In our last post, we discussed music therapy as an option for veterans dealing with symptoms of PTSD and/or TBI. By the way, how’s your stress release playlist going so far? We hope it’s helping.
In this post, we want to explain the science behind why music therapy can help and how it is particularly effective for veterans struggling with these conditions. This is going to get technical, but at the end, you’ll likely know a lot more about your brain than you did before.
First, a few key, scientifically proven facts:
1. PTSD and TBI are not a result of any kind of weakness physically or emotionally. Anyone who experiences a traumatic event or injury can end up with PTSD. Whether you suffered a physical hit or not, these diagnoses can happen to anyone, and it isn’t your fault. In fact, up to 20 percent of veterans from OIF and OEF suffered from PTSD, and while the statistics for Afghanistan are not yet known, the National Institutes of Health predict they will be similar or higher, and the VA acknowledges PTSD as an epidemic. 
2. Neither PTSD nor TBI are strictly emotional responses. While PTSD and TBI can manifest in behavioral changes, struggles to cope, depression, difficulty concentrating, or panic, those are symptoms, not the underlying problem. Instead, PTSD and TBI change the physical structures of the human brain, altering how regions of the brain interact, and even erase certain connections between your neurons.
3. Music can physically impact your brain, including helping to rebuild neural connections that allow the regions of your brain to work together.
So sit back, turn on some tunes if you want, and let’s talk about what this all means.
About that brain. None of us are born with the same brain we will have as an adult. All brains change over the course of a person’s lifespan. Some parts grow, some parts shrink, and the hormones that make our brains and bodies work change, too. This is all part of growing up, aging, responding to changing environments, basically being a person.
However, there are very specific ways PTSD and TBI impact brains, leading them to function very differently than “typical” brains. Those are the things we’re going to be focusing on here. The largest changes with PTSD start around a relatively small, almond-shaped area of the brain called the amygdala. One of the most important things the amygdala does is regulating stress and fear reactions. Like a tiny flare gun, the amygdala warns our brains and bodies when we experience stress, like a sudden change in our environments, entering a combat situation, losing someone we care about, or getting physically or emotionally inhjured.
Stress and fear are important and helpful to humans, although it doesn’t feel that way. As a veteran, you know this. Stress and fear are critical to how people pay attention in a combat situation. If you just go around trusting that everything will be fine all the time, you miss signals of someone behaving differently on the side of the road. People get seriously hurt. That’s why all people who serve are trained to be especially sensitive to, responsive of and aware of their surroundings. Stress responses, unpleasant as they are, keep us alive.
Here’s where the problem comes in with PTSD. In typical, non-traumatized brains, the amygdala’s stress and fear responses have checks and balances. Just like with politics, checks and balances in your brain work by different structures playing a part to mediate what the other parts are doing. For the amygdala, the checks and balances are supposed to come from parts of the brain that process memory, help us communicate or concentrate, and regulate our breathing, pulse and hormones to help our bodies to relax. When all of those structures and processes work together, stressful events are unpleasant, but intense physical manifestations of stress don’t last long. This is important to survival, too, because panic doesn’t help anyone function better.
You might have heard about cortisol, commonly known as “the stress hormone.” It gets released when the amygdala tells the adrenal system that something unusual is happening. Cortisol speeds up your pulse and your breathing, tightens your muscles, and basically tells your body it needs to “LOOK OUT, NOW!” But after it’s out of danger, a typical brain tells the body to relax. The amygdala communicates to the hippocampus, an area that produces neurons that bind with the cortisol receptors, meaning the cortisol stops doing its thing.
In traumatized brains, this entire system of neurobiological communication changes. Trauma severs and inhibits the connections between individual parts of the brain. So in a traumatized brain, when the amygdala starts a fear response, the other regions of the brain don’t do their part to help regulate and stop it. What happens instead is an incredibly unhelpful cycle: when the traumatic event happens, your body makes so much cortisol that it doesn’t know what to do with it. Then, your body learns that it can’t do a very good job of controlling cortisol, so it stops making as much of it. Because everyone still needs a fear response of some kind to keep them from doing incredibly dangerous and stupid things, this lowering of cortisol causes extra sensitivity when it is released. This makes stress progressively unbearable.
In the traumatized brain, anytime anything remotely stressful happens, like you remembering something from your tour(s), or an unexpected backfire of a car, or you smelling something that reminds you of an unpleasant experience, your amygdala goes into overdrive. And now it’s a rocket launcher instead of a flare gun. It makes your brain flood your body with cortisol. Unlike the typical brain, the traumatized brain now has no way of dialing it back. The brakes are gone.
In case you’re interested, here’s an image that explains the details of these neurological interactions: 
So, now we know that PTSD and TBI are physical, neurological conditions. What does all of this have to do with music therapy?
It turns out, when your parents told you they were worried Marilyn Manson would have a permanent effect on you, they weren’t wrong, they just weren’t exactly right, either. Music changes your brain’s biology, and it happens to affect exactly the same parts of the brain that are most negatively impacted by PTSD.
That’s right, music has a direct impact on the amygdala. See, that almond-shaped brain bit does more than just regulate stress. It also has a role scientists are just now learning about in how we experience positive or pleasurable things and how we learn to seek those things out. For veterans with PTSD, this might be a calm and relaxed emotional state, or one of agitation that helps your brain process things it hasn’t been able to handle or communicate consciously. Music therapy protocols are designed around this principle.
When humans are exposed to music, their neurons start learning to fire in different ways. Recent studies using functional brain imaging have documented the impact of music and sound on the brain. They have also documented all of this brain biology in PTSD patients. And if you look at fMRI images of PTSD patients and fMRI images of people listening to music, the same areas of the brain light up the most. But in typical brains, fMRI shows the connections with other parts of the brain. With consistent exposure to music, like the kind you get in musical training or in music therapy, the neurological changes music makes can be permanent. It literally rebuilds neural pathways the trauma stress response eliminated.
For PTSD patients and the people who care about them, the implications of this are profound. We’ll dive more into how music therapy protocols use this knowledge and the experience of music therapy in our next piece.
For now, instead of looking at PTSD in veterans as an emotional hurdle that can be overcome if a person just gets stronger, it’s important to understand that when people survive trauma, their brains change. Music therapy can treat these physical and structural changes by making the brain form new connections where the old ones used to be. That doesn’t mean that a person will be the exact same person as before they deployed or experienced trauma, but no vets come back from combat without experiencing change.
What it does mean is this: PTSD treatment can physically help. Recovery is possible.
For more resources on PTSD, including scientific articles and material for awareness and for sufferers, visit the VA’s PTSD Center website at https://www.ptsd.va.gov/