{"id":152223,"date":"2024-03-03T15:02:25","date_gmt":"2024-03-03T20:02:25","guid":{"rendered":"https:\/\/effectsofanxiety.net\/archives\/152223"},"modified":"2024-03-03T15:02:25","modified_gmt":"2024-03-03T20:02:25","slug":"discover-how-trauma-rewires-the-brain","status":"publish","type":"post","link":"https:\/\/effectsofanxiety.net\/archives\/152223","title":{"rendered":"Discover How Trauma Rewires the Brain"},"content":{"rendered":"
https:\/\/www.youtube.com\/watch?v=eCo0sDFaauU<\/div>CEUs are available at AllCEUs.com\/Trauma-CEU i’d like to welcome everybody today’s\u00a0 presentation on the neurobiological\u00a0\u00a0impact of psychological trauma and the\u00a0hpa axis or our threat response system\u00a0\u00a0 now what we’re talking about is not necessarily\u00a0 ptsd we’re talking about the impact of trauma\u00a0\u00a000:00:18<\/a>on our hpa axis and if we have excessive\u00a0 stimulation of that hpa axis it can contribute\u00a0\u00a0 to traumatic injury but not every trauma\u00a0 causes traumatic injury and we do want to\u00a0\u00a0 remember that there are things that we go through\u00a0 that or you may have gone through which may have\u00a0\u00a000:00:40<\/a>not been caused traumatic injury it was traumatic\u00a0 but you had enough resources and resilience and\u00a0\u00a0 all that kind of stuff that it didn’t cause injury\u00a0 or long-lasting effects and there are other things\u00a0\u00a0 or or somebody else may have gone through a\u00a0 similar situation and not had those resources\u00a0\u00a000:00:57<\/a>and experienced traumatic injury from it so we\u00a0 do want to recognize that every trauma impacts\u00a0\u00a0 every person differently at every point in\u00a0 time what was stressful for you five years ago\u00a0\u00a0 may not be stressful now or vice versa maybe\u00a0 five years ago you were just kind of walking\u00a0\u00a000:01:18<\/a>on sunshine and right now you’ve got a lot of\u00a0 stress and you’re already worn down so we’re going\u00a0\u00a0 to start by defining and explaining the hpa axis\u00a0 identifying the impact of trauma on the hpa axis\u00a0\u00a0 and the impact of chronic stress and cumulative\u00a0 stress on the hpa axis finally we’ll identify\u00a0\u00a000:01:38<\/a>symptoms of hpa axis dysfunction and interventions\u00a0 that are useful for people who are experiencing\u00a0\u00a0 hpa axis dysfunction i’m going to say that a lot\u00a0 hpa axis stands for hypothalamic pituitary adrenal\u00a0\u00a0 axis i call it our threat response system for\u00a0 short just because i get tired of saying hpa axis00:02:02<\/a>this presentation is based in part on the\u00a0 article post traumatic stress disorder the\u00a0\u00a0 neurobiological impact of psychological\u00a0 trauma that was published in 2011.\u00a0\u00a0 attention therapists all ceus is grateful to\u00a0 our new sponsor the diversion center they offer\u00a0\u00a000:02:20<\/a>workbooks that are 100 editable and delivered to\u00a0 you in a word document on topics including anger\u00a0\u00a0 management substance use disorders domestic\u00a0 violence parenting and shoplifting addiction\u00a0\u00a0 each workbook can be used for individual\u00a0 or group sessions and is over 120 pages\u00a0\u00a000:02:37<\/a>you have the option to add or remove\u00a0 content insert your name as the author\u00a0\u00a0 and reprint and resell the workbooks to your\u00a0 clients go to privatelabelworkbooks.com and take\u00a0\u00a0 advantage of their buy one get one free bundle\u00a0 offers remember that’s privatelabelworkbooks.com00:02:55<\/a>neurobiological abnormalities in ptsd or trauma\u00a0\u00a0 overlap with the features found in traumatic\u00a0 brain injury imagine that we actually see\u00a0\u00a0 physiological changes shrinkage of the hippocampus\u00a0 and other physiological changes as the result of00:03:16<\/a>environmental situational emotional trauma\u00a0\u00a0 not just actual traumatic brain\u00a0 injury like from a concussion\u00a0\u00a0 the response of an individual to trauma depends\u00a0 not only on the stressor characteristics you know\u00a0\u00a000:03:30<\/a>let’s look at what’s what actually happened\u00a0 but also on factors specific to the person\u00a0\u00a0 such as the perception of their stressor how close\u00a0 did this occur to the person’s safe zone we have\u00a0\u00a0 places where we feel safe you feel safe in your\u00a0 home hopefully you feel safe at work hopefully\u00a0\u00a000:03:50<\/a>if this whatever this trauma is occurs somewhere\u00a0 where you thought you were safe suddenly you don’t\u00a0\u00a0 feel safe anymore it’s going to have a stronger\u00a0 impact than for example if you experienced a\u00a0\u00a0 traumatic incident when you were on vacation\u00a0 a thousand miles away from your house your\u00a0\u00a000:04:11<\/a>similarity to the victim if you are the victim\u00a0 then obviously you’re very similar to the victim\u00a0\u00a0 if you are interacting with people and maybe you\u00a0 are the parent of the victim or the great aunt of\u00a0\u00a0 the victim um or even you are a therapist working\u00a0 with the victim or the survivor and you feel a\u00a0\u00a000:04:36<\/a>great deal of similarities with that person then\u00a0 it may impact you more one of the things i see\u00a0\u00a0 in emergency service personnel is we have some\u00a0 uh first responders that go out to say a child\u00a0\u00a0 drowning and it impacts them don’t get me wrong it\u00a0 impacts everybody but the ones that tend to have\u00a0\u00a000:04:58<\/a>a stronger reaction also tend to have or have had\u00a0 similarly aged children at home at some point so\u00a0\u00a0 it’s very similar they can almost see their child\u00a0 in that position and the degree of helplessness\u00a0\u00a0 how powerless that person felt which kind\u00a0 of goes along with what joseph pointed out\u00a0\u00a000:05:21<\/a>trump trauma definitely is affected by or our\u00a0 ability to handle trauma is affected by our age\u00a0\u00a0 children need to have those social supports\u00a0 they need to have their parents their primary\u00a0\u00a0 attachment figures there to help them feel safe\u00a0 children need to have a lot of other resources\u00a0\u00a000:05:42<\/a>because they don’t have as many experiences so\u00a0 something that may not seem like a big deal to us\u00a0\u00a0 may seem like a really big deal to a 10 or a 12\u00a0 or heaven forbid a five-year-old and they don’t\u00a0\u00a0 understand things the same way that we do they\u00a0 are also very egocentric a lot of times they feel\u00a0\u00a000:06:01<\/a>they think that something they did caused\u00a0 the problem or something they didn’t do\u00a0\u00a0 may have caused the problem or in the in\u00a0 the case of say a hurricane they may over\u00a0\u00a0 generalize and start having fears whenever any\u00a0 thunderstorm comes along because they were in that\u00a0\u00a000:06:20<\/a>hurricane so they think that every storm is going\u00a0 to be a hurricane we do need to make sure that we\u00a0\u00a0 work with children after stressful\u00a0 incidents to make sure that they understand\u00a0\u00a0 what happened to the best of their ability they\u00a0 may not get death they may not get addiction\u00a0\u00a000:06:44<\/a>and we need to help them depersonalize it so they\u00a0 understand it wasn’t something they did or didn’t\u00a0\u00a0 do we need to present them the information\u00a0 in a way that they will understand and keep\u00a0\u00a0 reiterating to them that they’re safe and help\u00a0 them feel safe recognize that a lot of children’s\u00a0\u00a000:07:03<\/a>behaviors when they are experiencing trauma\u00a0 are often reactions that are designed to elicit control or structure or comfort from those\u00a0 primary caregivers regression acting out\u00a0\u00a0 those sorts of behaviors we want to look and\u00a0 say what is this behavior communicating to us\u00a0\u00a000:07:29<\/a>people who’ve had prior traumas tend to have\u00a0 a stronger reaction to successive traumas\u00a0\u00a0 they’ve found that people who are in a state\u00a0 of hypocortisol ism um and we’re going to talk\u00a0\u00a0 about that in a little while but people who’ve\u00a0 experienced prior traumas and it’s impacted their\u00a0\u00a000:07:48<\/a>physiology actually are at a greater risk for\u00a0 developing ptsd from future traumatic events it\u00a0\u00a0 is they’re already primed so to speak or\u00a0 whatever you wanna however you wanna call it\u00a0\u00a0 the amount of stress in the preceding months also\u00a0 contributes to our reaction if you’ve had a great\u00a0\u00a000:08:08<\/a>six eight twelve months leading up to\u00a0 whatever this trauma was then you’re probably\u00a0\u00a0 stocked up on emotional cognitive social resources\u00a0 your energies built up however if you have had a\u00a0\u00a0 hell of a year and a lot of times they say\u00a0 that bad things come in threes usually by\u00a0\u00a000:08:29<\/a>the time you get to that third thing you’re done\u00a0 you’re exhausted um but if you’ve had stressors\u00a0\u00a0 and challenges even small ones they add up and\u00a0 they can wear down your recovery resources your\u00a0\u00a0 recovery capital so you may not be in the place\u00a0 to have the resilience that you you might have had\u00a0\u00a000:08:53<\/a>should you have not had such a hard time in the\u00a0 past few months current mental health or addiction\u00a0\u00a0 issues obviously if you’ve got something currently\u00a0 going on then you’re starting 20 yards back and\u00a0\u00a0 we need to take that into consideration\u00a0 people who are currently symptomatic for\u00a0\u00a000:09:14<\/a>some sort of mental health issue are\u00a0 probably going to have more difficulty\u00a0\u00a0 dealing with the traumatic stress because their\u00a0 neurotransmitters are already out of whack\u00a0\u00a0 and the availability of social support and\u00a0 i’m going to talk about this multiple times\u00a0\u00a000:09:28<\/a>but there are critical windows here social\u00a0 support in the first 24 hours is the most critical\u00a0\u00a0 if somebody gets social support in the first\u00a0 24 hours it helps them process what’s going\u00a0\u00a0 on before they start compartmentalizing it we can\u00a0 only experience crisis oriented stress for so long\u00a0\u00a000:09:50<\/a>before we start having to kind of try to pack it\u00a0 up and do something with it after about 24 hours\u00a0\u00a0 24 to 48 hours it’s still there it’s still raw\u00a0 but people have caught their breath a little bit\u00a0\u00a0 and they’ve started to push it back and social\u00a0 support is still helpful here because it’s still\u00a0\u00a000:10:11<\/a>easily accessible to process after about 72\u00a0 hours people have had to pack it up and put it\u00a0\u00a0 on that back burner for a little while because\u00a0 it is too overwhelming to continue to feel that\u00a0\u00a0 level of distress and it makes it harder\u00a0 sometimes to access it after about 72 hours\u00a0\u00a000:10:32<\/a>some people may start saying you know what\u00a0 i’ve got it it’s not that big of a deal\u00a0\u00a0 and in reality it probably is they have just\u00a0 put it away in a box somewhere that is going to\u00a0\u00a0 require energy at some point in time\u00a0 the vast majority of the population\u00a0\u00a000:10:52<\/a>has experienced trauma but their reaction is\u00a0 limited to an acute transient disturbance it\u00a0\u00a0 may be a few days a couple of weeks something\u00a0 like that the signs and symptoms of ptsd reflect\u00a0\u00a0 persistent adaptations of the body systems the\u00a0 neurobiological systems to the experience trauma\u00a0\u00a000:11:15<\/a>and you notice i crossed out the word abnormal\u00a0 adaptations it is a very normal adaptation the\u00a0\u00a0 stuff that happens because when we’re under\u00a0 stress that hpa axis kicks off and i’m fond\u00a0\u00a0 of it when it’s working well because it helps us\u00a0 survive it tells us fight or flee let me give you\u00a0\u00a000:11:35<\/a>the energy so you can fight or flee but when\u00a0 it stays active for too long it starts causing\u00a0\u00a0 lots of problems such as you know destruction\u00a0 of neurons and all that kind of stuff one of the\u00a0\u00a0 things that the body does is try to dampen that a\u00a0 little bit um so we’re not running so hot so often\u00a0\u00a000:11:58<\/a>and but that reaction you know our body’s\u00a0 reaction to try to balance out that persistent\u00a0\u00a0 high level of cortisol glutamate norepinephrine\u00a0 results in changes in our neurochemical system the hypothalamic pituitary adrenal access the\u00a0 hpa axis or our threat response system controls\u00a0\u00a000:12:24<\/a>reactions to stress and regulates many body\u00a0 processes i want you to think about why why\u00a0\u00a0 does the hpa axis control these things digestion\u00a0 well when we’ve got a fight or flea it is not\u00a0\u00a0 time to be resting and digesting it’s time to get\u00a0 that food out of the system to speed things up and\u00a0\u00a000:12:44<\/a>focus the energy on you know protecting ourselves\u00a0 the immune system when people are fighting or\u00a0\u00a0 fleeing you know cortisol actually suppresses the\u00a0 immune system suppresses initially suppresses and\u00a0\u00a0 inflammation in order to divert all that energy\u00a0 to the current crisis so people’s immune system\u00a0\u00a000:13:06<\/a>goes down mood and emotions are altered when that\u00a0 hpa axis is activated norepinephrine glutamate\u00a0\u00a0 adrenaline those are coursing through your system\u00a0 some dopamine those are your go get them those are\u00a0\u00a0 your excitatory neurochemicals which means it is\u00a0 turning down your body’s turning down if you will\u00a0\u00a000:13:29<\/a>the dial on serotonin which is more of a calming\u00a0 and gaba which is sort of our natural value\u00a0\u00a0 and our endogenous opioids those are going you\u00a0 know now is not the time to worry about pleasure\u00a0\u00a0 now is not the time to worry about reproduction\u00a0 so estrogen progesterone and testosterone\u00a0\u00a000:13:49<\/a>all get altered in their levels and the\u00a0 receptors that are being activated so\u00a0\u00a0 our sexuality and our libido goes down so you can\u00a0 see somebody who has a persistently activated hpa\u00a0\u00a0 axis may have digestive problems reduced\u00a0 immunity mood issues because that serotonin\u00a0\u00a000:14:10<\/a>and gaba is not helping to help the person feel\u00a0 calm and happy and relaxed and all those things\u00a0\u00a0 additionally that low serotonin also reduces\u00a0 pain threshold so people tend to feel more pain\u00a0\u00a0 energy storage and expenditure is also all over\u00a0 the place so people with for example diabetes\u00a0\u00a000:14:33<\/a>have a hard harder time controlling their blood\u00a0 sugar cortisol one of the things it does is tell\u00a0\u00a0 your body dump glucose dump glucose we need that\u00a0 fast energy so if cortisol is constantly surging\u00a0\u00a0 through your body then you’ve constantly got\u00a0 glucose surging through your body so that glucose\u00a0\u00a000:14:50<\/a>insulin balance it ain’t there and it’s important\u00a0 for people to remember that that they may feel\u00a0\u00a0 hypoglycemic faster they may get a little bit\u00a0 edgier faster these are all things that we need to\u00a0\u00a0 recognize when people are experiencing stress help\u00a0 them understand why they’re having these different\u00a0\u00a000:15:12<\/a>systems or symptoms and why it makes sense from\u00a0 a survival point of view and to a certain extent\u00a0\u00a0 that’s awesome i am glad your body is focusing\u00a0 to try to help protect you the ultimate result\u00a0\u00a0 of hpa axis activation is to increase levels\u00a0 of cortisol in the blood during times of stress\u00a0\u00a000:15:33<\/a>we call cortisol our our stress hormone\u00a0 and it’s there to help us get motivated but\u00a0\u00a0 when the hpa axis kicks off cortisol goes really\u00a0 high and it can eventually cause some problems\u00a0\u00a0 cortisol’s main role is in releasing glucose into\u00a0 the bloodstream to facilitate the fight-or-flight\u00a0\u00a000:15:55<\/a>response it also suppresses and modulates the\u00a0 immune system digestive system and reproductive\u00a0\u00a0 system cortisol plays a big role now when we\u00a0 think about people who experience chronic stress\u00a0\u00a0 what hormone do they have that is generally very\u00a0 high i’ll give you a hint it’s cortisol we’re\u00a0\u00a000:16:17<\/a>not necessarily just talking about some trauma we\u00a0 can be talking about chronic ongoing stress they\u00a0\u00a0 found that there are a lot of lifestyle factors\u00a0 that contribute to hpa axis hyperactivation the body reduces its hpa axis activation\u00a0 when it appears that further fight or flight\u00a0\u00a000:16:41<\/a>may not be beneficial remember think about a\u00a0 a bath you know you’re running a bath you turn\u00a0\u00a0 that hot water you know wide open that is your\u00a0 hpa axis that’s your fight or flight that is the\u00a0\u00a0 heat the get up and go but it starts getting\u00a0 a little too hot and you want to turn on the\u00a0\u00a000:16:59<\/a>cold so you don’t burn yourself well your\u00a0 body does the same sort of thing it wants\u00a0\u00a0 to protect those neurons wants to protect\u00a0 your body from running too hot so to speak\u00a0\u00a0 but eventually what happens that hot water you\u00a0 only have so much well unless you have limitless\u00a0\u00a000:17:15<\/a>hot water but most of us still have a hot water\u00a0 tank and eventually that hot water runs out\u00a0\u00a0 and then it starts running cold if you want to\u00a0 think about it that way the body’s trying to\u00a0\u00a0 balance against the excessive heat of\u00a0 the hpa axis but the hot water runs out\u00a0\u00a000:17:35<\/a>the body doesn’t cue into the fact that that’s\u00a0 happened yet so it continues to try to protect you\u00a0\u00a0 from that excessive stimulation which can lead\u00a0 to feelings of depression it also can create\u00a0\u00a0 a situation called hypocortisolism\u00a0 where the body is actually blocking\u00a0\u00a000:17:56<\/a>cortisol from going through because it’s\u00a0 saying okay we can’t have this much cortisol\u00a0\u00a0 going into the system because it’s overdoing\u00a0 it kind of like flooding a garden with water\u00a0\u00a0 you know that would be if the if the farmer put\u00a0 on a nozzle so he wasn’t putting so much water out\u00a0\u00a000:18:12<\/a>into the garden hypocortisolism is seen in stress\u00a0 related disorders such as chronic chronic fatigue\u00a0\u00a0 syndrome burnout and ptsd and it’s actually a\u00a0 protective mechanism designed to conserve energy\u00a0\u00a0 during threats that are beyond the organism’s\u00a0 ability to cope so this other reason for\u00a0\u00a000:18:34<\/a>feelings of flatness and apathy after persistent\u00a0 or ongoing hpa axis dysfunction is the body going\u00a0\u00a0 i’ve only got so much energy left and i’m going to\u00a0 conserve that right now so when there is a problem\u00a0\u00a0 i can spring into action oh but there’s a\u00a0 problem with that when they spring into action\u00a0\u00a000:18:59<\/a>then the hpa axis goes from apathetic and\u00a0 kind of flat and the person is you know blah\u00a0\u00a0 feels blah to emotional dysregulation there is\u00a0 no middle ground when the hpa axis has gone into\u00a0\u00a0 this um hypocortisol or glutathio glucocorticoid\u00a0 resistant state so we see a lot more emotional\u00a0\u00a000:19:24<\/a>dysregulation until we can get that hpa axis\u00a0 re-regulated and we need to look at all the causes\u00a0\u00a0 for dysregulation including sleep disturbances\u00a0 excess caffeine pain mood issues cognitions\u00a0\u00a0 lack of social support you know\u00a0 there’s a whole list of biopsychosocial\u00a0\u00a000:19:45<\/a>triggers for stress and stress activates that\u00a0 hpa axis dysfunctional hpa axis activation will\u00a0\u00a0 result in abnormal immune system responses which\u00a0 generally suppressed immune system for a while\u00a0\u00a0 but the interesting thing is initially the\u00a0 hpa axis suppresses inflammation but after\u00a0\u00a000:20:11<\/a>a stress response the way the system’s supposed to\u00a0 work the cortisol subsides and inflam inflammatory\u00a0\u00a0 cytokines are released into the body why because\u00a0 they circulate around and find any places of\u00a0\u00a0 injury cause inflammation cause blood to go to the\u00a0 area for repair and rejuvenation so it makes sense\u00a0\u00a000:20:35<\/a>but if that hpa axis stays activated and\u00a0 never kind of calms down then you have this\u00a0\u00a0 weird situation where you’ve got cortisol in the\u00a0 system but you’ve also got circulating systemic\u00a0\u00a0 inflammation what do we know about suppressed\u00a0 immune system and increased inflammation\u00a0\u00a000:20:54<\/a>a lot of times that’s related to the\u00a0 development or exacerbation of autoimmune issues\u00a0\u00a0 there can be increased inflammation and\u00a0 allergic reactions irritable bowel syndrome\u00a0\u00a0 such as constipation and diarrhea reduced\u00a0 tolerance to physical and mental stresses\u00a0\u00a000:21:11<\/a>including pain you know it could be the person is\u00a0 just edgy and irritable i say just and they also\u00a0\u00a0 may have difficulty tolerating pain tolerating\u00a0 hunger tolerating blood sugar alterations and\u00a0\u00a0 there are altered levels of sex hormones because\u00a0 the body is still getting this message that\u00a0\u00a000:21:31<\/a>it’s not safe to procreate our our little you\u00a0 know ankle biters aren’t going to be safe yet fatigue interestingly enough when we\u00a0 experience extended hpa axis activation\u00a0\u00a0 one of the symptoms is fatigue and fatigue\u00a0 is actually an emotion generated in the brain\u00a0\u00a000:21:51<\/a>which prevents damage to the body when the brain\u00a0 perceives that further exertion could be harmful\u00a0\u00a0 so i was at the gym today and i was doing\u00a0 a lactic acid threshold workout which\u00a0\u00a0 you know those suck i’ll just tell you and\u00a0 after about 30 minutes of working at 98 to 102\u00a0\u00a000:22:09<\/a>of my max heart rate i was starting to feel really\u00a0 fatigued i was like i don’t know if i can finish\u00a0\u00a0 this segment here that was my brain going okay\u00a0 you done pushed the envelope it’s time to back off\u00a0\u00a0 because you’re getting to the point where you\u00a0 could start hurting yourself fatigue in sports\u00a0\u00a000:22:30<\/a>is largely independent of the state of the muscles\u00a0 themselves and is more related to core temperature\u00a0\u00a0 glycogen levels i was fasting before i worked\u00a0 out so my blood sugar i had run through it by\u00a0\u00a0 that point my blood sugar was really low my core\u00a0 temperature was high oxygen levels in the brain\u00a0\u00a000:22:49<\/a>thirst sleep deprivation and level of muscle\u00a0 soreness and fatigue so thankfully i only\u00a0\u00a0 had two of those things working against me so i\u00a0 was able to complete my workout but fatigue can\u00a0\u00a0 be cumulative and we want people to recognize that\u00a0 and this is true during daily living too not just\u00a0\u00a000:23:10<\/a>in sports if people’s blood sugar levels are not\u00a0 adequate if they’re there’s not getting enough\u00a0\u00a0 oxygen to the brain they’re breathing shallowly\u00a0 if they’re dehydrated sleep deprived and have\u00a0\u00a0 muscle fatigue for whatever reason and sometimes\u00a0 people who are depressed report feeling a lot of\u00a0\u00a000:23:29<\/a>heaviness and muscle fatigue then you know you\u00a0 can see that they may be experiencing ongoing\u00a0\u00a0 fatigue that may be unrelated to sports it’s more\u00a0 related to that hpa axis activation because the\u00a0\u00a0 body is still acting as if it is being stimulated\u00a0 by something like running from a lion or sports00:23:56<\/a>psychological factors that can be involved in\u00a0 reducing fatigue including your emotional state\u00a0\u00a0 if you are enthusiastic about it which most\u00a0 of us are not enthusiastic about trauma\u00a0\u00a0 but if you’re enthusiastic about it it can reduce\u00a0 fatigue which is why athletes tend to see that00:24:15<\/a>finish line and they start to get enthusiastic\u00a0 and they can push past that fatigue we want to\u00a0\u00a0 help people see the finish line we want to help\u00a0 people feel efficacious we want to help people\u00a0\u00a0 see the progress that they’ve made and see that\u00a0 their destination is not unreachable knowledge of\u00a0\u00a000:24:35<\/a>an endpoint you know if you’re just you keep going\u00a0 and it’s like eventually maybe you’ll feel better\u00a0\u00a0 you know it’s hard to keep going but if you\u00a0 know that okay this is 10 weeks of therapy or\u00a0\u00a0 you know this is a mile run or\u00a0 whatever it is or you know that\u00a0\u00a000:24:53<\/a>this pain you know you had surgery and the doctor\u00a0 says you know in three to six weeks you should be\u00a0\u00a0 feeling significantly less pain that i know\u00a0 shoulder surgery is a huge hugely painful surgery\u00a0\u00a0 and but people who go through it they know okay\u00a0 this is really hideous right now but i know\u00a0\u00a000:25:14<\/a>hopefully after this recovery period\u00a0 i will feel better other competitors\u00a0\u00a0 or motivators can reduce fatigue so if we have\u00a0 good social support for people who are around us when people are going through trauma that\u00a0 can be seen as motivators not competitors\u00a0\u00a000:25:36<\/a>necessarily when we’re talking about trauma\u00a0 but they are people that are there to motivate\u00a0\u00a0 us to cheer us on from the stands so to\u00a0 speak if we want to keep with this analogy\u00a0\u00a0 and visual feedback can help reduce fatigue\u00a0 use baseline charts use journals use logs to\u00a0\u00a000:25:54<\/a>help people see that they are gradually improving\u00a0 fatigue is one sign that the body is getting ready\u00a0\u00a0 to down regulate the hpa access to start holding\u00a0 on to those energy reserves in counseling practice\u00a0\u00a0 we need to figure out how we can reduce fatigue\u00a0 and help clients restore hpa axis functioning and\u00a0\u00a000:26:17<\/a>a lot of it comes back to incur having them have a\u00a0 survivor mentality and a positive emotional state\u00a0\u00a0 helping them devise an end point so that they\u00a0 can see getting social support and motivation and\u00a0\u00a0 making sure that they are rested\u00a0 nourished and all those other things\u00a0\u00a000:26:41<\/a>low cortisol has been found\u00a0 to relate to more severe ptsd\u00a0\u00a0 or hyperarousal symptoms sensitized negative\u00a0 feedback loop in veterans diagnosed with ptsd\u00a0\u00a0 showed that they had greater\u00a0 glucocorticoid responsiveness\u00a0\u00a000:26:57<\/a>so what does that mean that means that people\u00a0 who’ve experienced extended hpa axis activation\u00a0\u00a0 they go into that period of hypocortisolism and\u00a0 then when there is a threat there is a greater\u00a0\u00a0 cortisol response so when there\u00a0 is a stressor instead of having\u00a0\u00a000:27:17<\/a>you know a little bit of cortisol dumped into\u00a0 the system it is wide open generally low cortisol\u00a0\u00a0 is seen in people who have experienced extended\u00a0 stress as a result of trauma or or chronic stress\u00a0\u00a0 but when a threat is perceived\u00a0 there’s an exaggerated stress response\u00a0\u00a000:27:41<\/a>and i call this flat or furious so they either\u00a0 feel kind of flat or they are super agitated\u00a0\u00a0 evidence points toward a role of trauma experience\u00a0 in sensitizing the hpa axis independent of ptsd\u00a0\u00a0 development so hpa access can dysregulate we can\u00a0 have problems with it even if the person doesn’t\u00a0\u00a000:28:04<\/a>develop diagnosable ptsd which is why i always\u00a0 say we want to look for traumatic injury we\u00a0\u00a0 don’t necessarily want to just hold it out there\u00a0 for only people who meet the criteria of ptsd\u00a0\u00a0 as i mentioned earlier those with prior\u00a0 trauma histories are often more at risk\u00a0\u00a000:28:24<\/a>of ptsd from later traumas so we can help them\u00a0 hopefully prevent the development of ptsd if we\u00a0\u00a0 notice that they have had a history\u00a0 of trauma or chronic stress they do\u00a0\u00a0 have an hpa axis that is dysregulated or\u00a0 dysregulating we can help them start to\u00a0\u00a000:28:48<\/a>take positive holistic steps\u00a0 to re-regulate that hpa axis\u00a0\u00a0 so if there is another trauma which in life\u00a0 there’s going to be occasional um if there is\u00a0\u00a0 another trauma they are at less risk of developing\u00a0 ptsd because they’re not hypocortisol-ish00:29:13<\/a>core endocrine features of trauma include abnormal\u00a0 regulation of cortisol and thyroid hormones okay hypocortisolism in ptsd occurs due to increased\u00a0\u00a0 negative feedback sensitivity of the hpa axis\u00a0 we’ve already talked about that studies suggest\u00a0\u00a000:29:40<\/a>that low cortisol levels at the time of exposure\u00a0 to trauma often predict the development of ptsd\u00a0\u00a0 glucocorticoids your cortisol interferes\u00a0 with the retrieval of traumatic memories\u00a0\u00a0 and an effect that may independently independently\u00a0 prevent or reduce ptsd symptoms cortisol that\u00a0\u00a000:30:00<\/a>fight or flight stress hormone interestingly says\u00a0 you know what you really don’t want to remember\u00a0\u00a0 that so it prevents some of our traumatic\u00a0 memories from being solidified if you will\u00a0\u00a0 which is another reason that when people are\u00a0 experiencing stress when they’re experiencing\u00a0\u00a000:30:20<\/a>hpa axis dysregulation they have a harder\u00a0 time with concentration and learning because\u00a0\u00a0 that cortisol circulating through their system is\u00a0 inhibiting the formation of memories and learning core neurochemical fact features of trauma or\u00a0 ptsd include abnormal regulation of catecholamine\u00a0\u00a000:30:44<\/a>serotonin amino acids peptides and opioid\u00a0 neurotransmitters each of which is found\u00a0\u00a0 in brain circuits that regulate and integrate\u00a0 stress and fear responses the take-home message\u00a0\u00a0 from that is there are core actual changes in\u00a0 dozens not just not just these but dozens of\u00a0\u00a000:31:06<\/a>hormones and chemicals in our body as a result\u00a0 of hpa axis activation and extended hpa axis\u00a0\u00a0 activation or hypocortisolism glucocorticoid\u00a0 resistance results in a whole different set of\u00a0\u00a0 hormone and chemical changes it’s important for\u00a0 us to recognize this it doesn’t mean it can’t be00:31:32<\/a>rebalanced i don’t want to say fixed i want to\u00a0 say rebalanced we can help people give their hpa\u00a0\u00a0 access a break but eating better getting good\u00a0 sleep practicing good cognitions those things\u00a0\u00a0 aren’t going to fix it overnight it’s kind of like\u00a0 gaining weight think about if you gain a hundred\u00a0\u00a000:31:53<\/a>pounds you’re not gonna lose a hundred pounds\u00a0 in two three weeks what they’re carrying is a\u00a0\u00a0 hundred pounds of stress if you want to look at\u00a0 it that way and it’s going to take time of living\u00a0\u00a0 right reducing their stress practicing some of the\u00a0 tools that they learn in counseling and dealing\u00a0\u00a000:32:12<\/a>with any remaining traumatic memories that\u00a0 they’ve got in those boxes in order to help them\u00a0\u00a0 re-regulate that hpa axis the catecholamine family\u00a0 of neurotransmitters includes dopamine are let’s\u00a0\u00a0 keep doing that again and again neurochemical\u00a0 norepinephrine which is our focus and let’s go\u00a0\u00a000:32:35<\/a>get it neurochemical and both of those are derived\u00a0 from the amino acid tyrosine so we got to eat\u00a0\u00a0 foods that have tyrosine it’s not hard anything\u00a0 with protein in it in order to let our body\u00a0\u00a0 make those neurotransmitters when a stressor\u00a0 is perceived the hpa axis releases cortico\u00a0\u00a000:32:58<\/a>crh which interacts with norepinephrine to\u00a0 increase fear conditioning and encoding of\u00a0\u00a0 emotional memories enhancing arousal and vigilance\u00a0 and increa in integrating endocrine and autonomic\u00a0\u00a0 responses to stress so when that fear response\u00a0 takes over that fight-or-flight reaction takes\u00a0\u00a000:33:17<\/a>over the body actually secretes chemicals that\u00a0 make us hyper vigilant that make us more aware\u00a0\u00a0 of what’s going on and alert to threats which is\u00a0 great from a survival perspective in the short\u00a0\u00a0 term in the long term it really sucks there’s\u00a0 an abundance of evidence that norepinephrine\u00a0\u00a000:33:37<\/a>accounts for certain classic aspects of\u00a0 trauma symptomatology including hyperarousal\u00a0\u00a0 heightened startle responses and increased\u00a0 encoding of fear memories so remember that\u00a0\u00a0 cortisol initially blocks the encoding\u00a0 of those memories but in an extended\u00a0\u00a000:33:56<\/a>exposure the norepinephrine is going to\u00a0 counterbalance that because remember in\u00a0\u00a0 an extended exposure the body starts turning\u00a0 down or blocking the cortisol from going through\u00a0\u00a0 for a lack of a more clinical explanation\u00a0 right now which means norepinephrine surges and\u00a0\u00a000:34:15<\/a>takes over it becomes can become more powerful\u00a0 and is able to start encoding those fear memories\u00a0\u00a0 poor serotonin transmission in trauma may cause\u00a0 impulsivity hostility aggression depression and\u00a0\u00a0 suicidality too little serotonin is associated\u00a0 with depression too much serotonin is associated\u00a0\u00a000:34:38<\/a>with anxiety too little serotonin is also\u00a0 associated with impulsivity and low pain tolerance now you don’t need to memorize these\u00a0 but i think it’s important and i try\u00a0\u00a0 to teach this as much as possible there are\u00a0 multiple types of serotonin receptors and\u00a0\u00a000:34:59<\/a>serotonin is responsible for or integrated in\u00a0 just about every body system and reaction there\u00a0\u00a0 is out there from appetite and blood pressure to\u00a0 heart rate impulsivity memory mood respiration\u00a0\u00a0 sexuality sleep sociability and it goes\u00a0 on interestingly certain ssri selective\u00a0\u00a000:35:20<\/a>serotonin reuptake inhibitors most of\u00a0 them focus on this 5-ht-1a receptor\u00a0\u00a0 but look at all the other receptors that are\u00a0 out there and they’re throughout our body and\u00a0\u00a0 some of those can get a little bit wonky and\u00a0 if you’re taking something that acts on 5ht1a\u00a0\u00a000:35:39<\/a>to help with your mood and your cognition and\u00a0 your appetite and your sleep because you’re having\u00a0\u00a0 those symptoms of depression but it’s actually\u00a0 your 5-ht 2a receptor that’s wonky guess what\u00a0\u00a0 you’re not going to feel much response from that\u00a0 particular ssri so we do want to educate patients\u00a0\u00a000:36:01<\/a>that there are multiple serotonin receptors there\u00a0 are multiple different medications that target\u00a0\u00a0 different serotonin receptors but it’s not always\u00a0 about the serotonin norepinephrine dopamine and\u00a0\u00a0 some of our other thyroid and gonadal hormones are\u00a0 also involved in the functioning of the receptors\u00a0\u00a000:36:25<\/a>for all of our neurotransmitters\u00a0 and mood depression can be caused by\u00a0\u00a0 imbalance of any of our neurotransmitters not\u00a0 just serotonin gaba has a profound anxiolytic\u00a0\u00a0 effect in part by inhibiting the norepinephrine\u00a0 circuits when gaba is released gaba is created\u00a0\u00a000:36:45<\/a>from glutamate so it reduces glutamate levels but\u00a0 it also inhibits inhibits the norepinephrine so\u00a0\u00a0 gaba turns down it’s the cold water if you want\u00a0 to think of it that way to the hpa axis hot water\u00a0\u00a0 patients with ptsd have decreased peripheral\u00a0 benzodiazepine binding sites gaba is our one\u00a0\u00a000:37:06<\/a>of our natural benzodiazepines so patients with\u00a0 b ptsd don’t have as many receptors for gaba as\u00a0\u00a0 patients who haven’t experienced trauma which is\u00a0 kind of interesting so it’s harder for that gaba\u00a0\u00a0 system to work if there are fewer receptors\u00a0 in the body it may indicate the usefulness\u00a0\u00a000:37:28<\/a>of emotion regulation and distress tolerance\u00a0 skills due to potential emotional dysregulation\u00a0\u00a0 one of the things we need to do is help reduce\u00a0 excitotoxicity which is the fancy word for too\u00a0\u00a0 much glutamate and norepinephrine in order\u00a0 to reduce distress improve stress tolerance\u00a0\u00a000:37:47<\/a>in and enable acquisition of new skills harder to\u00a0 learn new skills when that cortisol level is high\u00a0\u00a0 we need to help people develop those distress\u00a0 tolerance skills so they can get into their\u00a0\u00a0 wise mind which is partly turning down the\u00a0 adrenaline turning down the norepinephrine\u00a0\u00a000:38:04<\/a>turning down the cortisol so they can\u00a0 focus and think and learn and remember our glutamate receptors or nmda receptors\u00a0 are implicated in synaptic plasticity or our\u00a0\u00a0 brain synapses ability to function and adapt as\u00a0 well as learning and memory glutamate binds to\u00a0\u00a000:38:30<\/a>our nmda receptors and high levels of glutamate\u00a0 are secreted during high levels of stress so\u00a0\u00a0 when glutamate is going through our body there’s\u00a0 fighter flea let’s get that energy let’s you know\u00a0\u00a0 get to it those nmda receptors are um super\u00a0 activated you know they are on fire if you will\u00a0\u00a000:38:53<\/a>which can lead people to feel anxious\u00a0 hyper vigilant all those other things\u00a0\u00a0 one of the things that they found with the\u00a0 ketamine is that it actually blocks the nmda\u00a0\u00a0 receptors one of the interesting side\u00a0 effects and too much to go into right now\u00a0\u00a000:39:09<\/a>except for to hit the highlights you can read the\u00a0 article by clicking on the hyperlink but ketamine\u00a0\u00a0 actually blocks those receptors so it blocks\u00a0 the glutamate but it doesn’t lead people to feel\u00a0\u00a0 depressed it actually leads to more focus and\u00a0 more controlled energy so it redirects that system\u00a0\u00a000:39:31<\/a>instead of turning it off completely what it’s\u00a0 doing is helping the body redirect that energy\u00a0\u00a0 to more task oriented goals overexposure of\u00a0 neurons to glutamate so too much glutamate\u00a0\u00a0 in our brain is excito toxic which means it\u00a0 actually starts causing brain cells to die\u00a0\u00a000:39:50<\/a>and results in loss of volume of the hippocampus\u00a0 in people who’ve experienced trauma elevated\u00a0\u00a0 glucocorticoids or cortisol increases sensitivity\u00a0 of the nmda receptors so the more cortisol we\u00a0\u00a0 have the more sensitive those glutamate receptors\u00a0 are so when the glutamate comes comes in they are\u00a0\u00a000:40:13<\/a>super excited rendering the brain more vulnerable\u00a0 to excitotoxic insults so instead of being\u00a0\u00a0 you know turning on the heat a little bit when\u00a0 that glutamate hits those nmda receptors that have\u00a0\u00a0 been sensitized all of a sudden you know it’s like\u00a0 charcoal that’s been primed with lighter fluid00:40:35<\/a>things we need to remember it may take\u00a0 clients who’ve experienced trauma who\u00a0\u00a0 have high levels of cortisol more time to master\u00a0 new skills because it’s harder for them to focus\u00a0\u00a0 that norepinephrine is focused on fight or\u00a0 flea not learning memory and concentration\u00a0\u00a000:40:51<\/a>if the brain becomes excitotoxic during stress it\u00a0 inhibits learning and memory so exposure therapies\u00a0\u00a0 for these particular clients may or may not be\u00a0 super helpful if it’s increasing the excitotoxic\u00a0\u00a0 environment in their brain too much can be\u00a0 dangerous which is why exposure therapies\u00a0\u00a000:41:13<\/a>need to be taken uh very seriously and not just\u00a0 done by somebody who hasn’t been well trained\u00a0\u00a0 endogenous opioids or our natural opioids that\u00a0 we have act on the same nervous system receptors\u00a0\u00a0 as morphine and heroin opioids even the endogenous\u00a0 ones are system depressants they slow things down\u00a0\u00a000:41:38<\/a>and ex in exert inhibitory influences on the\u00a0 hpa axis so the opioids along with gaba and\u00a0\u00a0 serotonin help turn things down a little\u00a0 bit alterations in our endogenous opioids\u00a0\u00a0 may be involved in certain ptsd symptoms such as\u00a0 numbing stress-induced analgesia and dissociation\u00a0\u00a000:42:01<\/a>recognizing that again these symptoms are merely\u00a0 outward manifestations of changes in the neurobio\u00a0\u00a0 biology of the patient now trexon we all know that\u00a0 as the anti-overdose drug basically appears to be\u00a0\u00a0 effective in treating symptoms of dissociation and\u00a0 flashbacks in traumatized persons the naltrexone\u00a0\u00a000:42:24<\/a>basically goes in and blocks those opioid\u00a0 receptors so the person is not experiencing\u00a0\u00a0 the emotional numbing and the stress-induced\u00a0 analgesia which they may not be real keen on\u00a0\u00a0 highlights um one of the things that this\u00a0 does point out is the risk for opioid abuse\u00a0\u00a000:42:44<\/a>for people with ptsd they may be self-medicating\u00a0 because they figured out they may not consciously\u00a0\u00a0 have put two and two together but they figured\u00a0 out when they use opioids they get some relief a hallmark feature of ptsd\u00a0 is reduced hippocampal volume\u00a0\u00a000:43:04<\/a>the hippocampus is a part in the brain\u00a0 that is implicated in the control of stress\u00a0\u00a0 memory and context contextual aspects of\u00a0 fear conditioning so the hippocampus tells us\u00a0\u00a0 let’s look around and identify all the triggers or\u00a0 signs that there is a threat prolonged exposure to\u00a0\u00a000:43:22<\/a>stress and high levels of cortisol damages the\u00a0 hippocampus this reduction in hippocampal volume\u00a0\u00a0 may reflect the accumulated toxic effects of\u00a0 repeated exposure to glutamate and increased\u00a0\u00a0 glucocorticoids or that whole flat fat sorry\u00a0 flat and furious sort of situation which if\u00a0\u00a000:43:46<\/a>you’re working with somebody for example who\u00a0 has borderline personality disorder symptoms\u00a0\u00a0 there’s a lot of flat to furious and emotional\u00a0 dysregulation in people with those symptoms\u00a0\u00a0 so we do want to recognize that they may be\u00a0 experiencing trauma on a regular basis what\u00a0\u00a000:44:06<\/a>not necessarily what we perceive as traumatic but\u00a0 for them they are going from flat to furious and\u00a0\u00a0 that’s exhausting and from a neurochemical\u00a0 standpoint it is reflective of trauma decreased hippocampal volumes might also\u00a0 be a pre-existing vulnerability factor\u00a0\u00a000:44:26<\/a>for developing ptsd we’ve already talked about\u00a0 how hypocortisolism or glucocorticoid resistance\u00a0\u00a0 makes people more prone to develop ptsd well\u00a0 they’ve said well maybe it’s that or maybe\u00a0\u00a0 it’s only people who’ve had that for so long\u00a0 that it’s reduced the volume of their hippocampus\u00a0\u00a000:44:48<\/a>they’re not really sure but we do know that\u00a0 prior trauma prior alterations of the hpa axis do\u00a0\u00a0 prime people for being more at risk for\u00a0 later development of ptsd the amygdala\u00a0\u00a0 is a limbic structure involved in emotional\u00a0 processing and is critical for the acquisition\u00a0\u00a000:45:07<\/a>of fear responses it is a very primitive area\u00a0 of our brain but it is there to protect us\u00a0\u00a0 functional imaging studies have revealed hyper\u00a0 responsiveness in ptsd patients during the pres\u00a0\u00a0 presentation of stressful scripts cues and\u00a0 trauma reminders so again looking at the\u00a0\u00a000:45:28<\/a>hpa axis goes from flat to furious there’s a\u00a0 dump of cortisol whenever some somebody who is\u00a0\u00a0 experiencing hypocortisolism is exposed to future\u00a0 stressors ptsd patients further show increased\u00a0\u00a0 amygdala responses to general emotional stimuli\u00a0 even the ones that are not trauma associated\u00a0\u00a000:45:49<\/a>such as emotional faces so they tend to be more\u00a0 emotionally raw emotionally responsive sensitive\u00a0\u00a0 whatever you want to say so things that are\u00a0 totally not related to the trauma can trigger a\u00a0\u00a0 much stronger response in them than in someone who\u00a0 didn’t have that pre-existing hpa axis dysfunction00:46:14<\/a>early adverse experiences\u00a0 including prenatal stress\u00a0\u00a0 even you know when it’s the baby’s still cooking\u00a0 and stress throughout childhood has profound and\u00a0\u00a0 long-lasting effects on the development of our\u00a0 neurobiological systems thereby programming\u00a0\u00a000:46:31<\/a>subsequent stress reactivity and vulnerability\u00a0 to develop ptsd kids who’ve experienced a bunch\u00a0\u00a0 of adverse childhood experiences everything\u00a0 from environmental stress to poor nutrition\u00a0\u00a0 to exposure in utero to drugs and alcohol you\u00a0 know there’s a lot of different insults that the\u00a0\u00a000:46:52<\/a>pediatric brain can experience may set them\u00a0 up without any overt traumatic experience\u00a0\u00a0 may set them up to be at risk for emotional\u00a0 dysregulation and potentially even eventually ptsd\u00a0\u00a0 later in life so it’s really important that\u00a0 we get in there with early prevention programs00:47:17<\/a>a variety of changes take place in the brains\u00a0 and nervous systems of people with ptsd\u00a0\u00a0 pre-existing issues causing\u00a0 hypocortisolism the brain has\u00a0\u00a0 already down regulated it started blocking\u00a0 the cortisol receptors so to speak so\u00a0\u00a000:47:33<\/a>there is not as much glutamate and norepinephrine\u00a0 and stuff released if cortisol can’t get through\u00a0\u00a0 then it can’t trigger the release of all of\u00a0 those excitotoxic chemicals like glutamate and\u00a0\u00a0 norepinephrine so if the body’s already down\u00a0 regulated the person may experience more ptsd\u00a0\u00a000:47:54<\/a>remember if that cortisol can’t get through\u00a0 then when norepinephrine is released\u00a0\u00a0 there is more fear in coding cortisol is the one\u00a0 that blocks that fear in coding this points to the\u00a0\u00a0 importance of prevention and early intervention\u00a0 of adverse childhood experiences remember that\u00a0\u00a000:48:14<\/a>people with hypocortisolism may or may not have\u00a0 ptsd i recently wrote an article about lifestyle\u00a0\u00a0 factors that contribute to hpa axis dysfunction\u00a0 and they found that or i found in the research\u00a0\u00a0 that exposure to noise for example people who\u00a0 live near wind farms or airports tend to have much\u00a0\u00a000:48:38<\/a>higher rates of use of antidepressant medications\u00a0 and symptoms of hypocortisolism and symptoms of\u00a0\u00a0 hyperactivated hpa axes than people who aren’t\u00a0 exposed to that chronic noise for example\u00a0\u00a0 hypocortisolism sets the stage for the flat\u00a0 and the furious leading to toxic levels of\u00a0\u00a000:48:59<\/a>glutamate upon exposure to stressors reduction of\u00a0 hippocampal volume and persistent negative brain\u00a0\u00a0 changes now once that hippocampal volume has been\u00a0 reduced a lot of times there’s no building it back\u00a0\u00a0 up the good thing is most humans only use a very\u00a0 small proportion of our brain so there is a lot\u00a0\u00a000:49:19<\/a>of room for workarounds if you will so i don’t\u00a0 want people to think that oh i’ve already shrunk\u00a0\u00a0 my brain so there’s nothing i can do totally\u00a0 not not it in most cases there are a lot of\u00a0\u00a0 workarounds think about people who’ve experienced\u00a0 massive strokes um or massive brain injury\u00a0\u00a000:49:38<\/a>a lot of them regain their abilities to walk\u00a0 to talk to write to do whatever they did before\u00a0\u00a0 sometimes not a hundred percent but a lot\u00a0 of times the brain is very um receptive\u00a0\u00a0 to functioning it wants to help people do what\u00a0 they need to do and it develops its own little\u00a0\u00a000:50:02<\/a>workarounds which i think is really cool people with ptsd are more\u00a0 reactive to emotional stimuli\u00a0\u00a0 even stimuli unrelated to\u00a0 trauma this is so important for00:50:17<\/a>our clients to understand as well as their\u00a0 loved ones and us as clinicians because it\u00a0\u00a0 highlights the need for really good self-care and\u00a0 really good distress tolerance skills and coping\u00a0\u00a0 skills and awareness mindfulness\u00a0 of trauma so they become more aware\u00a0\u00a000:50:36<\/a>of okay this is going on it’s stressing me out and they can intervene early before they become\u00a0\u00a0 super dysregulated you know sometimes they can\u00a0 notice that oh this is going to be stressful and\u00a0\u00a000:50:52<\/a>they can prepare ahead of time they may be able\u00a0 to mitigate stressors so they mitigate or at least\u00a0\u00a0 reduce the impact on that hpa axis because\u00a0 they can start developing a certain level of\u00a0\u00a0 control over their reactions through biofeedback\u00a0 and the use of a lot of other skills that they\u00a0\u00a000:51:19<\/a>can learn purposeful action acceptance and\u00a0 commitment therapy uh cognitive processing therapy\u00a0\u00a0 um dialectical behavior therapy those are the\u00a0 big you know buzzwords if you will for hpa axis\u00a0\u00a0 resolution or rebalancing in addition\u00a0 to healthy healthy nutrition exercise\u00a0\u00a000:51:44<\/a>circadian rhythm balancing making sure that\u00a0 people are maintaining their circadian rhythms and nutrition sleep exercise and circadian rhythms all\u00a0 of those if they are out of whack if they are poor\u00a0\u00a0 then they can contribute to hpa axis activation\u00a0 that includes the use of caffeine and nicotine\u00a0\u00a000:52:07<\/a>i know i i loved my caffeine before i\u00a0 had to give it up but it’s important to\u00a0\u00a0 help people recognize that\u00a0 there are things that they’re\u00a0\u00a0 doing in their daily life which may be\u00a0 contributing to them continuing to feel00:52:24<\/a>flat or have the experience\u00a0 of emotional dysregulation feelings of fatigue set in when the brain\u00a0 perceives that continued effort is futile\u00a0\u00a0 and or the brain says can’t run keep running this\u00a0 hot you know i’m going to have to turn on some\u00a0\u00a000:52:44<\/a>some cold water because we can’t keep keep\u00a0 sitting in this hot bath reducing fatigue can\u00a0\u00a0 be accomplished in part with psychological factors\u00a0 including motivation and knowledge of competitors\u00a0\u00a0 knowing what is what you’re dealing with can\u00a0 help people feel a sense of personal control\u00a0\u00a000:53:04<\/a>feedback about frequent successes encouragement\u00a0\u00a0 helping them know that endpoint remember\u00a0 all those fatigue things that we looked at\u00a0\u00a0 there are a lot of things that we can take from\u00a0 sports and translate to hpa axis activation\u00a0\u00a000:53:20<\/a>because when that hpa access is activated it’s\u00a0 telling us to fight or flee so fight or run if you\u00a0\u00a0 will both of those are sort of sport type things\u00a0 when that hpa axis is activated what happens our\u00a0\u00a0 heart rate goes up our breathing increases it’s as\u00a0 if our body is doing something physiolog physical\u00a0\u00a000:53:40<\/a>but sometimes we’re still sitting still so we\u00a0 can take some lessons from that and help people identify ways to feel empowered hopeful and\u00a0 less fatigued 46 of people in the u.s are\u00a0\u00a0 exposed to adverse childhood experiences so\u00a0 there is a lot of room for early intervention\u00a0\u00a000:54:03<\/a>we also can provide everyone not just people\u00a0 with traumatic injury but everyone instruction\u00a0\u00a0 and skills to handle emotional dysregulation\u00a0 including mindfulness being aware of triggers\u00a0\u00a0 preventing them when possible having a plan\u00a0 to mitigate them if you couldn’t prevent them\u00a0\u00a000:54:22<\/a>vulnerability prevention and awareness what makes\u00a0 you more likely to respond strongly to something\u00a0\u00a0 you know for me too much um too much\u00a0 sugar not enough food low blood sugar\u00a0\u00a0 or not enough sleep tends to make me more\u00a0 vulnerable i tend to get really cranky\u00a0\u00a000:54:43<\/a>emotion regulation skills distress tolerance\u00a0 skills and problem solving skills of those exposed\u00a0\u00a0 to trauma education about and normalization of\u00a0 their heightened emotional reactivity it’s your\u00a0\u00a0 brain’s way of trying to protect you totally makes\u00a0 sense it may really tick you off right now but if\u00a0\u00a000:55:03<\/a>you look at it from you know have a little bit\u00a0 of a cognitive restructuring and look at it as a\u00a0\u00a0 survival mechanism then we can look at ways\u00a0 to help your brain calm down recognize it safe\u00a0\u00a0 and develop new strategies\u00a0 for dealing with the stress00:55:23<\/a>okay so i went through a\u00a0 lot of stuff in 55 minutes\u00a0\u00a0 um and there’s if you want to download\u00a0 that article that um this is based on which oops00:55:42<\/a>post-traumatic stress disorder the neurobiological\u00a0 impact of psychological trauma it is a tough read\u00a0\u00a0 i will tell you it takes you have to sit down you\u00a0 can’t have the tv going and really focus on it and\u00a0\u00a0 maybe take it in chunks it’s a longer article\u00a0 but it has so much wonderful information in it\u00a0\u00a000:56:01<\/a>that i strongly recommend if you work with people\u00a0 who’ve experienced trauma even adverse childhood\u00a0\u00a0 experiences you take a look at it remember\u00a0 that not every trauma causes traumatic injury\u00a0\u00a0 so one of the adverse childhood experiences\u00a0 for example is divorce well not every person\u00a0\u00a000:56:22<\/a>experiences divorce as and gets traumatic injury\u00a0 from it it may actually be an improvement of a\u00a0\u00a0 situation so we do want to not necessarily tell\u00a0 people that they’re wrong if they don’t think\u00a0\u00a0 they were injured by it but we want to take into\u00a0 consideration the fact that they may have been\u00a0\u00a000:56:42<\/a>injured by it and every experience we go\u00a0 through impacts our phenomenological reality\u00a0\u00a0 so the divorce that your parents went through when\u00a0 you were six the experiences you had at school\u00a0\u00a0 the experiences you had last week all impact the\u00a0 way you react to every situation henceforth and\u00a0\u00a000:57:04<\/a>forevermore now you can choose you can become\u00a0 aware of how the past is impacting you now\u00a0\u00a0 and choose how it impacts you now but that is sort\u00a0 of one of those advanced skills after people start\u00a0\u00a0 being able to get that hpa access to recalibrate\u00a0 and respond a little bit more mildly to distress
Source : Youtube<\/a><\/div><\/div>","protected":false},"excerpt":{"rendered":"

https:\/\/www.youtube.com\/watch?v=eCo0sDFaauUCEUs are available at AllCEUs.com\/Trauma-CEU i’d like to welcome everybody today’s\u00a0 presentation on the neurobiological\u00a0\u00a0impact of psychological trauma and the\u00a0hpa axis or our threat response system\u00a0\u00a0 now what we’re talking about is not necessarily\u00a0 ptsd we’re talking about the impact of trauma\u00a0\u00a000:00:18on our hpa axis and if we have excessive\u00a0 stimulation of that hpa axis … Continue reading Discover How Trauma Rewires the Brain<\/span><\/a><\/p>\n","protected":false},"author":3,"featured_media":152224,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false},"version":2}},"categories":[132],"tags":[],"class_list":["post-152223","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-weird-stuff"],"jetpack_publicize_connections":[],"jetpack_sharing_enabled":true,"jetpack_featured_media_url":"https:\/\/effectsofanxiety.net\/wp-content\/uploads\/2024\/03\/1709496146-maxresdefault.jpg","_links":{"self":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/posts\/152223","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/comments?post=152223"}],"version-history":[{"count":0,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/posts\/152223\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/media\/152224"}],"wp:attachment":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/media?parent=152223"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/categories?post=152223"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/tags?post=152223"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}