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Understanding the clinical course
of PTSD
The presentation and clinical course of PTSD are variable among individuals, highlighting the heterogeneity of the disorder. Symptoms, duration, and severity can all vary for each individual.
PTSD is the development of characteristic symptoms after exposure to one or more traumatic events. Characteristic symptoms are described by the American Psychiatric Association’s DSM-5 diagnostic criteria as the 4 core symptom clusters of PTSD and may occur soon after exposure to a traumatic event or may be delayed.
Intrusion

(re-experiencing)
Persistent avoidance
Negative changes in cognitions and mood
Alterations in arousal and reactivity
Explore how PTSD can leave patients tied to their symptoms
Evolving research suggests that the dysregulation of neurotransmitter systems associated with PTSD, including norepinephrine (N), serotonin (S), and dopamine (D), may contribute to the symptoms of PTSD
The amygdala, hippocampus, prefrontal cortex (PFC), and striatum are key brain regions involved in the balance between the approach and avoidance systems in PTSD.
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The avoidance system is linked to fear-related processes
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The approach system is closely related to reward processes
Neurotransmitters, including N, S, and D, can alter the activity of key brain regions associated with the approach and avoidance systems.
Healthy cognitive behavior requires balance between the approach and avoidance systems.12 Neurotransmitters may be linked to the pathophysiology of PTSD and its associated symptoms.
Dysregulation of neurotransmitters in these brain regions may be associated with PTSD symptoms
Hyperarousal and 
intrusion
Norepinephrine
Mood and hyperarousal
Serotonin
Mood and
avoidance
Dopamine
Norepinephrine system hyperactivity associated with PTSD may contribute to hyperarousal and intrusion symptoms
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High levels can increase amygdala activity and fear conditioning
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Hyperactivity can impair PFC function, leading to restricted control of emotions
Serotonin deficits associated with PTSD may contribute to negative mood and hyperarousal symptoms
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Hyperactivity of the amygdala may contribute to excessive fear responses and reactivity
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Stress can alter activity in the hippocampus, which can affect mood
Dopamine dysfunction associated with PTSD may contribute to negative mood and avoidance symptoms
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Striatal dopamine dysfunction may contribute to negative mood symptoms, such as anhedonia and emotional numbing
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High dopamine levels in the medial PFC may contribute to avoidance
Specializations
Myrna Williams Psychological Services specializes in treating a broad spectrum of psychological conditions to meet the diverse needs of our community. Our expertise includes, but is not limited to:
At Myrna Williams, LCSW Telehealth Psychological Services, we understand how overwhelming anxiety and depression can feel. Our approach offers a blend of cognitive-behavioral therapy, mindfulness, and supportive counseling to empower you with effective strategies for managing symptoms.
By focusing on your strengths, we aim to foster a sense of hope and a more positive outlook, helping you to navigate life's ups and downs with confidence.
