PTSD: Does trauma change the brain for good?

Katy Kandaris-Weiner, LPC

A traumatic event can happen in an instant, whether it is an instance of abuse, physical or sexual assault, or a severe accident. Trauma is also something that can be prolonged, whether it is repeated exposure to conflict, war, or the impact of a serious health condition. Yet, the terrifying truth about post-traumatic stress disorder (PTSD) is that it can develop regardless of time frames. PTSD does not play favorites, and it does not only choose to impact those who have been repeatedly exposed to trauma. Whether or not a traumatic experience is acute, chronic, or complex, PTSD lingers around well after the event(s) have transpired, and one reason it lingers is that it causes changes in the brain.

How does PTSD/Trauma change the brain?

According to neuroimaging research and studies, the brain of someone with PTSD looks different both structurally and functionally. Certain regions of the brain deal with emotional processing and stress response: the amygdala, hippocampus, and prefrontal cortex. The changes in these regions of the brain impact how someone with PTSD responds to stress. Here is a closer look at the effect of trauma on each one:

The Hippocampus

In people with post-traumatic stress disorder, the hippocampus appears smaller in size. This region of the brain is responsible for memory functions and emotions, and it is where images show the most significant impact of trauma. The hippocampus helps one form new memories and distinguish those present memories from past ones. While some people with PTSD may struggle to recall certain parts of their traumatic event, some individuals experience vivid memories. In either case, people with PTSD do not always properly process things like flashbacks and nightmares, causing anxiety due to this malfunctioning hippocampus. Also, when an individual is presented with an environmental situation that in any way resembles something from their traumatic past, their neural mechanisms trigger an extreme stress response, and this constant stress may further damage the hippocampus.

The Amygdala

PTSD causes increased activity in the amygdala, the brain's region that is tied to fear responses. When someone responds to stimuli that are in some way connected to their traumatic experience, this hyperactivity in the amygdala leads to high-stress levels, panicking, and anxiety.

The Ventromedial Prefrontal Cortex

The ventromedial prefrontal cortex is the part of the brain responsible for regulating the emotional responses, such as negative emotions and fear, triggered by the amygdala. Like the hippocampus, people with PTSD show a reduction in volume in this region as well, yet different from the amygdala, PTSD patients may exhibit hypoactivity here as opposed to hyperactivity. The ventromedial prefrontal cortex's impaired functional ability leads to people with PTSD experiencing fear, anxiety, and stress, even when they are not faced with the stimuli that they might connect with their past experiences.

There is hope through therapy

The unfortunate thing about PTSD is that it is characterized by symptoms and impacts that affect someone well after a traumatic event has already ended. In fact, it is the mind that tells them their trauma is not over, and it can feel quite hopeless. But where there are feelings of hopelessness, there is room for hope. And because a brain structure and function can change as a result of PTSD, it just means that the brain is capable of changing again. Therapy can help to alter brain activity and repair imbalances within the brain. If you are struggling with PTSD symptoms, don't wait any longer to reach out and ask for help. Call us today and start seeing changes in your day to day life. While trauma changes those it touches, through therapy and other help it can heal and a hopeful future can begin.

Works Cited

Bremner, J Douglas. “Neuroimaging in Posttraumatic Stress Disorder and Other Stress-Related Disorders.” Neuroimaging Clinics of North America, U.S. National Library of Medicine, Nov. 2007,

Koenigs, Michael, and Jordan Grafman. “Posttraumatic Stress Disorder: the Role of Medial Prefrontal Cortex and Amygdala.” The Neuroscientist : a Review Journal Bringing Neurobiology, Neurology and Psychiatry, U.S. National Library of Medicine, Oct. 2009,

Matthew Tull, PhD. “How Damage to the Brain's Hippocampus May Play a Role With PTSD.” Verywell Mind, 5 Feb. 2020,

NHS Choices, NHS, 2007,

Viatcheslav Wlassoff, PhD. “How Does Post-Traumatic Stress Disorder Change the Brain?” Brain Blogger How Does PostTraumatic Stress Disorder Change the Brain Comments, 2015,

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Katy Kandaris-Weiner, LPC

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