Individuals living with post-traumatic stress disorder (PTSD) can feel as though they’re caught in an unbreakable cycle of fear, anxiety and distress. Evidence-based treatments such as talk therapy and medication are very effective for many patients. However, they don’t work for a significant number of individuals. Neurorehabilitation is gaining attention as a potential breakthrough for those with treatment-resistant PTSD.
Understanding PTSD
PTSD affects an estimated 6% of the population, per The National Institute of Mental Health. The condition is usually triggered by a traumatic event such as being in active combat, surviving an assault or living through a natural disaster. However, the onset of PTSD isn’t always related to a specific incident. Sometimes, a person can develop it after learning about a loved one experiencing a traumatic event.
PTSD affects how the brain processes fear and stress. Common symptoms include flashbacks of the event, nightmares that disrupt sleep and a heightened state of alertness, known as hypervigilance, where the person is constantly on edge, expecting danger at every turn.
The individual may start avoiding situations that could trigger memories of the trauma. Over time, the symptoms they’re enduring can wear down a person’s ability to function normally, affecting all aspects of their daily life.
Avoiding triggering situations can lead to isolation from friends and family and a reduced quality of life. Nightmares and flashbacks are particularly distressing, as they force individuals to relive their trauma.
Hypervigilance can also cause the patient to become overstimulated in certain environments. While the term is mainly used in relation to neurodivergent conditions, such as autistic spectrum disorder and ADHD, PTSD and overstimulation are closely linked. When an individual becomes inundated by sensory input, it can be challenging to concentrate or remain calm in environments most people find tolerable.
To cope with these overpowering feelings, some people may engage in repetitive behaviors, such as tapping, rocking or fidgeting. Referred to as stimming, PTSD patients may use this self-soothing mechanism to regain a sense of control or calmness when feeling overwhelmed by the world around them.
While many people with PTSD respond well to talk therapies such as cognitive behavioral therapy and medications including Sertraline or Paroxetine, some continue to struggle. Despite receiving appropriate care, their symptoms remain intense and persistent, leading to other co-occurring mental health conditions such as depression and anxiety.
Neurorehabilitation for Treatment-Resistant PTSD
Neurorehabilitation first emerged in the mid-20th century as researchers started to understand neuroplasticity, the brain’s remarkable ability to reorganize itself. Neuro rehab integrates advances in neuroscience, technology and therapeutic practices, and it’s now used to treat stroke, traumatic brain injury and neurological conditions such as Parkinson’s disease.
Neurological therapies are designed to help the brain recover and adapt after injury or trauma. Common forms include physical, occupational, speech and cognitive behavioral therapy to help improve motor skills, memory and problem-solving abilities.
With PTSD patients, the aim of neurorehabilitation is to retrain the brain and reduce symptoms by targeting its responses to trauma. Emerging therapies, such as neurofeedback, transcranial direct current stimulation (tDCS), transcranial magnetic stimulation (TMS) and deep brain stimulation (DBS), have yielded promising results in addressing treatment-resistant PTSD.
Neurofeedback
As the name might suggest, neurofeedback involves monitoring brain electrical activity and providing real-time feedback, helping patients learn to control their responses. The goal is to teach a person to consciously alter their brain wave patterns. For example, if the brain shows patterns associated with anxiety or hyperarousal, the program might play soothing music or a video to encourage relaxation.
Transcranial Magnetic Stimulation
TMS involves placing a magnetic coil near the scalp to stimulate specific areas of the brain. For PTSD patients, that’s often the prefrontal cortex, a region involved in mood regulation and decision-making. Sessions are typically short, and some patients may see improvement after just a few treatments.
Transcranial Direct Current Stimulation
With tDCS, a low, constant electrical current is applied to specific areas of the brain through electrodes placed on the scalp. Unlike with TMS, which uses magnetic fields, tDCS relies on a more subtle electrical current to modulate neuronal activity. Sessions are usually 20–30 minutes in length, and patients may undergo several treatments per week.
Deep Brain Stimulation
DBS is more invasive. It involves surgically implanting electrodes deep within specific brain regions and connecting them to a pulse generator, usually placed under the skin near the collarbone. Because of the associated risks, DBS is used for patients with severe PTSD who haven’t responded to other, less invasive treatment methods.
Cognitive Behavioral Therapy Integration
Cognitive behavioral therapy (CBT) is sometimes integrated with neurofeedback or TMS as part of neurorehabilitation. During CBT sessions, therapists might engage patients in exercises to change distorted thought patterns. The stimulation from TMS or neurofeedback may make the brain more receptive to these cognitive changes.
Benefits for Individuals With Treatment-Resistant PTSD
The primary benefit of neurorehabilitation is the potential for symptom relief where other treatments have failed. Talk therapies and medications often take weeks or even months to show results. Some people may experience a plateau or have their symptoms return shortly after discontinuing treatment.
Because neurorehabilitation models target specific brain areas, symptom relief is often quicker and more effective for longer periods. Neurorehabilitation approaches are generally noninvasive and can be adapted to the individual patient’s needs, making them a more flexible option.
Finding Specialized Care
Neurorehabilitation can significantly improve recovery for those with treatment-resistant PTSD. If you’re considering this innovative approach, look for a specialized provider experienced in these treatment methods. Discuss your interest in neurorehabilitation with your current therapist or primary care physician. They can provide referrals to facilities that offer these advanced treatments.
Once you’ve chosen a provider, be sure to take your relevant medical records — including previous therapy notes or psychiatric evaluations — to your first session. To help tailor your treatment plan, you may be asked to provide your detailed history during the initial assessment.
Our specialists at Sun Health Center use cutting-edge neuro therapy technology to help you overcome distress from treatment-resistant mental illnesses. Learn more about our services today and start on the road toward a more fulfilling life.
