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The Biology of PTSD

The Biology of PTSD

For about 40 years, there’s been an intense debate whether PTSD is a mental illness or psychological injury. This is because trauma changes the physical structure of the brain, particularly the amygdala and hippocampus. These changes can result in mood swings and depression, often treatable with counseling or ketamine therapy.


Post-traumatic stress disorder (PTSD) is a mental health illness sparked by a horrifying event you experienced or witnessed. Symptoms can include nightmares, flashbacks, and serious anxiety, plus hysterical thoughts about the incident.

If you’ve gone through such an event, you may have short-term problems coping and adjusting, but with time and proper care, you’ll usually get better. Worsening symptoms that last months or years and interfere with daily life could be a sign of PTSD.


We know the brain plays a critical role in how we perceive pain, and how pain signals are transmitted throughout the body. Because of this, the brain’s role in symptoms of PTSD can’t be ignored. The illness is characterized by:

  • A struggle to find the right words to express feelings and thoughts
  • An inability to control emotions
  • Short-term memory loss
  • Frequent, intense fear, even in the absence of a threat or danger

The biology of PTSD plays a key part in our understanding of its effect on the hippocampus, the ventromedial prefrontal cortex, the amygdala, and cortisol levels.

The Hippocampus and PTSD

According to Dialogues in Clinical Neuroscience, “Due to the hippocampus’ role in memory and emotional experience, it is thought that some of the problems people with PTSD experience may lie in the hippocampus.” Some studies have shown that constant stress may damage the hippocampus, leading to potentially higher instances of PTSD in some trauma survivors.

The Ventromedial prefrontal cortex (PFC) and PTSD

The magazine Nature Neuroscience says the ventromedial PFC helps stifle negative emotions, as well as plays a part in social and personal decision-making. It’s also a major factor in “the latter part of memory consolidation, as well as regulating extinction—the weakening and eventual dissipation of a conditioned response.”

The Amygdala and PTSD

The prominent symptoms of PTSD include nightmares and unwanted, intrusive memories – both of which are influenced by the amygdala. According to the Dana Foundation, “The amygdalae, a pair of small almond-shaped regions deep in the brain, help regulate emotion and encode memories—especially when it comes to more emotional remembrances.”

Research has shown that the volume or size of the amygdala is altered due to trauma and can manifest itself in PTSD as increased stress, mood changes, and other symptoms typical of the condition. According to a 2020 study in Translational Psychiatry, “The amygdala is a core component in neurobiological models of stress and stress-related pathologies, including post-traumatic stress disorder (PTSD). While numerous studies have reported increased amygdala activity following traumatic stress exposure and in PTSD, the findings regarding amygdala volume have been mixed.”

Cortisol levels and PTSD

The Society of Endocrinology defines cortisol as “a steroid hormone that regulates a wide range of vital processes throughout the body, including metabolism and the immune response. It also has a very important role in helping the body respond to stress.” It’s the body’s main stress hormone and is comparable to a biological alarm system, acting to control moods, motivation, and fear. As a result, it plays a big role in how people suffering from PTSD interact with others and the world around them.

If cortisol levels are out of whack, PTSD sufferers may be at a greater risk of inflammation, high blood pressure, high blood sugar, interrupted sleep cycles, and low energy – all contributing to elevated “fight-or-flight” responses in times of perceived danger.

People who suffer from PTSD are intimately familiar with symptoms that can affect their lives, but medicine like ketamine can help.


Since being added to the Diagnostic and Statistical Manual of Mental Disorders-3 in 1980 (the current edition is DSM-5), PTSD has been primarily treated through therapy, self-help, and medicine, or a combination as appropriate. However, four decades of research have uncovered tantalizing evidence that PTSD and other mental and chronic pain disorders can be treated with ketamine therapy. While ketamine is an anesthetic, the medicine also works to repair and strengthen damaged neurotransmitters in the brain.


PTSD is a mental health condition that harms millions of people worldwide. Early research focused on combat veterans, but we know now that anyone who survives a deadly, traumatic experience – men, women, and children – can develop PTSD months or years after the incident. Thankfully, the symptoms are treatable with ketamine.

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