What Happens in Our Brains When We Experience a Bad Event?

Life does not always provide us with good memories, but it often leaves us with lessons. To learn from an experience, we must first understand what happened and why it happened. While understanding the positive and negative outcomes logically is easy, the emotions we experience are often unpredictable and difficult to understand. So I want to explain how the brain processes bad events. And how can it evolve into a trauma especially in PTSD patients.

In normal situations our brains are organized when taking in information. Consider a simple example: seeing and smelling a flower with pink petals and a fresh scent.

Firstly your eyes take in the shape, colors, petals, and the symmetry of the flower with the lights input. Your nose detects odor molecules, that fresh smell. Then these signals are converted into electrical signals to travel through your retina and optic nerve by the eye and the olfactory receptors to the nerves by the nose. 

Visual information is first relayed through the thalamus and then sent to the visual cortex in the occipital lobe. The visual cortex detects the movement of the different shapes and the layered colors of the flower. The associated areas of your brain get involved comparing what you’re seeing right now with your memories telling you that it is a flower. The hippocampus retrieves past experiences about flowers; the gardens you saw, the sunlight hitting the petals… Then we put meaning and emotion into it: the amygdala evaluates the emotional significance , do we like it , is it dangerous , is it boring? The meaning comes with the prefrontal cortex that adds comments to the experience: the colors are beautiful, nature is worth spending time in it. Only then our bodies start reacting, activating the parasympathetic system getting us more relaxed, slower breathing relaxed muscles… When our minds are busy with something else, even when we are inside nature,even positive sensory input may not be processed deeply enough to get us a calming effect.

The smell is a special case where it bypasses the thalamus first and goes straight into the olfactory bulb, and then the amygdala ,then finally into the hippocampus where it retrieves past events linked with the smell. This is actually why remembering past events and getting more emotional quicker  when we smell an old perfume we used to use. 

All of the information we got and all the bread we shipped to other bakeries (if you’ve read my earlier paper you’ll get the message.) gets made up into a memory also in the hippocampus. The visual, smell and the emotions we felt combine together to make a full experience. We then continue our lives with the new info we have learned with that experience, maybe how good Lillies smell. 🌺

But when the experience is quite bad, we get affected by a lot of stress hormones while still in the processing part of the experience. Let’s take the example of a car crash. There are two paths of information passing through the brain now. First we get the sensory input: fast movements and flashes from the eyes, loud noises from the ears, pressure and pain the the body. The first path is the fast one, the info passes through the thalamus and amygdala where amygdala activates our stress hormones(adrenaline, noradrenaline…)preparing the body for immediate action.

The slower pathway involves the thalamus and higher cortical regions like the prefrontal cortex that renders the input  understanding this isn’t just loud noises its a car crash , and the amygdala where we start to feel scared. In this situation the amygdala takes control dominating the prefrontal cortex; reducing the regulatory influence, overriding rational thinking and sending emergency signals through the body. The hypothalamus gets activated sending fight flight of freeze signals. These signals affect two main systems: 1st one being the Sympathetic Nervous System where adrenaline gets released more making our heart rate go up, breathing faster and muscles tenser. The 2nd one being the HPA Axis where cortisol gets released (stress hormone). As all of these happen the amygdala over-activating, the prefrontal cortex getting overrode; the hippocampus also gets disrupted resulting in the memory encoding becoming sensory loaded and fragmented. This causes distortion in the perception where we can feel the time moving slower, seeing in a tunnel vision and getting less aware of our surroundings. So the memory encoding becomes a sensory sum instead of a smooth experience. We stored the event completely differently now.

Now, normally we firstly expect to handle a normal situation the brain is able to evaluate events by reconstructing what happened, considering alternatives, and updating future behavior.

But why can’t we do these easily when the event gets traumatic?

I have explained it simply but it is a hard thing to do in real life even when the event isn’t traumatic because of two main reasons: human brains are evolutionarily biased toward survival and predictability; but the current society doesn’t really give us enough space to try out changing.

I’m not going to go into the first reason deeper in this paper, but our brains have survived because of our adaptiveness. This causes us to choose predictability over new possibilities. It also causes us to adapt to reacting to bad events memories like it’s gonna come again with the slightest sensory overload, to act faster than before, ensuring survival. But that affects our mind and body negatively, also impacting why we can’t handle the event like a normal situation we want to change.

Then when exactly does the event become traumatic? Normally the brain records what happened (hippocampus), how it made us feel (amygdala) and what it means (prefrontal cortex). This ensures we think of the event in the past tense, knowing it has ended now. But when the amygdala was overriding the prefrontal cortex and disrupting the hippocampus, we don’t get a flowing memory. Instead we get; fragments (sounds, images, body sensations), no clear timeline and intense emotional charge.

 The experience is stored, but not processed. (Important notice; not every intense event evolves into trauma, it typically involves perceived threat, helplessness, lack of support, and prior vulnerability.)

So what happens after trauma?This is basically what people call acute stress response:

intrusive thoughts, strong emotional reactions, sleep problems, hyper-alertness. These are all normal after a traumatic event, your brain is attempting to process unresolved details. That explains why we remember different details of the event when we think of it again and again.

Normally our bodies recover naturally when we have time to process everything calmly and controlled because the prefrontal cortex comes back, the memory gets reorganized and we now understand that it was a past event. But if the experience was too extreme it could lead to PTSD.

In PTSD the brain fails to process and integrate the trauma over time and the body lives like the event is still happening. Amygdala is still firing stress signals every time there is sensory or thought provoking the neural links reaching the trauma due to dysregulation in these systems, the dorsolateral prefrontal cortex can’t reach to calm amygdala down and hippocampal systems can’t tag the event as “past”. While the amygdala gets sensitive, patients tend to overreact to minor things happening; making them more impulsive. When the prefrontal cortex loses activity patients feel like they can’t think clearly. And the most important one; when the prefrontal and hippocampus together cannot link the event as a past one, patients feel as if they are reliving the event rather than recalling it. They relive the event in their bodies, biologically. This means a trauma isn’t just thoughts and feelings, it lies in our body physically too. 

 This is known as a flashback in short. A flashback is not just remembering. It is a  reactivation of the original sensory and the emotional state. Because like I said the memory was just stored as a fragmented experience, the body can’t distinguish if it’s a past event or a present one.The bodies stress hormones act up and make the person feel unwell physically while the mind is overflowing with thoughts. So when approaching a flashback in therapy, just basic talking might not help the patient. Because thalamuses sensory processing gets focused on internals more than the external environment. In other words you can’t detect the outside world so you become hyperfocused on the rough feelings you have experienced at the event.The patient should be able to think clearly for therapy to work. A possible better option might be physical stimuli when a flashback happens, maybe a fidget toy to squeeze that’s just sharp enough or getting into a stretching position that doesn’t sprain but stretches the muscles enough. 

While we talk about how therapy can work and how they can learn to manage their symptoms, the results we get are mostly approved by the patient themselves or the people around them. Because as the patient tries to live with uncontrollable thoughts and actions towards their environment, they feel confused. Confused about why they are reacting in a way they do not want to. Helpless, as they do not know how to manage their thoughts or emotions. Weak, as they fail to contain themselves… This is a hard process for everyone that’s affected. They are in need of an understanding and a clear path for all the questions on their minds, but they are too ashamed of themselves to try and get help. We shouldn’t try to bear everything ourselves and learn to not be ashamed to ask for help.

As all humans we should always remember that we are allowed to make mistakes, we are always capable of trying again and it is normal to need help in some areas of life. None of us is perfect and none will be. We are just too lucky mammals that evolved into genius, but we still have the same biological system as centuries ago. We just start and adapt into the new world we are in; and this society or ethics we try to adapt into is not compatible with our original mammal system. 

Another method of treatment for PTSD is, of course, medicine. The medical treatment for PTSD started in 1980’s after following the Vietnam War and this caused positive and negative results such as:

• Positives

Patients tended to mix into their earlier social lives easier

Hormonal stability, no extremes

Easy access (as the war has limited all supplies amongst medicine)

Conformity(?) We will get back to this part.

• Negatives

The root cause of psychological distress is not investigated, information is not gathered to fully overcome it step by step. It primarily targets the symptoms.

Incorrect medication leads to much bigger problems; and in some cases, over-reliance on medication reduce the psychological exploration if not combined with therapy.

A therapy group and a therapist also gives a person a place to be understood and belong; if the patient does not have reason to investigate the root problem for their distress, of course they do not.

When the patient’s wish is a cure without the mental work, psychiatrists also start to pay less attention to them as a person and sometimes make people feel like just prescriptions.

When we take a look from the outside the patients seem dismissive right? Just taking the pill instead of trying to understand the root problem in them… But no, this is not simple avoidance, but often rooted in fear. Fear of not being able to handle the mental work and just get worse thinking about the event. Fear of the negative thoughts being true, learning that you act this way because you are simply a weak or a bad person and so on. Of course these aren’t the real results of therapy, directly oppositely therapy helps us understand our true self about what we did and why we did it, sometimes even more justifying than needed. But when you are in a position that you couldn’t even help yourself, you don’t see the power in yourself to handle all the extra mental work so you just hope that medication alone will solve the distress.

In these types of situations I believe people should take the pills and see if they work at first, and then they should be led to continue their therapeutic treatment by their psychiatrists. This might help the person to fully overcome the issue, lowering the risk of it all happening again with an outburst.

Also the process of therapy groups and seeing people also stricken by your mental illness gives you some kind of comfort. Knowing you’re not alone, there are people that understand you and why you are that way without judgement feels safe. You lose that feeling of depending on each other like a family when you start to depend on pills.

The suppressing and stabilising effect of those pills also affect how you feel happiness. You start to feel numb but you start to act better, so socially you mix in with people better than before. People may notice the way you look more empty but they probably won’t be as disturbed as you are about it. For some people this feeling is a relief. They feel better when they feel empty because if there are no extreme feelings you probably won’t make a mistake that will hurt your beloved ones. But for other people this feeling is drowning; wanting to feel more but being unable to feels restricting. Sometimes it feels even worse than when they are unmedicated because if they don’t care how they react to other people, the important thing becomes how they want to feel. Some people choose extreme happiness and agony together to just monotone numbness. But also it is true that mixing in makes you feel better quicker and adapt quicker. But another question comes to mind when all this happens, the pills also tend to feel like a muffler to the patient if they’ve become too attached to their “sick” self. So sometimes it makes people backfire.

Shortly, the effects differ in every patient and it  gets us conformity but doesn’t really affect the patient for their better at most times; it just acts as a suppressor.

Another point I should mention is psychiatrists really lose diligence in prescribing medicine when they get too used to it. Sometimes they act too fast to choose when all they have to do is write up a pill. This shouldn’t be the situation, they shouldn’t lose interest in the patient or the case and they definitely shouldn’t act too fast. It is their job and it should be done in a way they won’t be too tired of it, the diagnosis lives with the patient their whole life and a wrong prescription may ruin their lives forever if it backfires.

I shouldn’t close off without explaining what those “pills” I’m talking about are. In PTSD those pills are mostly SSRI’s (Selective Serotonin Reuptake Inhibitors). They block the reuptake pumps in the brain where neurons communicate, so serotonin stays longer in the synapse. By doing this it helps reorganize the neural circuits and desensitize the receptors. It makes the amygdala less reactive to threat triggers, helps prefrontal cortex to work better and boosts BDNF (Brain-Derived Neurotrophic Factor) which is basically a neuroplasticity booster so it gives us a better chance to reprocess the trauma. These all work in harmony for the PTSD to calm down and our brain to have a clearer path.

This was my attempt to understand and explain these processes more clearly.