The Neurological Disability of PTSD

Many people with PTSD refuse to admit that it can be a disability.  But there is biological evidence indicating how it can be.  Trauma affecting the brain that has experienced previous traumas undergo a change in brain structure.  Namely, the hippocampus decreases in size as well as part of the pre-frontal cortex.  While researchers do not yet know why the hippocampus shrinks, there is evidence that its size is related to depression.1  Depression is a major symptom of PTSD.  Studies have also shown that the size of the medial pre-frontal cortex and its response to emotional cognitive tasks is reduced as the severity of PTSD symptoms are greater.2  Conversely, activity in the amygdala, the part of the brain responsible for “fight or flight” is heightened when PTSD symptoms are greater.  The function of the medial pre-frontal cortex is believed to have a role in decision-making and memory recall, and it “likely relies on the hippocampus to support rapid learning and memory consolidation.”3  The hippocampus is known to facilitate access to memory.

The changes to the brain are responsible for difficulties with verbal declarative memory, such as thinking of words, working memory, and executive decision-making.  It might be partially responsible for dissociation and experiencing mental fogginess.  There has not been enough research to ascertain the cause of many mental states.

The good news is that there is also evidence that the size of the hippocampus can increase with interventions “such as learning, environmental enrichment, exercise and chronic treatment with antidepressants.”4  Dr. Majid Fotuhi, a medical doctor and specialist in memory disorders, believes that ill-effects on the hippocampus can be reversed.5  He has been known to promote vigorous exercise as an intervention: exercise to the point of “huffing and puffing” as this supplies needed oxygen to the brain, which is essential for neurogenesis.

(reposted in part from

1 Khan, S. A., Ryali, V., Bhat, P. S., Prakash, J., Srivastava, K., & Khanam, S. (2015). The hippocampus and executive functions in depression. Industrial Psychiatry Journal, 24(1), 18-22. doi:10.4103/0972-6748.160920

2 Shin, L., Rauch, S., & Pitman, R. (2006). Amygdala, medial prefrontal cortex, and hippocampal function in PTSD. Annals of the New York Academy of Sciences, 1071(01), 67-79.

3 From the Abstract of Euston, D. R., Gruber, A. J., & McNaughton, B. L. (2012). The Role of Medial Prefrontal Cortex in Memory and Decision Making. Neuron, 76(6), 1057–1070.

4 From the Abstract of Sahay, A., Scobie, K., Hill, A., O’Carroll, C., Kheirbek, M., Burghardt, N., . . . Hen, R. (2011). Increasing adult hippocampal neurogenesis is sufficient to improve pattern separation. Nature, 472(7344), 466-470. doi:10.1038/nature09817

5 Fotuhi, M., Do, D., & Jack, C. (2013). Modifiable factors that alter the size of the hippocampus with ageing. Nature Reviews Neurology. Aug2013 Supplement, P29.

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