The concepts of brain functioning and neurobiological aspects of trauma presented in Uhernik (2017) are insightful and thorough. The author provides a basic understanding of brain structure and function with its relation to psychology and trauma therapy in an outside-the-box format, highlighting alternative modes of therapy with strong ties to neuroscience. Choosing a specific concept to elaborate on proved difficult in that many of the topics presented were incredibly interesting. Nevertheless, I chose as most interesting and relevant the link between systemic inflammation and brain health.
Uhernik (2017) describes novel research in neuroscience which has found associations between immune system systemic inflammation and neurodegenerative mental health conditions. In essence, although inflammation is a needed process the body typically undergoes, there are times when this inflammatory process can be associated with mental health conditions such as major depressive disorder (MDD), anxiety, and posttraumatic stress disorder (PTSD) (Uhernik, 2017; Doney et al., 2021). Research has pointed to the ability of cytokines, protein molecules directing the body’s inflammatory processes, to cross the blood-brain barrier (BBB) through the hypothalamus-pituitary-adrenal (HPA) axis (Uhernik, 2017). Due to inflammation being caused when the body is subjected to environmental toxins, infection, illness, or chemical toxins, researching regarding how this affects mental health has been increasing (Doney et al., 2021; Sankowski et al., 2015; Slavich & Sacher, 2019).
Slavich and Sacher (2019) present a very interesting theory regarding inflammation and MDD. The authors present a substantive review of literature that supports Social Signal Transduction Theory of Depression, a biopsychosocial theory which takes into account the way social stressors affect biological processes which in turn have an effect on mental health by altering the mechanisms involved in the HPA axis and central nervous system. They specifically look at the difference between males and females, with the goal of understanding why females are twice as likely to endure MDD after puberty. The research points to hormonal fluctuations in the menstrual cycle having a direct effect on systemic inflammation and greater risk for MDD (Slavich & Sacher, 2019).
Doney et al. (2021) delve deeper into barrier dysfunction presenting supporting evidence for a correlation between BBB and gut barrier dysfunction and inflammation. They state that chronic stress is the primary environmental risk factor for MDD, PTSD, and bipolar disorder (BP). Stressors can then cause a cascade of symptoms affecting the HPA axis, sympathetic nervous system, central immune system, and peripheral immune system (Doney et al., 2021). The circulating pro-inflammatory cytokines, an already established distinguisher amongst clients with MDD, induce the behaviors prevalent in depression, anxiety, and PTSD (Doney et al., 2021). Additionally, co-morbidity has been shown between mood disorders and gut disorders, such as irritable bowel syndrome (IBS) and Chron’s disease which, along with other research presented, suggest that gut barrier dysfunction caused by inflammation may affect mood regulation (Doney et al., 2021). Moreover, studies found that when the immune system is dysregulated, functioning of the limbic brain region is altered. As Uhernik (2017, p. 29) states “limbic system functioning is critical for therapists, particularly those working with trauma”. The reason it is so important for therapists working with trauma is because it is where emotions originate, it links the brain to the endocrine system, regulates the fight-or-flight response, is involved in the formation of memory and spatial awareness (especially important for stuck memories in conditions like PTSD), and regulates responses to fear from the amygdala (Uhernik, 2017). It is interesting to note that inflammation also has been found to have a direct effect on the amygdala’s sensitivity to fear (Doney et al., 2021).
Sankowski et al. (2015) provide a great overview of the way inflammation affects neurodegenerative disorders. They specifically address how immune system dysregulation relates to sepsis, systemic lupus erythematosus, and multiple sclerosis in order to study the way neurodegeneration affects the brain. It was found that inflammatory conditions can cause a host of brain damage including cognitive decline, vascular issues which compromise nutrition to the brain which can reduce connectivity, tissue damage, higher risk of neurodegenerative diseases, activation of neuronal cell death, and penetration of immune cells through the BBB (Sankowski et al., 2015).
As previously stated, this information is not only interesting but incredibly relevant. With the advent of COVID-19, fear, anxiety, and reduced health has become the new normal to many around the world, especially those who do not have the peace of Messiah in their hearts. Scripture states that we are not to worry about anything, but through prayer and supplication present our requests to God (Philippians 4:6-7, The Scriptures). When considering the biological effects of stress, this command takes on new meaning. The sole assurance of a believer is that when walking in the path of the one and only God, peace through any circumstance is provided through trust in Him. All has been overcome and even death has lost its sting through Messiah (1 Corinthians 15:55-56, The Scriptures). Believers who fully trust in Him can confidently walk forward in His path because we are constantly reminded in Scripture that we should not fear but be strong, courageous, and confident that His will is being done (Deuteronomy 31:6, The Scriptures). Therefore, when the world brings fear through a disease and a vaccine which both are linked to producing a cytokine storm (Baldelli, 2021), believers can stand confidently in the knowledge that the true God’s will is being done in the life of those who love Him and obey His commands, walk His path with Messiah, and above all pursue Truth (John 14:6,15-17, 23-24, The Scriptures).
References
Baldelli, L., Amore, G., Montini, A., Panzera, I., Rossi, S., Cortelli, P., Guarino, M., Rinaldi, R., & D’Angelo, R. (2021). Hyperacute reversible encephalopathy related to cytokine storm following COVID-19 vaccine. Journal of Neuroimmunology, 358. https://doi.org/10.1016/j.jneuroim.2021.577661
Doney, E., Cadoret, A., Dion-Albert, L., Lebel, M., & Menard, C. (2021). Inflammation-driven brain and gut barrier dysfunction in stress and mood disorders. European Journal of Neuroscience. https://doi.org/10.1111/ejn.15239
Sankowski, R., Mader, S., & Valdés-Ferrer, S.I. (2015). Systemic inflammation and the brain: Novel roles of genetic, molecular, and environmental cues as drivers of neurodegeneration. Frontiers in Cellular Neuroscience. http://dx.doi.org/10.3389/fncel.2015.00028
Slavich, G.M. & Sacher, J. (2019). Stress, sex hormones, inflammation, and major depressivedisorder: Extending Social Signal Transduction Theory of Depression to account for sex differences in mood disorders. Psychopharmacology, 236(10), 3063-3079. http://dx.doi.org/10.1007/s00213-019-05326-9
The Scriptures. (2018). Institute for Scripture Research.
Uhernik, J. A. (2017). Using neuroscience in trauma therapy: Creative and compassionate counseling. Routledge.
Discerning Trauma 