala in check, and instruct them that, for example, ‘I know that’s a snake, but it’s behind a piece of plexiglass, so we’re good.’” Whalen says, “It’s much like a parent and child. Children are less flexible in their responses to situations than parents, whose job is to instruct them and help them regulate.”

So, as a child in constant fight or flight mode, I believe it is possible that my amygdala was over-stimulated, and because my parents did not “instruct me” or “help me regulate” my responses to stressful situations (mainly because they were the cause of the stressful situations) I hypothesize that this left me with a underdeveloped prefrontal cortex-temporal lobe/amygdala connection via the UF.

My hypothesis is strengthened by a 2006 research study of 10 year-old children who had suffered from socioemotional deprivation. Researchers found that the left uncinate fasciculus showed “reduced fractional anisotropy compared to that in other children, and that this might underlie their cognitive, socioemotional, and behavioral difficulties.” Why they didn’t just say, “their mental illnesses,” instead is beyond me.

In my experience, when I processed the emotional and physical information of my PTSD symptoms stored by the amygdala (namely, fear, panic, and anxiety) via DBT, I believe this information was then transferred to my narrative memory which allowed it to finally be used to strengthen the prefrontal cortex-temporal lobe connection causing the body sensations and negative feelings associated with it to disappear. (Abracadabra!)

Here’s a fun fact for all of us with mental illnesses related to lack of serotonin in our brains: A recent nuerogenetics study concluded that people with a genetic variation affecting the serotonin neurotransmitter system tend to have a thinner UF (remember, that is the nerve fiber that connects the prefrontal cortex to the temporal lobe where the amygdala lives.) These same individuals show “increased amygdala reactivity and decreased coupling between the amygdala and medial prefrontal cortex,” according to researchers.

What do you guys think of all of this? Do you think that your mental illness has more of a genetic component, an environmental component, or both?

Do you think that if people who don’t understand mental illness had this information they would be less likely to tell us to, “Snap out of it” or any number of other ludicrous pieces of advice they think are helpful?

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3 thoughts on “PTSD Scientifically Speaking

  1. WIL, this is a brilliant post. How methodical and insightful, I learned quite a bit–including the fact that i NEED DBT!!! I’m checking it out Monday, see if anyone around this small town does it. We have SO much in commin it’s unreal. My big work areas are also not judging myself and validating myself (especially when my mother CONTINUES not to). I need distance from her, which I’m doing pretty good at. I read that either our amygdala or hippocampus shrinks due to or via PTSD. I always imagine my brain as this shriveled thing with dead-end synapses. This is incredibly interesting. My mother has Major Depressive Disorder and I’m bipolar, ptsd-ridden, ADHD, and dissociative disorders. I too blame the environment (like you I wasn’t taught regulation or validated by my abusive parents) and biology. I was pre-disposed and then let out into the land of abuse only to expand my illnesses/pre-disposal. And yes, my people-pleasing (and other attitudes/coping roles) greatly effect my adulthood–they don’t work!!!! It’s so hard to not be pleasing, but I work at it every day, it’s been my working goal for a few years. I’m behind on the therapy. I was in CBT/psychotherapy for eleven years and quit because she turned on me (she’s my mother’s friend.,…dah dah daaaa) and told me i was aweful to my poor mother when i was trying to work out her abandoning me–my therapist then abandoned me. Currently I’m only see a psychologist (who’s brilliant) and she’s careful with me and is building trust together because of my last therapist-betrayal. Mostly I just talk so far. And just talking is quite overwhelming. The course of therapy is up to me. It’s hard. That’s how i know it’s working. It’s HARD. I’m in the anger stage of Ptsd (quite delayed if you ask me, as it started full-force three damn years ago). I never understood why I wasn’t angry but it’s coming out now, and I’m not putting up with my mother’s shit and she does not like it. I’m currently getting the icy silent treatment with rude remarks. Ugh. She’s exhausting. Sorry I’m vearing away from the post topic. Have you ever heard of Dr. Andrew Moskowitz? He has a BRILLIANT book I bought ($44!!) called Psychosis, Trauma and Dissociation: Emerging Perspectives on Severe Psychopathology. It’s incredible. I’ll read more into into and share the facts with you. I love reading the science of this stuff. Anyway, thank you so much for this intelligent post. I’ll be coming back to read it again and again. And I’m heading for DBT on Monday, thank you!
    Amy Jo

  2. That must have been awful – what happened with your therapist, and being your mom’s friend sounds like a definite conflict of interest. I hope you find a good DBT counselor. I have to drive 30 miles to mine one way, but it is so worth it. I, too, love the all of the science stuff. If I had the stamina I’d go back to school and become a neuroscientist :) I have not read Moskowitz but look forward to hearing about his book from you.

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