Understanding PTSD & Anxiety

The areas of the brain of a person with PTSD that usually show up on scans are the amygdala and the hippocampus – regions associated with memory and emotions, especially fear. The amygdala is highly active when someone is experiencing anxiety, stress, or phobias, while the hippocampus commonly shrinks in the brain of a person with PTSD, which can help explain why they experience flashbacks.

Both the amygdala and the mid-anterior cingulate cortex become over-stimulated when a person suffers from PTSD. The amygdala engages in the assessment of threat-related stimuli (basically what in the environment is considered a danger), the formation and storage of emotional memories; fear conditioning; and memory consolidation. The ACC also plays a role in emotional awareness (particularly empathy); registering physical pain, and regulating autonomic functions like heart rate and blood pressure.

The hippocampus, right inferior frontal gyrus, ventromedial PFC, dorsolateral PFC, and orbitofrontal cortex all become hypoactive, some to the point of atrophy:

• Hippocampus: involved in the formation of new memories and is also associated with learning and emotions.
• Right inferior frontal gyrus: inhibition and attentional control.
• Ventromedial PFC: implicated in the processing of risk and fear.
• Dorsolateral PFC: attention and working memory, and very complex functions, such as planning activities, so it’s very high level structure.
• Orbitofrontal cortex: involved impulse control and response inhibition. This hypothesized role for the frontal areas of the brain can be traced back to Phineas Gage, who allegedly experienced a drastic reduction in social inhibition after a railroad accident that caused extensive damage to his prefrontal and orbitofrontal cortices. An atrophied OC likely negatively influences social inhibition.

The traumatized brain and its sociability.

Optimism or pessimism is not necessarily a "choice" for many with differing brain activity.

Memory in the anxious or traumatized person is usually poor, due to the effects of a shrunken hippocampus; their conversational ability is narrowed.

With a lack of memory to supplement healthy conversation, it pushes the sufferer further away from others, magnifying their anxiety. Trauma sufferers will recall non-emotional memories more than emotional memories, the drawback here is that emotional conversation is crucial to bonding in every type of human relationship. An absence of creative ability to produce creative and emotional conversation is the Achilles heel of trauma sufferers.

"Present findings indicate that hippocampal region (HR) damage impairs aspects of everyday language comprehension and production that require creativity"

"Creativity, Comprehension, Conversation and the Hippocampal Region: New Data and Theory" by Donald G. MacKay and Rutherford Goldstein

With an overactive amygdala, the traumatized person is naturally more distrustful, leading them to identify negative patterns and perceive the world more critically. This makes them less able to open up to people, due to their inherently high cynicism. The initial phase for forming relationships in normal people is much larger in anxiety-afflicted brains.

"Fundamental to all human languages is an unlimited expressive capacity and creative flexibility that allow speakers to rapidly generate novel and complex utterances."

"We conclude that the relational binding and representational flexibility afforded by the hippocampal declarative memory system positions the hippocampus as a key contributor to language use and processing."

"The hippocampus and the flexible use and processing of language"
by Melissa C. Duff and Sarah Brown-Schmidt

The conclusion that can be drawn is that traumatized and anxious people are socially disadvantaged to an extent, due to several cause and effect neurological factors. The major effects being high social distrust, high social fear, higher social inhibition, and low memory retention leading to their social skills being negatively impacted.

Trauma has the effect of deactivating areas of the brain associated with emotion and memory. In a situation of helplessness - the human brain will shut down areas of governing response and recall to prevent the host from being targeted further or acting rashly in a dangerous environment. These effects can linger for a lifetime.

From the above graphic, it shows a child merely separated from their parents can suffer significant mental changes.

While the resulting cynicism has several advantages in identifying threats, it backfires in sufferers emotional health - lacking the liberal openness of a neurotypical person, the traumatized person will struggle to socialize and be overly anxious, manifesting in what society calls "introversion".