Trauma, Brain Health, and Resilience Beyond
June is big for mental health awareness, with PTSD Awareness Month, Brain Health Awareness Month, Pride Month for the LGBTQ+ community, and World Refugee Day on July 20.
Each of these observances is significant, but my focus today is to address shared pain points within these communities through the lens of trauma and brain health.
My hope is to offer insights on the interplay between trauma and brain health. From there, you can extrapolate further, distill what’s relevant, and apply to your understanding as you see fit.
There’s a lot to get through here, so please bear with me, and let’s jump in.
First, let’s get to know PTSD — and trauma — a little better.
Generally speaking, Post-Traumatic Stress Disorder (PTSD) is a mental health condition that can develop after experiencing or witnessing a traumatic event.
Of the many trauma-related mental health diagnoses that exist, PTSD is perhaps the most well known — for better or worse — thanks to pop culture.
Of course, this has led to some stereotypes as well.
I took this photo at One World Trade Center, New York. This shows a snapshot of the video that plays during the observation deck tour, in which survivors, locals, builders, and project supporters describe the trauma of 9/11, as well as efforts to honor our losses and begin the healing process.
Reality:
Triggers are trauma-related stimuli that act as reminders of the original trauma experience.
Triggers can be thoughts, feelings, memories, sights, smells, people, places, situations, etc.
Triggers are not minor, and cannot simply be ‘shrugged off’ after a few seconds or a change of subject.
Myths:
People with PTSD are paranoid, jumpy, skittish, potentially violent, and often suffer nightmares and flashbacks.
People with PTSD must have a military/law enforcement background, or else were a victim of extreme violence.
“Triggers” are basically inconveniences that are bothersome because they cause annoyance and/or frustration.
Truthfully, it doesn’t take extreme violence or injury to produce unwanted, intrusive memories that become triggers. And these triggers can be debilitating.
In recent years, the term “trigger” has become so popularized & diluted by social media, that it can come across as meaningless outside of the therapy room. (If everything is a trigger, is anything actually a trigger? Or is this just a "new normal"?)
So I want to take a moment to clarify that there is a difference between clinically diagnostic, "capital-T" triggers vs. subclinical, non-PTSD-diagnostic, "lowercase-t" triggers.
It's important to recognize the nuance here: triggers and traumas can exist on a continuum.
Awareness of this is critical for self-compassion and healing. In my practice, clients often like to differentiate between "capital-T" and "lowercase-t" traumas for the same reason.
It is NOT my intention to minimize the impact of "lowercase-t" triggers, which can still be tremendously disruptive in day-to-day life. In recognition of that, please know that I'm referring to both "capital" and "lowercase" varieties when I talk about triggers here.
How is PTSD diagnosed?
For a formal PTSD diagnosis, one must display a variety of mental, emotional, and physical distress in response to triggers.
Criteria include:
Avoidance of triggers.
Emotional and behavioral reactivity that either began or worsened after the trauma, such as…
irritability, anger, or aggression.
risky or destructive acts.
hypervigilance, or an overly heightened sense of awareness.
an overly sensitive startle reaction.
poor concentration or inattention.
disturbed sleep, including insomnia, hypersomnia, nightmares and/or night terrors.
Unpleasant thoughts or feelings that either began or worsened after the trauma, which can cause…
repressed memories, or an inability to recall key features of the trauma.
negative thoughts or assumptions about oneself or the world.
negative mood and/or difficulty experiencing positive mood.
decreased interest in activities one used to enjoy.
feeling isolated, or self-isolating.
excessive self-blame or blame at others for causing the trauma.
What kind of trauma can cause PTSD?
In reality, how PTSD manifests can vary greatly because “trauma” itself has various manifestations, making it nuanced, complex, and unique to each person’s experience.**
Trauma can be defined by how it occurred:
Physical
Sexual
Mental
Emotional
Medical
Religious
Cultural
Intergenerational
Etc…
Trauma can be defined by duration or degree:
Acute: trauma is isolated to a single incident.
Chronic: trauma is repeated and prolonged.
Complex: trauma exposure consists of many varied traumatic events of a particularly invasive, often interpersonal nature.
**These categories are not mutually exclusive; that is, a person can experience trauma from various sources AND the trauma can be acute, chronic, or a combination thereof.
Now we know what causes trauma. But what does trauma cause?
Trauma, it turns out, has measurable and lasting effects on the brain, which can then cause people to think, feel, and act in maladaptive ways.
Sometimes this “trauma response” is externalized and becomes observable to others, doing damage to a person’s career, daily routines, sense of security, goals and ambitions, relationships with others and with themselves. But the real damage actually starts with — and is done internally to — the physical brain itself.
Let’s take a closer look at these effects now.
The brain’s immediate response to trauma
WHY DOES YOUR BRAIN DO THIS?
When confronted with danger, the brain switches from “thoughtful reasoning” to “red alert, battle-ready” mode. So while you may want to take time to observe your surroundings or calmly plan the next steps, your brain actually renders this physiologically impossible. Instead, it pulls all mental, emotional, and physical resources toward immediate action — attacking, escaping, waiting out, or placating the threat.
Plainly put, the brain’s focus shifts to surviving the threat in the moment.
When experiencing something traumatic, the most immediate and prominent emotion that emerges is typically fear.
Fear activates the sympathetic nervous system, which functions as the brain’s first line of defense:
The amygdala (involved in threat recognition) initiates the fight/flight/freeze/fawn response.
The hypothalamus-pituitary-adrenal (HPA) axis (involved in hormone regulation) releases stress hormones — cortisol, adrenaline, norepinephrine, and oxytocin (more on these later).
This flood of stress hormones then impairs the hippocampus (involved in memory formation and retention) and the prefrontal cortex (involved in decision-making, impulse control, emotional regulation, and overall executive functioning).
The brain’s longer-term response to trauma
Once survival has been assured, the brain doesn’t necessarily ease off the gas right away. In fact, if the duration, intensity, and nature of the original trauma are jarring enough, one’s brain structure and chemistry may not return to baseline at all.
Here’s what can happen instead:
1. Structural brain changes. Some areas of the brain may actually undergo physical remodeling.
The amygdala enlarges, allowing “fear circuitry” to remain active, and elevating baseline anxiety levels.
The hippocampus shrinks, leading to long-term impairments in both memory and trauma contextualization.
The white matter of the prefrontal cortex shrinks in both function and volume. (Severe disconnection here may even cause dissociation.)
2. Functional brain changes. Dysregulated neurochemical pathways leave lasting negative impacts on brain function and mental health.
Cortisol impairs memory and executive functioning, as mentioned above, as well as blood glucose regulation, brain energy use, and immune system functioning.
Adrenaline and norepinephrine, responsible for the initial fight-or-flight response, further dysregulate healthy brain function.
Oxytocin, the “social bonding” hormone that supports stress reduction and resilience, becomes impaired.
3. Behavioral changes. Disrupted brain functions manifest in noticeable ways in daily life.
Abnormal threat detection, or perceiving threats even in neutral situations.
Emotional dysregulation that can look like spontaneous ‘breakdowns,’ or ‘explosive’ moods.
Cognitive impairments or developmental delays (with trauma occurring in early childhood).
Unhealthy or maladaptive attachments, such as “trauma bonding,” which increase risk of re-traumatization.
Based on this evidence, what can we conclude about trauma?
Trauma responses are encoded in our brain and translated through our body in meaningful, lasting ways.
Trauma responses are very real, not “made up” or imagined.
Trauma responses start as neurological adaptations, not moral failings.
The science is clear: trauma negatively impacts brain structures, chemistry, and function. So it only makes sense that understanding the exact nature of these impacts is vital for post-trauma care and healing.
And through it all, trauma survivors deserve compassionate care without stereotyping, judgment, or shame.
Trauma responses reflect real, neurological adaptations — not moral failures!
Trauma responses reflect real, neurological adaptations — not moral failures!
To heal trauma, we must also address brain health — this means taking a mind-body approach to care.
Our brain is the control center for our thoughts, emotions, and behaviors; nurturing its wellbeing is obviously fundamental to overall mental health.
Just as trauma can impair brain structures and functions, good brain health supports quicker recovery from traumatic experiences.
Healing therefore requires a holistic approach that supports brain health and its connection to overall wellness.
This is the mind-body connection at work.
How can we better support our brain health?
cognitive engagement and learning
cognitive rest and pacing
strong social connections
healthy nutrition
regular physical activity
sufficient high quality sleep
effective stress management
A healthy brain is better equipped to process and handle adversity. These factors all build resilience by enhancing our ability to cope with daily challenges and widening our capacity for distress tolerance, even in the event of persisting trauma responses and chronic adversity.
To be clear, recognizing the biological underpinnings of trauma is just one essential step toward destigmatizing trauma survivor experiences and post-trauma recovery. Brain health practices are not a substitute for trauma-focused care or therapy, but they are a valuable complement to promote overall mental wellness.
What else can help support trauma recovery?
Neuroplasticity in the brain. The brain itself is capable of initiating neuronal reorganization, connections, and (re)growth.
Medication. Oxytocin treatments in particular are a recent, new avenue of exploration.
Therapy. Consider working through triggers via behavioral therapies or hypnosis, thought restructuring with CBT, and restoring a healthy mind-body connection through mindfulness practices, to name a few.
Social health. Having safe supports who see and appreciate you exactly as you are is priceless.
Some final lessons in resilience:
While the impacts of trauma on brain health are universal, I want to call special attention to two communities with ample trauma experience, who repeatedly confront their unique challenges with remarkable resilience:
LGBTQ+ identifying folx generally experience higher rates of trauma compared to cis-identifying heteronormative folx due to discrimination, stigma, and violence. One important way this diverse community responds is by putting inclusivity front and center, affirming safe space for both its members and allies. The numerous celebrations to come during Pride Month are evidence of this.
Refugees experience highly acute trauma from forced displacement, major losses, and absolute uncertainty, and are often fleeing violent environments to begin with. Communities that share the same heritage are not always available, and refugees must additionally face the cognitive challenge of learning a new language while assimilating to a new culture. Asking for help is not just a vital survival skill — it’s a strength.
These communities illustrate the benefits of culturally sensitive support AND safe, stable spaces for long-term trauma recovery and wellbeing.
What else can you learn from their examples?
In closing, trauma may affect your brain, but it doesn’t take away your control.
Now that we understand the neurological consequences of trauma, we can flip the script on victim-blaming.
Instead of feeding into stigma that causes survivors to bury their trauma wounds and only see themselves as victims, let’s focus on self-compassion, empowerment and post-traumatic growth.
If you identify as a trauma survivor (whether that’s “capital” or “lowercase,” acute or chronic)…
Start by approaching yourself in a non-judgmental manner.
Are you talking to yourself with compassion and grace?
Remember that resilience takes work to develop, and seeking support is a sign of strength.
Build physical and mental health habits that move you towards the healing and growth that you deserve.
The key to recovery lies in your thoughts and actions toward yourself.
If you don’t identify as a trauma survivor… consider this a reminder that you can help foster greater wellbeing in your community simply by showing up with empathy and creating an emotional safe space where possible.
By promoting brain-healthy practices and accessible, culturally-sensitive support for those who have experienced trauma, we can all foster hope and facilitate post-traumatic healing.
Remember: trauma responses aren’t always overt. You never know who may be struggling, and a little empathy goes a long way.
By raising awareness of these topics, it is my aim to support those affected by trauma, and prioritize actions that nurture our brains.
Understanding the intricate connection between trauma and brain health, and recognizing its diverse impact across communities, empowers us to create more informed and compassionate decisions about our mental health.
If you’re having difficulty navigating the impact of trauma or need support building healthy brain practices, please know that help is available. Consider exploring this in a therapeutic setting with a mental health professional who can provide non-judgmental support and a safe space to process your experiences.
In my practice, I enjoy collaborating with clients to challenge negative narratives and habits, grow through trauma, and build resilience throughout. If you’re interested in working together, consider scheduling a complimentary 10-minute phone consultation here to get started!
Disclaimer: This blog is intended for informational purposes only, and does not constitute medical or psychiatric advice. Please consult with a qualified healthcare professional directly for personalized guidance and support.