PTSD signs: What is the reason for persisted fear?


PTSD– post-traumatic stress disorder is a condition that develops in one after they encounter a scary or dangerous event. The brain stores the event as a trauma. Usually, the fight-flight response helps combat the condition to avoid harm. Although you can overcome bad memories with time, some people face difficulty overcoming the trauma. Any specific unpleasant conditions trigger fear in them, resulting in post-traumatic stress disorder. They also face trouble sleeping. Other signs of PTSD include memory deficits, decreased focus, aggression, and mental instability.  

Factors that increase the risk for PTSD

  • Near-death experience
  • Loss of loved-ones
  • Watching someone die nearby
  • Abuse in childhood– PTSD in children can result in autism.
  • Helplessness and extreme fear
  • No social support
  • History of mental illness

What will help reduce the signs of PTSD?

  • Seek out a friend and family support
  • Find a support group
  • Have ways to cope up with the situation
  • Try to act out efficiently to trauma-triggering conditions
  • Consult a therapist for professional help.

How does re-experience with trauma in PTSD feel?

In the event of re-experience, the individual undergoes distressing dreams and intrusive thoughts. They frequently recall the traumatic event and suffer from psychological distress. This response to re-experience is a result of the cortex and limbic system’s activity. PTSD also exhibits hyperactivity of Amygdala and reduced activity of the medial prefrontal cortex (mPFC). Besides, the mPFC is responsible for inhibiting the excitatory responses from Amygdala. The reduced activity results in emotional reactivity. The re-experience also exhibits high activity of insula– role in body awareness, and low activity of anterior cingulate cortex— attention and emotion.   

Conclusively, the effect due to re-experiencing, is due to failure of the cortical inhibition– involved in the inhibition of reactivation of memory associated trauma.

The thoughts and emotions of the trauma are centered around visceral experiences.

Avoidance–the first sign of response in PTSD

The Hippocampus is responsible for avoidance of a trauma associated circumstance. The Hippocampus, along with Amygdala and insula, plays a role in the extinction phase. PTSD exhibits two ways of avoidance– active (run towards a safe-side chamber) and passive avoidance (freeze in response to the situation). Both these ways can be maladaptive because, in the long run, the individual has no control over it. The Amygdala is the gate for response under the stimulus. Any lesions in the Amygdala can affect risk-taking behavior. These lesions eventually affect behavioral engagement and result in functional impairments.

What is the reason for fear and anxiety signs of PTSD

Everyone exhibits fear in response to environmental stimuli. A person encountering a neutral cue, immediately followed by an aversive cue, will respond fearfully to the same neutral prompt in the next encounter. This reaction is a result of a conditioned fear response. They anticipate an unpleasant event right after the same neutral cue encounter. 

The fear extinction results in reduced fear response to a specific cue. The person develops a new memory to inhibit the response, rather than erasing the bad memory.

PTSD individuals can also create new memories, but they lack the retaining capacity. This loss eventually results in persistent fear in them.

The size of the ventromedial prefrontal cortex translates to the extent of fear of extinction. It inhibits the Amygdala responsible for fear-extinction. As a result, they have a more conditioned fear response along with generalized anxiety the whole time. 

What brain activities contribute to PTSD signs?

  • Memory deficits: PTSD makes it challenging to recollect certain memories. This effect is due to the atrophy (neural cell death) observed in the Hippocampus. The hippocampus primarily focuses on storing memory and recollection. The reduced Hippocampal volume makes it difficult to recollect the memory also in fear-extinction.
  • Decreased focus: PTSD exhibits enhanced focus in attention-limiting tasks due to the activation of the prefrontal cortex. Meanwhile, they also exhibit reduced attention in focused tasks. They tend to deviate from the essential activity and focus on the non-essential ones.
  • Emotional instability: PTSD sufferers always have a shouting and hyperactive Amygdala. They constantly express negative emotions. This instability is due to the failure of emotional regulation, making it challenging to exert voluntary control over their emotions. This emotional overdrive is due to the decreased prefrontal cortex activity.

Moreover, they fail to express positive emotions as well. This reward center consists of two phases (approach and consumption phase), which are both disrupted in PTSD. Additionally, less activity is associated with motivation.

  • Aggressive behavior: Amygdala along with locus coeruleus generates a hormonal cascade responsible for threat detection. PTSD forces failure of these circuits, making the person aggressive. They also exhibit dysfunction in the regions of the brain associated with aggression.

Related: Anxiety attack signs: What should you do to combat anxiety?

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