Trauma, the brain and the nervous system – Part 2: the science of recovery

BY DR. Vicky Onyeka, Junior Medical Doctor

In my first post, I wrote about how the nervous system works, and how trauma disrupts brain development.

To continue, a common feature in all the ways the brain reacts to childhood trauma is that due to these intense environments and external stimuli, the brain is often worked past its normal metabolic and physiological capacity, resulting in low energy stores, low neurochemical reserves, low functional capacity and low performance. Think: constantly driving a car that is empty of all its oils and has damage to multiple parts.

In normal circumstances, the brain should be allowed to replenish its reserves and recover. However, in most of these traumatic environments, the time or the resources to do this are not available.

There are many more symptoms of trauma, including but not limited to:  

  • Short term memory problems (e.g. forgetfulness)
  • Poor or slower learning 
  • Oversleeping or trouble falling asleep or staying asleep 
  • Chronic fatigue which may progress to myalgic encephalomyelitis 
  • Chronic pain syndrome 
  • Poor concentration
  • Daydreaming or spacing out 
  • Low energy and motivation
  • Thought block (e.g. losing your stream of thought and/or speech)
  • Inability to relax mentally and physically (e.g. rumination or restlessness)

If the brain is not allowed to recover either because the trauma has not been treated, the trauma is recurrent or constant, the brain – and thus body – will remodel to adapt to the environment, to enable the individual to survive. This neurophysiological, neurochemical and neuroanatomical remodelling can be shown in behaviour, thought and personality modifications. These changes may be “okay” for the trauma, but are dysfunctional in day-to-day life and long term. The remodelling can be manifested as a personality disorder or personality disorder traits

It can also manifest as chronic, hard-to-diagnose, hard-to-treat conditions, such as chronic pain syndrome, chronic fatigue syndrome aka myalgic encephalomyelitis, fibromyalgia and many autoimmune conditions,  as the physiology of the brain, nervous system, immune system and many other systems are re-wired. This is why many studies have shown a strong correlation between these conditions, mental health issues and past trauma.

If someone has a broken toe bone that is untreated, the foot will remodel along with the person’s gait (manner of walking). This may be okay in the short term to minimise pain, but the new gait is dysfunctional to the rest of the body – it can cause back, hip and shoulder problems, which will go on to affect the person’s ability to exercise, work and even do basic daily tasks. 

Dr. Vicky Onyeka

Failure to visit these traumas and help treat these individuals can lead to a whole array of mental health disorders, which is the brain actually “crying out” for help and treatment, or in other words, for healing.

IS RECOVERY POSSIBLE?

If trauma can remodel the brain, then an environment that promotes healing and recovery can do this too.  Our brain not only responds to negative external stimuli, but also positive stimuli. 

As with any sort of recovery within the human body (e.g. after surgery), this will take time, especially because the brain does not get a break unlike other parts of the human body.

As the brain recovers, the body will follow.  

Medical suggestions to support recovery

  • Supplements: Your brain and body will likely be depleted in neurochemicals and hormones (mentioned in the previous post). The best way to replete these is to provide the building blocks of these via essential vitamins and minerals, such as: iron, vitamin D, vitamin B complex (B1, 2, 3, 5, 6, 7, 9, 12), zinc, magnesium.  
  • GP for blood tests: This is to really find out if you are deficient in vitamins, minerals and hormones. Trauma can either contribute to deficiencies in these essential molecules, which may in turn, contribute to the development of the following conditions, which can make the recovery much harder if not addressed:
    • Hypothyroidism: Low thyroid levels. Thyroid is the hormone that regulates the metabolic rate of various tissue in the body (speed and processing). Low levels cause a slowing of the brain and body and thus presents similarly to depression with weight gain, hair loss, feeling cold all the time, dry skin, muscle weakness, lethargy, constipation, period irregularities, reduced libido, decreased appetite, etc.
    • Adrenal insufficiency: This is when the adrenal glands (the glands that produce cortisol – the stress hormone) are run down either temporarily or permanently. The symptoms are chronic fatigue, depression, dizziness, weight loss, abdominal pain, diarrhoea, constipation, loss of appetite, joint pain & muscle cramps, personality change, irritability, poor memory and concentration, hair loss.
    • Peripheral neuropathy: This is when the nerves at the furthest parts of the body are functioning below capacity. Symptoms include weakness, tingling in legs, restless legs, possibly leg pain.
  • Anti-depressants: Only recommended for a short duration as this is a quicker way to improve the low neurochemical stores. Prolonged use does not encourage the brain to recover its own function and has side effects which can require hospital admission. Only a small number of people who have experienced extreme or prolonged trauma that have irreversible remodelling are recommended to be on this – this is not without side effects and requires regular monitoring by your GP or psychiatrist.
  • Anti-psychotics: Unfortunately, the brains of individuals with chronically high levels of dopamine (addiction, schizophrenia) are not known to be able go back to normal levels. Thus, these medications are needed for life with careful regular monitoring by a GP or psychiatrist. 
  • Nutrition: Eating more protein, greens and colourful fruit and vegetables as well as, eating less empty-calorie junk foods helps to replenish low stores and thus promote better mental and physical performance. 
  • Holistic care
    • Rest
      • Passive Rest: unwinding at home, speaking to a loved one, watching non-triggering videos that encourage relaxation and laughter
      • Active Rest: exercise, exploring nature, walks, cycling, exploring hobbies
    • Avoiding triggers of the trauma: remove yourself from activities, people or environments that make the symptoms of your trauma worse
    • Guided psychotherapy by psychologists and professional therapists (re-opening these “psychological wounds” can come with adverse effects, such as depression, emotional distress, insomnia, nightmares, etc.)
    • Good hormones – oxytocin and endorphins: derived mostly from spending time with loved ones (trusted friends and family) who provide environments of love, care, peace, relaxation, happiness, empathy, nurture, compassion and patience. These hormones encourage brain and body recovery.

Lastly, with recovery, one can get back to normal, near normal or a new normal. It is still possible to catch up physically and mentally once the environment changes and the trauma is dealt with.

However, sometimes, if left untreated for too long or if the trauma was so significant, it’s not possible for the brain to go completely back to its former potential function and physiology. In this case, it’s best to embrace this new level of function (like learning to live with a new body after a part of it is surgically removed due to severe damage). This means adjusting activities and life around this to make it work for you, e.g. changing jobs or roles within your job. 

It’s okay to start life again from a new baseline and work from there at your own pace.

Dr. Vicky Onyeka