Trauma & the Brain: Understanding the Effects

How Does Trauma Affect the Brain?

Determining how trauma affects the brain is complex, as various factors interplay into how individuals respond to and cope with traumatic events. However, humans have automatic survival instincts, such as the fight-or-flight response, that activate when people encounter threats. This reaction starts a series of internal changes that prepare us for potential danger, almost like a “gas pedal” that floods the body with stress hormones (i.e., cortisol and adrenaline).⁵

The problem is that fight-or-flight responses are only helpful with certain kinds of threats, such as running from a predator. The amygdala detects these threats but cannot always differentiate between real and perceived danger.⁵ In the case of trauma, people can become trapped in a cycle of fight-or-flight due to chronic exposure to abuse, neglect, or life-changing events. Ultimately, being constantly fearful can affect specific brain regions, including the amygdala, hippocampus, and prefrontal cortex.

Below are the effects of trauma on the brain:

Effects of Trauma on the Amygdala

The amygdala is a part of the brain that can become overactive in those with trauma histories. This change can cause survivors to become hypersensitive to threats and more prone to stress and anxiety, especially in cases of childhood trauma and adverse childhood experiences. ^1,6 Early trauma exposure can interrupt development, meaning the amygdala is more likely to misfire and produce false alarms that activate fight-or-flight responses.^1,5,7

Issues that can occur due to the effects of trauma on the amygdala include:

• 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 someone encounters trauma reminders or triggers.⁸
• 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, restless energy, irritability, trouble focusing, and physical symptoms associated with anxiety disorders are all linked to an overactive amygdala.^5,8 These physiological changes are often a result of an overactive fight-or-flight response, meaning those with trauma histories may be more likely to develop co-occurring anxiety.
• Panic attacks: Individuals can experience panic attacks during the peak of fight-or-flight.^6,8
• Avoidance: Trauma survivors with an overactive amygdala are more likely to rely on avoidance coping, which involves avoiding people, places, or situations that trigger stress or anxiety.⁸

Effects of Trauma on the Hippocampus

The hippocampus is mainly responsible for assigning meaning and associations to memories, including traumatic ones. This brain region also plays a role in emotional regulation and stress responses.⁹ Some studies show people who experience trauma (especially childhood trauma) have smaller hippocampal regions than the average population.^6,7,9 These findings may help explain why trauma survivors are more likely to struggle with mood disorders, mental illnesses, and other emotional problems.^1,6

Issues that can occur due to the effects of trauma on the hippocampus include:

• Depression: The hippocampus can impact mood, suggesting those with trauma histories have an increased risk of developing depression. Survivors of childhood trauma are three times more likely than others to develop this mood disorder.⁴
• Chronic stress: Research shows trauma survivors are more likely to report struggling with chronic or toxic stress. They may also have higher baseline levels of stress, making them more easily upset or overwhelmed, even when faced with minor issues and problems.^1,6,7
• Health problems: Increased stress and cortisol levels weaken the immune system, making people more susceptible to illnesses and infections. Studies have shown childhood trauma 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 unhealthy coping mechanisms.⁹ For example, those who experienced trauma in childhood are more likely to smoke, drink, and adopt disordered eating and exercise patterns.⁴
• Interpersonal problems: Impaired emotional regulation can make relationship issues more frequent and intense. Many trauma survivors struggle with insecure attachment styles and fears of abandonment that add more stress and tension to their relationships.⁴

Effects of Trauma on the Prefrontal Cortex

Trauma impacts the medial frontal cortex, a part of the prefrontal cortex.^1,6 This brain region is responsible for most of the more complex thinking processes known as executive functions, such as the ability to plan, think things through, and make good choices.^3,6,7

Trauma can suppress the prefrontal cortex, leading to executive dysfunction. Traumatic stress that happens frequently, too early in life, or for extended periods can contribute to long-lasting impairments in these skills. ^1,6,7

Issues that can occur due to the effects of trauma on the prefrontal cortex include:

• Impulsive decision-making: Decreased executive functioning makes considering long-term goals and consequences of actions difficult.³ Trauma survivors may experience stronger urges to make poor choices and have less of an ability to resist them.
• Learning problems: The prefrontal cortex helps people think logically, analyze information, and solve problems. Damage to this part of the brain can lead to learning problems, such as difficulties memorizing or understanding new concepts.^2,6
• Shorter attention span: Trouble focusing is both a short and long-term effect of trauma.⁵ The prefrontal cortex is a necessary component of concentrated attention, meaning impairments may manifest as symptoms of ADHD.^2,6,7

Childhood Trauma & the Brain

Research suggests a link between emotional trauma and the brain, especially when individuals experience early traumas. Childhood trauma interrupts normal brain development, sometimes increasing the risk of depression, substance use disorders, ADHD, and chronic health illnesses. Survivors are also more likely to experience cognitive or language delays, lower professional success, or increased criminal activity.^2,4,6

Trauma Vs. Traumatic Brain Injury (TBI)

Emotional trauma differs from traumatic brain injury (TBI). TBI usually involves a physical injury that causes long-lasting or permanent damage to the brain. The neurological effects of trauma are not permanent, and scientists have proven neuroplasticity (the brain’s ability to rewire itself) can sometimes override these impacts. Moreover, 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. Several factors can affect how quickly a person recovers or which treatments best suit their needs. For example, a support system, an optimistic mindset, and healthy stress-coping skills can boost resilience and accelerate healing.

In addition to positive life changes, a licensed therapist can help you work through your trauma. Various therapies are effective in the treatment of trauma, and some can provide relief after a few sessions. EMDR for PTSD, cognitive processing therapy (CPT), prolonged exposure therapy, and accelerated resolution therapy (ART) can assist survivors in regaining a sense of control, stability, and safety in their lives.¹²

Below are ways to combat the effects of trauma on the brain:¹⁰

• Form, strengthen, and maintain close relationships with others
• Provide emotional support to others who you care about
• Identify your 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
• 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