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

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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.

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 ...

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Overview

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.

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.

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Editorial Reviews

Thomas Elbert and Brigitte Rockstroh
“[...] 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.”
Jennifer J. Jasterling - The Lancet Neurology
“A clearly written book on the topic of neurobiology of stress.offers creative solutions to treatment of stress-related disorders.”
Johan Vanderlinden
“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.”
Dennis S. Charney
“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.”
Philip A. Saigh
“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.”
Charles L. Whitfield
“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.”
Publishers Weekly
The answer to the title is yes, according to Bremner, the director of Emory University's Center for Positron Emission Tomography, an associate professor of psychiatry and radiology at Emory's school of medicine and the editor of two textbooks on trauma. In this general introduction to the psychology of post traumatic stress disorder, or PTSD, Bremner's central thesis is that various discrete diagnoses for trauma-related illnesses can be unified: "patients exposed to different types of trauma have more in common than they have differences." Bremner sees the damage of trauma as being inflicted chiefly to the hippocampus, the part of the brain that stores memory, and his book is most articulate on this subject. His lab work on dissociation in Vietnam veterans and studies of sexually abused women are grimly cogent. The tone is relaxed and avuncular, to the point where the book sometimes meanders, as when Bremner gives the history of radiation or a discourse on gun-control laws. There is also the occasional sentence that may flummox the lay reader: "Stress results in an inhibition of neurogenesis in the dentate gyrus... an effect mediated by the NMDA receptor...." Too specialized for a general audience, yet not well-organized enough for specialists, this book may not get the audience demanded by some of its insights. (Sept. 15) Copyright 2002 Cahners Business Information.
Library Journal
The stress response, paradoxically, can both ensure our immediate survival and threaten long-term physical and mental well-being. These titles describe the mechanisms involved in responding to stress, but they take different tacks. Bremner (psychiatry and radiology, Emory Univ. Sch. of Medicine) focuses on traumatic stress-its effects on individuals and their ability to work and to relate to others. His premise is that "stress-induced brain damage underlies and is responsible for the development of a spectrum of trauma-related psychiatric disorders." Bremner offers a persuasive argument for revising the current diagnostic schema of the Diagnostic and Statistical Manual IV (which currently classifies numerous trauma as distinct conditions) to provide for one single spectrum of disorders, including both acute and chronic posttraumatic stress disorder and related conditions. Like McEwen, Bremner details the biological mechanisms of the stress response, focusing especially on the changes that occur within the brain. The author also touches briefly on Freudian psychotherapy, the use of medical scanning devices, the nature vs. nurture argument, the validity of delayed recall, etc. Despite some occasional repetitive and awkward constructions in his text, Bremner offers an interesting and valuable perspective on the subject of traumatic stress. His book will particularly interest professionals. McEwen (head, Neuroendocrinology Laboratory, Rockefeller Univ.) uses the term allostasis to denote the stress response in which maximum energy is delivered to those parts of the body that will be critical for self-protection. Allostatic load, on the other hand, describes a system that turns against itself. McEwen discusses in detail the processes by which stress affects the cardiovascular and immune systems as well as the brain. The brain, according to McEwen, can be "the target as well as the initiator of the stress response." This system, however, need not inevitably threaten us. Lifestyle changes, including proper diet, exercise, rest, and the development of positive coping skills, can make an enormous difference in our ability to minimize the effects of chronic stress. McEwen's book is skillfully written and will appeal to a wide readership.-Laurie Bartolini, Illinois State Lib., Springfield Copyright 2002 Cahners Business Information.
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Product Details

  • ISBN-13: 9780393703450
  • Publisher: Norton, W. W. & Company, Inc.
  • Publication date: 7/10/2002
  • Pages: 240
  • Product dimensions: 5.90 (w) x 8.60 (h) x 1.30 (d)

Meet the Author

J. Douglas Bremner, M.D., is Associate Professor of Psychiatry and Radiology and Director of the Emory Center for Positron Emission Tomography at Emory University School of Medicine in Atlanta, Georgia, and Director of Mental Health Research at the Atlanta VAMC in Decatur, Georgia. He has authored over 150 publications, and written or edited three books, most recently Does Stress Damage the Brain? Understanding Trauma-Related Disorders from a Mind-Body Perspective.

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Table of Contents

Preface
Pt. I Mind and Brain from a Trauma-Centric Perspective
1 The Lasting Effects of Stress on Mind and Brain 3
2 The Working Mind: What It Does and Why 38
3 Evolving Concepts for the Biology of Stress 69
4 Effects of Stress on Memory and the Brain 100
Pt. II The Widening Influence of Trauma in the World Today
5 The Scope and Breadth of Traumatic Stress In Society Today 139
6 A Brief History of the Classification of Stress-Induced Psychiatric Illness 174
7 PTSD and Other Stress-Related Psychiatric Disorders as Diseases of the Brain Caused by Stress 221
8 Treatments for PTSD and Other Stress-Related Disorders May Act Through the Brain 249
9 The Whole-Body Approach to Understanding Traumatic Stress 265
References 277
Index 300
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