Brain structures involved in dealing with fear and stress. (Photo credit: Wikipedia)
A good friend of mine pointed me to a recent Nature essay that describes the biological markers for PTSD and resilience–and provides some of the answer of why some seem to recover fairly quickly while others continue to struggle. Here’s a couple key quotes:
“Functional magnetic resonance imaging (fMRI), which tracks blood flow in the brain, has revealed that when people who have PTSD are reminded of the trauma, they tend to have an underactive prefrontal cortex and an overactive amygdala, another limbic brain region, which processes fear and emotion…”
“People who experience trauma but do not develop PTSD, on the other hand, show more activity in the prefrontal cortex.”
Of course, we need to understand that we are complex beings with complex histories and current social connections. We don’t only look at neural activity but with increasing understanding, we learn how experiences such as childhood trauma, poor social support influence brain activity.
Some worry that the discussion of biological features of PTSD will lead only to increasing chemical interventions (meds, surgeries, etc.). I do not believe this to be the case given that we are also learning about the ways that current relationships and psychotherapies are altering brain activity.
Musings on Faith and Psychology 
Phil, do you have thoughts on the trial use of the Stellate ganglion block with veterans for the treatment of PTSD? Fran
http://www.foxnews.com/health/2012/09/21/doctor-injection-can-cure-ptsd-in-veterans/
Sounds promising. I was talking to a colleague today about a variety of techniques and medications that block memory formation and association between memories and trigger reactions. So, this has merit and would be revolutionary. We’ll have to see as the trials get larger.
Ketamine is another trial drug that may be shoing some promise as well.
I wonder if Prolonged Exposure Therapy “works” by activating the prefrontal cortex. Perhaps effective therapies for PTSD are the ones that connect executive function and the sensory-emotional (prefrontal cortex and amygdala). Perhaps PTSD is ‘healed’ when amygdala and prefrontal cortex are balanced, each fully functioning simultaneously. Some might only need recalibration of balance. Others might need frequent “tune-ups.” Balanced is easily maintained with one and easily tipped out again for another.
Dear Phil, can you share a bit about your experience re: patients who have undergone EMDR therapy?