08/01/2023
The brain changes under stress.
Brain imaging studies of posttraumatic stress disorder (PTSD) have identified a few key brain regions whose function appears to be altered in PTSD, most notably the amygdala, the ventromedial prefrontal cortex (vmPFC) and the hippocampus.
The amygdala is an almond-shaped region ("amygdala" is greek for almond) that is key to the normal expression of emotions, especially fear. Brain imaging studies see high activity in the amygdala when subjects experience anxiety, stress or phobias.
The vmPFC can be thought of as a "higher" or "more sophisticated" part of the brain, involved in less well defined activities such as "emotional processing" and "decision making".
The hippocampus is a large region that is, very simply, involved in memory, especially spatial memory (such as for, and of, places)
A very generalised model of what happens during normal responses to anxiety is this; a person enounters some environmental cue that signals danger, for example, they see a tiger. This information is sent to the amygdala, which gets fired up and starts sending out "fight or flight" responses to other parts of the brain. However, the vmPFC, being involved in "higher thinking", has a quiet word with the amygdala, saying "look, the tiger is in a cage, you know what a cage is, tigers can't escape from cages, it's OK, calm down". Another part of the brain, the hippocampus, helps out, providing information about the context of the event (we're at a zoo, we know what zoo's look like, we've seen them before). In summary, the vmPFC inhibits the amygdala to keep fearful responses in check.
Brain imaging studies of PTSD sufferers generally show two things; reduced activity in the vmPFC and increased activity in the amygdala. A long-held interpretation of these studies is that, in PTSD, the vmPFC is asleep at the wheel, allowing the amygdala to go unchecked and thus produce many of the intense anxiety symptoms that are a key feature of PTSD.