Anatomy of PTSD

Now that we have a familiarity with Post Traumatic Stress Disorder and have become familiar with its etiology (roots), what is it really? In the past, we could say that someone had PTSD, and would treat it symptomatically as a mental illness. We observed the external PTSD manifestations, but did really not understand the internal physiological implications. We had questions as to how PTSD affects the brain, which then adversely affects the anatomical systems.

Then came the magnetic resonance imaging machine (MRI), which enables us to do a functional MRI or fMRI. This is a procedure which allows us to watch the brain and its components, in real time (as it is happening). It gives us the opportunity to initiate a PTSD moment and watch what effect it has on the brain. It shows us the parts of the brain that are affected and hopefully, will assist us in devising a cure. One of the effects the researchers have noticed is that the hippocampus becomes smaller during an episode. The hippocampus is the area in the brain that stores memories.

The hippocampus, which is Greek for sea horse, consists of elongated ridges on the floor of each lateral ventricle of the brain, thought to be the centers of emotion, memory. The autonomic nervous system composed of a pair of structures found inside each temporal lobe that are shaped like sea horses. The hippocampus helps store and release memory. For those who remember the juke boxes of yesteryear, the idea is to put your coin in, choose a record, and watch as the chosen record is put on the turntable and played. When the record is finished, the record is picked up and put back into place. This is analogous to how our brain chooses a memory. The memory is chosen, moved from the hippocampus to the frontal lobe, and then when the memory has been re-lived, it is moved back again to the hippocampus.

Researchers have found that in PTSD, the recall is disrupted. The memory, rather then just being “played” and returned to its place, can possibly trigger various extreme reactions before being returned to the hippocampus. Accordingly, a damaged memory in the hippocampus causes harrowing episodes to occur. Ulrike Schmidt, a senior psychiatrist and research group leader at the Max Planck Institute of Psychiatry in Germany, gives an example of a rape victim who suffers a flashback after seeing a stranger who resembles her rapist.

A soldier in combat requires rapid memory feedback, and a smaller hippocampus appears to cause the soldier to have delusions as opposed to reacting as he has been trained.


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