Does Stress Damage the Brain?:
Understanding Trauma-Related Disorders from a Mind-Body Perspective

J. Douglas Bremner

Praise for Does Stress Damage the Brain?:

"Useful for the undergraduate student."
—Canadian Child and Adolescent Psychiatry Review

Overview – Excerpt – Table of Contents

Why is it that we can remember exactly where we were when John Kennedy was shot, or when the Space Shuttle Challenger exploded, or on September 11, 2001? Does what we see, hear, feel, and in other ways experience, especially during times of stress, result in permanent changes to our brains? Is this one of the reasons stressful events become seared in our memories? These provocative questions, and many others, are answered here by J. Douglas Bremner, a leading scientist whose discoveries, and that of his colleagues, showed that extreme stress may result in lasting damage to the brain, especially a part of the brain involved in memory.

Readers will join Bremner as he recounts the harrowing stories of people under stress-from WWI soldiers to Vietnam combat veterans to survivors of the September 11 terrorist attacks-and gathers evidence for his intriguing proposition that stress actually damages the brain. As this book will explain, scientists now believe that stress-related brain damage may cause certain psychological disorders, such as posttraumatic stress disorder (PTSD). There are in fact a range psychological disorders related to stress, what we are now calling the 'trauma spectrum disorders,' that may be manifestations of stress-induced changes in the brain.

This new understanding of trauma-related problems as essentially neurological disorders has many important implications. What a difference it would make if someone who experiences anxiety or depression realized that they were not at fault for these experiences, but rather these experiences were the result of brain-based changes as a result of stress? In certain cases, thinking about the effects of stress on the brain may help understand puzzling phenomena, like delayed recall of childhood abuse.

The scope and breadth of traumatic stress today make this book especially relevant. Our country will be sorting out the many patterns of response to recent traumatic events for years to come. If knowledge is power, then all readers will benefit from a greater knowledge of the potential effects of traumatic stress on mind, brain, body, and spirit. With over ten years of experience in researching the effects of stress on people, Douglas Bremner is uniquely qualified to help us make sense of the ways in which we experience stress.

Everyone who has ever experienced stress, or wondered about the effects of stress on their minds and bodies, will benefit from the insights in this clearly written and accessible book.

Praise for Does Stress Damage the Brain:

"Which organ do you value most? It ought to be your brain.Are there ways of protecting or perhaps even improving the functioning of this precious organi? The book reviewed here could potentially change the way you think about your brain and the way it functions. Does Stress Damage the Brain? By psychiatrist and neuroscientist J. Douglas Bremner is an account of brain functioning and stress that adds facts, depth and detail to the subject..Bremner's account addresses atrophy of the hippocampus as a result of stress, a phenomenon that can make the individual more vulnerable to life-threatening encounters. Two prime targets for stress hormones in the brain are the hippocampus and the amygdala. In these structures, neurons may change shape, and connectiviity and even the number of cells may be dramatically altered. The journalists' questions of 'when, where, what and who?' are the territory of the hippocampus. The emotional impact is added by the amygdala and, through its connections, the frontal cortex. When stress levels are very high, the hippocampus may be damaged, and its essential role in forming memories, particularly those for context, is at risk. In dangerous situations, it is important to remember one context, not many. Because of this, the hippocampal formation becomes more specific through pruning, while at the same time strengthening the amygdala's fear networks. Traumatic stress may cause even greater brain damage, so symptoms that are related to psychological trauma can be understood as neurological disorders. In his book, Bremner reviews the neuronal, hormonal, autonomic, mental and behavioural bases of allostatic load brought about by traumatic experiences..Bremner rehearses well-known facts, but he also conveys an insight that slowly arises to a revolutionary thinking in medicine and psychiatry: that stressful experiences differentially activate a variety of responses designed by evolution to counter danger. The different chemical messengers may cause deficits in hippocampus-based learning and memory, and their effects on the amygdala and medial prefrontal cortex may lead to impaired inhibition of fear responses. As a result, emotional and autobiographical memory may become fragmented. In addition, repeated or chronic exposure to traumatic stress may lead to long-term dysregulation of these systems, resulting in impaired functioning and symptoms of stress-related disorders such as hyper-arousal, dissociation, flashbacks, avoidance depression..The benefit of [this book] (perhaps more for clinicians and educated laypersons than for neuroscientists) is in the integration of well-known biological evidence from a 'mind-body' perspective."
       --Thomas Elbert and Brigitte Rockstroh, Dept. of Psychology, University of Konstanz, Germany, Nature, vol. 421, January 2003

'A clearly written book on the topic of neurobiology of stress.offers creative solutions to treatment of stress-related disorders."
       --The Lancet Neurology, Jennifer J. Jasterling

"Never before has the impact of stress and trauma experiences on the functioning and structure of the brain been so clearly and convincingly demonstrated as in this book by J. Douglas Bremner. This book is characterized by clear-headed thinking, careful analysis, and sound research, and also has important implications for the therapeutic management of trauma patients. It will therefore become a historical landmark in the trauma field and is a 'must read' for all clinicians, researchers, and mental health workers."
       -- Johan Vanderlinden, Ph.D.
Catholic University of Leuven and University Center St-Jozef, Belgium

"Posttraumatic stress disorder is among the most common and disabling of all neuropsychiatric disorders. In recent years, research conducted by J. Douglas Bremner has identified substantial effects of psychological stress on brain structure and function. This work has led to a revolution in thinking on how to conceptualize PTSD and, most importantly, to discover new treatment approaches. This book eloquently describes these advances and the clinical implications for all people exposed to severe stress."
       -- Dennis S. Charney, M.D.
Director, NIMH Mood and Anxiety Disorders Research Program
Bethesda, MD

"Dr. Bremner has written an exceptionally interesting and useful book. In lieu of focusing on a single avenue of stress-related psychopathology, Dr. Bremner cogently recognizes that trauma spectrum disorders (PTSD, dissociation, depression, anxiety, and borderline personality) share common brain abnormalities and overlapping psychiatric symptoms. The chapters are well written and provide significant information regarding the history, epidemiology, etiology, and treatment of stress-related disorders. This is a state-of-the-art work that will serve as an outstanding reference for practitioners and researchers."
       -- Philip A. Saigh, Ph.D.
Professor of School Psychology, City University of New York

"Timely, intelligent and clinically accurate. Bremner clearly describes the hidden knowledge that stress hurts the brain and body. And more-he offers the reader important solutions."
       -- Charles L. Whitfield, M.D., author of The Truth about Depression, and Barbara Whitfield, R.T., author of Final Passage

About the Author

J. Douglas Bremner, M.D., is Director of the Emory Center for Positron Emission Tomography at Emory University Hospital, Director of Mental Health Research at the Atlanta Veterans Administration Medical Center, and is the editor of Trauma, Memory, and Dissociation and Posttraumatic Stress Disorder.

ISBN: 0-393-70474-2
April, 2005
Paperback, 311 pages