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Trauma Brain: Long-Term Effects & How to Heal

Published: September 9, 2022 Updated: November 28, 2022
Published: 09/09/2022 Updated: 11/28/2022
Headshot of Hailey Shafir, LPCS, LCAS, CCS
Written by:

Hailey Shafir

LPCS, LCAS, CCS
Dr. Maria Simbra, MD, MPH
Reviewed by:

Dr. Maria Simbra

MD, MPD
  • How Trauma Affects the Brain ImmediatelyImmediate Effects of Trauma
  • How Trauma Affects the Brain Long-termLong-Term Effects of Trauma
  • How Does Childhood Trauma Affect the Brain?Childhood Trauma & the Brain
  • Emotional Trauma vs. Traumatic Brain Injury (TBI)Emotional Trauma vs. TBI
  • How to Heal the Brain After TraumaHealing the Brain After Trauma
  • Final ThoughtsConclusion
  • Additional ResourcesResources
  • Trauma Brain InfographicsInfographics
Headshot of Hailey Shafir, LPCS, LCAS, CCS
Written by:

Hailey Shafir

LPCS, LCAS, CCS
Dr. Maria Simbra, MD, MPH
Reviewed by:

Dr. Maria Simbra

MD, MPD

Trauma can interfere with regions of the brain that govern fear and stress responses, emotion regulation, and executive functions.1,2,3 These neurological effects increase the risk of developing emotional, behavioral, and mental health problems, especially when trauma occurs in childhood.1,4 The effects of trauma on the brain are reversible, often with the guidance and support of a trauma-informed therapist.

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How Trauma Affects the Brain Immediately

All humans (as well as many other animals) have built-in survival instincts. One of these is the ‘fight or flight’ response, which originates in a part of the brain called the amygdala. One of the primary functions of the amygdala is to detect threats and danger. When the amygdala identifies a potential threat, it works to ‘sound the alarm’ by activating the sympathetic nervous system.2,5

The sympathetic nervous system is like a gas pedal that floods the body with stress hormones and chemicals such as cortisol and adrenaline. This puts the body into a state of fight or flight, causing several physiological changes in the body and brain. These changes aren’t random –they are meant to increase the chance of survival in a life-or-death situation.5

Effects of Trauma During Fight or Flight

Once the amygdala identifies a threat and sounds the alarm, the fight or flight response is activated by the nervous system. Physical or emotional trauma can trigger this response, and so can high levels of stress or anxiety. When this happens, most people experience sudden changes in their body and brain.5

Below are five possible ways that trauma affects the brain and body during the fight or flight5:

  1. Increased heart rate and blood pressure to help redirect blood towards vital organs and slow down digestion
  2. Rapid breathing to get more oxygen into the body quickly before the body may need to be deprived of oxygen due to intense action (i.e. running fast)
  3. A burst of adrenaline, physical strength, and energy designed to help someone more easily outrun or overpower a predator
  4. Increased alertness and hypervigilance to help a person be more aware of potential threats in their surroundings, as well as dilated pupils for sharpened senses
  5. Sweating or shaking as a result of increased cortisol and adrenaline in the bloodstream, and tensing of muscle groups in preparation for action

Faulty Threat Detection & False Alarms

The problem is that fight or flight responses are only helpful when people are faced with certain kinds of threats. For example, these survival instincts are useful in helping someone run away from or fight off a predator. However, they won’t help someone who is worried about an upcoming surgery or college exam. While the amygdala’s job is to detect threats, it usually can’t differentiate between different kinds of threats.5

For this reason, any stressful, scary, or upsetting situation can cause the amygdala to activate the fight or flight response. Sometimes, these are ‘false alarms’, or situations that aren’t actually dangerous. For example, this often happens to people suffering from specific phobias or other anxiety disorders who overreact to certain situations, including ones that aren’t actually dangerous.5

How Trauma Affects the Brain Long-term

The effects of trauma are numerous, but they also can vary from person to person, depending on a number of individual and environmental factors. For instance, the kind of trauma someone experiences; how old they were; how long it lasted; how they coped; and whether or not they had support can all change the effects of trauma on the brain.4,6

Recent brain imaging research has helped scientists identify how trauma affects the brain, and which regions of the brain are impacted. When comparing brain images between those with PTSD and the general population, there are three regions most affected: the hippocampus, amygdala, and prefrontal cortex.1,7

Below is how traumatic stress may affect the amygdala, hippocampus, and prefrontal cortex:

The Effects of Trauma on the Amygdala

The amygdala is part of the limbic system in the brain, and can become overactive in those who have experienced trauma. This can cause one to become overly sensitive to threats and more prone to stress and anxiety.1,6 This is especially true for people who have experienced childhood trauma that interfered with their brain’s development. In situations that trigger memories of this trauma, the amygdala is more likely to misfire and produce false alarms that activate fight or flight responses.1,5,7

There are many ways that an overactive amygdala can affect someone, including displays of:

  • Classic symptoms of PTSD: One of the most common trauma responses is the development of posttraumatic stress disorder (PTSD). Symptoms of PTSD can include flashbacks, avoidance behaviors, and intense emotional responses when one encounters trauma reminders or triggers.8
  • Hypervigilance: An overactive amygdala can cause people to become overly alert, on-edge, and aware of certain kinds of threats, known as hypervigilance. Hypervigilance is a symptom of PTSD that involves being overly alert and watchful for certain types of danger, including traumatic experiences that happened in the past.8
  • Anxiety disorders: Excessive worrying or nervousness, restless energy, irritability, trouble focusing and physical symptoms like G.I. upset are all linked to an overactive amygdala.8 These physiological changes are often a result of the fight or flight response occurring too often or in response to situations that aren’t really dangerous, which is a key symptom of anxiety disorders.5
  • Panic attacks: Panic attacks involve intense symptoms of anxiety that occur suddenly and may include racing heart, shortness of breath, tightness in the chest, and dizziness. Panic attacks are often experienced during the peak of fight or flight responses, and may be a symptom of an anxiety disorder, PTSD, or another disorder.5,8
  • Avoidance: Someone with an overactive amygdala is more likely to rely on avoidance coping, which involves avoiding people, places, or situations that trigger their stress or anxiety. Avoidance is a symptom often associated with anxiety disorders, specific phobias and PTSD.8

The Effects of Trauma on the Hippocampus

While the amygdala is one part of the brain’s limbic system, there are also others that have different jobs related to processing memories and emotions. One of these is the hippocampus, which is mainly responsible for learning and storing memories. Some studies have shown that people who experience trauma (especially childhood trauma) have smaller hippocampal regions than normal.6,7,9

The hippocampus is the part of the brain that assigns meaning and associations to memories, including traumatic ones. It also plays a key role in emotion regulation and stress responses.9 This may help explain why trauma survivors are more likely to struggle with mood disorders, mental illnesses, and other emotional problems.1,6

As a result of impairments in the hippocampus, it’s possible that trauma survivors are more likely to suffer from the following:

  • Depression: Because the hippocampus plays a role in emotion regulation, it also has an impact on a person’s mood. This may be why traumatic experiences increase the risk of developing mood disorders like depression. This is especially true for survivors of childhood trauma, who are three times more likely than others to develop depression.4
  • Chronic stress: The hippocampus (along with other parts of the limbic system) also helps manage stress. Research has shown that trauma survivors are more likely to report struggling with chronic stress (also called toxic stress). They may also have higher baseline levels of stress than most people. Having a lower stress tolerance makes a person more easily upset or overwhelmed, even when faced with minor issues and problems.1,6,7
  • Health problems: Higher levels of stress and mood related issues can impact a person’s physical health, too. It’s been well established through research that increased levels of stress and cortisol (stress hormone) weaken the immune system, making people more susceptible to a variety of illnesses and infections. Studies have also shown that childhood trauma greatly increases the risk of developing chronic health conditions like diabetes, heart problems, and autoimmune disorders.2,4
  • Unhealthy lifestyle choices:  Impaired hippocampal regions may lead to a decrease in one’s ability to manage their emotions and stress in healthy ways.9 This can make a person much more likely to use unhealthy coping methods. For example, studies have  shown that those who experienced trauma in childhood are more likely to smoke, drink, and adopt unhealthy eating and exercise patterns.4
  • Interpersonal problems: Relationship problems and conflicts are something everyone experiences from time to time, but having impaired emotion regulation can make these issues more frequent and intense. Also, many trauma survivors (especially those who experienced childhood trauma) struggle with insecure attachment styles and fears of abandonment that add more stress and tension to their relationships.4

Help For Trauma / PTSD

Talk Therapy – Get help recovering from trauma from a licensed therapist. Betterhelp offers online therapy starting at $60 per week. Get matched With A Therapist


Virtual Psychiatry – Get help from a real doctor that takes your insurance. Talkiatry offers medication management and online visits with top-rated psychiatrists. Take the online assessment and have your first appointment within a week. Free Assessment


Guided Psychedelic Journeys – Ketamine is a prescription medication that clinicians can prescribe off-label to treat trauma, depression, anxiety, and OCD. Innerwell pairs ketamine with support from licensed psychotherapists. Find out if you’re a good candidate: Take Online Assessment 

Choosing Therapy partners with leading mental health companies and is compensated for marketing by BetterHelp, Talkiatry, and Innerwell.

The Effects of Trauma on the Prefrontal Cortex

The medial frontal cortex, a part of the prefrontal cortex, is the last part of the brain most impacted by trauma.1,6 The prefrontal cortex is responsible for most of the more complex thinking processes known as ‘executive functions’. Executive functions include the ability to plan ahead, think things through, and make good choices, all of which are essential tasks for normal life.3,6,7

Trauma can suppress the prefrontal cortex, leading to impaired executive functioning. When people are in fight or flight mode, the prefrontal cortex becomes less active and basic survival instincts take over. When traumatic stress happens frequently, too early in life, or for extended periods of time, it can lead to long-lasting impairments in executive functions.1,6 Studies have shown that people with PTSD have lower executive functioning than the general population.3,7

Trauma-induced damage to the prefrontal cortex may result in:

  • Impulsive decision making: Poor executive functioning, due to problems in the prefrontal cortex, can cause someone to make riskier decisions. They may experience stronger urges to make poor choices, and have less of an ability to resist them. This may explain why people with trauma histories have higher rates of impulsivity. Decreased executive functioning also makes it harder to consider long-term goals and consequences of one’s actions.3
  • Learning problems: Because the prefrontal cortex helps people think logically, analyze information, and solve problems, damage to this part of the brain is often linked to learning problems. Poor grades, difficulty memorizing, or understanding new concepts can all be the result of trauma.2,6
  • Shorter attention span or ADD: Trouble focusing is both a short and long-term effect of trauma.5 The prefrontal cortex is a necessary component of concentrated attention, so impairments in this region of the brain may manifest as symptoms of ADD or ADHD<.2,6,7

How Does Childhood Trauma Affect the Brain?

There’s a strong link between emotional trauma and the brain, especially when this trauma occurs in childhood. Childhood trauma is particularly detrimental to the brain, because it can interfere with key stages of normal brain development.

Research shows that childhood trauma significantly increases the risk for:1,2,4,6

  • Mood disorders such as depression
  • Drug or alcohol use, and substance addictions
  • Cognitive and language delays
  • Lower educational and vocational success
  • Increased criminal activity
  • Higher rates of chronic health and mental health issues
  • Attention problems and higher rates of ADD and ADHD

Emotional Trauma vs. Traumatic Brain Injury (TBI)

Emotional trauma is not the same as a traumatic brain injury (TBI), as a TBI usually involves a physical injury that causes long-lasting or permanent damage to the brain. The neurological effects of trauma are not permanent in nature, and scientists have proven that neuroplasticity (the brain’s ability to rewire itself) can sometimes override these impacts. Moreover, one’s environment and choices can either help or hinder this process. Starting treatment, adopting healthier habits, and learning new coping skills can also help heal the effects of trauma in the brain.10

How to Heal the Brain After Trauma

Healing from trauma is an individualized process that is different for everyone. A number of factors can affect how quickly a person recovers or which treatments they respond well to. Having a strong support system, an optimistic mindset, and healthy stress coping skills are proven to boost resilience and accelerate healing.

Here are some ways to boost trauma resilience:10

  • Form, strengthen, and maintain close relationships with others
  • Provide emotional support to others who you care about
  • Identify your personal strengths and talents
  • Have a creative outlet or hobby you enjoy
  • Have a strong belief system or sense of hope and optimism
  • Develop better communication skills, learn to say no, and set boundaries
  • Learn, seek out information about, and be open to new ideas and experiences
  • Maintain a good sense of humor
  • Be able to ask others for help in times of need
  • Actively work to solve problems in your life
  • Express yourself and your feelings
  • Set limits for yourself and stick to them
  • Be flexible and adaptive to new situations
  • Practice healthy coping skills

In addition to pursuing positive changes in life, it’s also important to enlist the help of a licensed therapist who can help you work through your trauma. A variety of therapies have been proven effective in the treatment of trauma, and some can provide relief after a few sessions. These  trauma-informed therapies include: EMDR, Cognitive Processing Therapy (CPT), Prolonged Exposure Therapy, and Accelerated Resolution Therapy (ART).12

Final Thoughts

Traumatic experiences can have a profound effect on someone’s life, and also their brain. Neurological changes can negatively impact one’s relationships and ability to function. However, these effects can be treated and reversed, often with the help of trauma-informed therapy.

Additional Resources

Education is just the first step on our path to improved mental health and emotional wellness. To help our readers take the next step in their journey, Choosing Therapy has partnered with leaders in mental health and wellness. Choosing Therapy may be compensated for marketing by the companies mentioned below.

Online Therapy 

BetterHelp – Get support and guidance from a licensed therapist. BetterHelp has over 20,000 therapists who provide convenient and affordable online therapy.  Complete a brief questionnaire and get matched with the right therapist for you. Get Started

Virtual Psychiatry

Talkiatry – Get help from a real doctor that takes your insurance. Talkiatry offers medication management and online visits with top-rated psychiatrists. Take the online assessment and have your first appointment within a week. Free Assessment

Mindfulness

Mindfulness.com – Change your life by practicing mindfulness. In a few minutes a day, you can start developing mindfulness and meditation skills. Free Trial

Guided Psychedelic Journeys

Innerwell – Ketamine is a prescription medication that clinicians can prescribe off-label to treat trauma, depression, anxiety, and OCD. Innerwell pairs ketamine with support from licensed psychotherapists. Find out if you’re a good candidate: Take Online Assessment 

Choosing Therapy Directory 

You can search for therapists by specialty, experience, insurance, or price, and location. Find a therapist today.

Choosing Therapy partners with leading mental health companies and is compensated for marketing by BetterHelp, Talkiatry, Innerwell, and Mindfulness.com

For Further Reading

  • Mental Health America
  • National Alliance on Mental Health
  • MentalHealth.gov

Trauma Brain Infographics

How Trauma Affects the Brain Immediately   How Trauma Affects the Brain Long-Term    How to Heal the Brain After Trauma

11 sources

Choosing Therapy strives to provide our readers with mental health content that is accurate and actionable. We have high standards for what can be cited within our articles. Acceptable sources include government agencies, universities and colleges, scholarly journals, industry and professional associations, and other high-integrity sources of mental health journalism. Learn more by reviewing our full editorial policy.

  • Nutt, D. J., & Malizia, A. L. (2004). Structural and functional brain changes in posttraumatic stress disorder. Journal of Clinical Psychiatry, 65, 11-17

  • Seo, D., Rabinowitz, A. G., Douglas, R. J., & Sinha, R. (2019). Limbic response to stress linking life trauma and hypothalamus-pituitary-adrenal axis function. Psychoneuroendocrinology, 99, 38–46. https://doi.org/10.1016/j.psyneuen.2018.08.023

  • Polak, A. R., Witteveen, A. B., Reitsma, J. B., & Olff, M. (2012). The role of executive function in posttraumatic stress disorder: A systematic review. Journal of affective disorders, 141(1), 11-21.

  • Felitti, V. J. (2009). Adverse childhood experiences and adult health. Academic pediatrics, 9(3), 131-132.

  • Sperber, S. (2022). Fight or Flight Response: Definition, Symptom, and Examples. Berkeley Well-Being Institute. Retrieved from: https://www.berkeleywellbeing.com/fight-or-flight.html

  • McLean, S. (2016). The effect of trauma on the brain development of children: Evidence-based principles for supporting the recovery of children in care. Melbourne: Australian Institute of Family Studies. https://aifs.gov.au/resources/practice-guides/effect-trauma-brain-development-children

  • Cozolino, L. J. (2005). The impact of trauma on the brain. Psychotherapy in Australia, 11(3).

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596

  • Zhu, Y., Gao, H., Tong, L., Li, Z., Wang, L., Zhang, C., … & Yan, B. (2019). Emotion regulation of hippocampus using real-time fMRI neurofeedback in healthy human. Frontiers in human neuroscience, 13, 242.

  • Ahern, N. R., Kiehl, E. M., Lou Sole, M., & Byers, J. (2006). A review of instruments measuring resilience. Issues in comprehensive Pediatric nursing, 29(2), 103-125

  • American Psychological Association. Div 12 Psychological Treatments. Society of Clinical Psychology. https://div12.org/diagnosis/posttraumatic-stress-disorder/

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Headshot of Hailey Shafir, LPCS, LCAS, CCS
Written by:

Hailey Shafir

LPCS, LCAS, CCS
Dr. Maria Simbra, MD, MPH
Reviewed by:

Dr. Maria Simbra

MD, MPD
  • How Trauma Affects the Brain ImmediatelyImmediate Effects of Trauma
  • How Trauma Affects the Brain Long-termLong-Term Effects of Trauma
  • How Does Childhood Trauma Affect the Brain?Childhood Trauma & the Brain
  • Emotional Trauma vs. Traumatic Brain Injury (TBI)Emotional Trauma vs. TBI
  • How to Heal the Brain After TraumaHealing the Brain After Trauma
  • Final ThoughtsConclusion
  • Additional ResourcesResources
  • Trauma Brain InfographicsInfographics
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