Seeing a therapist may not only improve mental health, but can also have a positive effect on underlying biological features of mental disorders, a new study suggests.
Scientists in Hungary have published a paper in Biological Psychiatry, with results that show that cognitive behavioral therapy — also known as talk therapy — can reduce psychological symptoms of post-traumatic stress disorder (PTSD) as well as the underlying biological changes the disorder causes.
The study, led by the National Institute of Psychiatry and Addictions as well as the University of Szeged in Hungary, analyzed 39 PTSD patients and included a group of 31 people who had experienced trauma but did not develop PTSD. The researchers used magnetic resonance imaging to measure certain brain regions and took blood samples to find changes in expression of FKBP5, a gene that plays a role in PTSD and stress hormones. The PTSD patients then received 12 weeks of cognitive behavioral therapy, while the other 31 did not receive any therapy. After 12 weeks of therapy, the researchers once again measured brain regions and FKBP5. They found that PTSD patients had lower FKBP5 gene expression, as well as smaller hippocampal and medial orbitofrontal cortex volumes, before talk therapy, which was linked to an improvement in PTSD symptoms.
“The results show that structural changes in the brain, such as the shrinkage of the hippocampus, are reversible in trauma victims,” Dr. Szabolcs Kéri said in a press release. “Talk therapy may help normalize these alterations and improve symptoms. Furthermore, the regeneration of hippocampus correlated with the expression of a gene that balances the activity of the stress hormone cortisol at the level of cells.”
What Are The ‘Biological’ Features Of PTSD?
A 2011 study pointed out that several pathological features of PTSD overlap with features found in patients with traumatic brain injury (TBI), “paralleling the shared signs and symptoms of these clinical syndromes.” Some of the neurobiological features that occur in PTSD patients includes a lack of baseline Cortisol, a steroid hormone that is released in response to stress, which may lead to a prolonged, and intensified, stress response. An abnormally functioning hippocampus — an area in the brain that regulates memory and spatial navigation — may also account for PTSD’s cognitive symptoms. PTSD also can cause changes in neural plasticity as well as myelination patterns, the authors note. “The biological perturbations observed in patients suffering from PTSD are numerous,” the 2011 study authors write, “and likely reflect an enduring dysregulation of multiple stress-mediating systems that occurs as a result of a psychological ‘shock.’”
Currently, PTSD patients have several options for treatment — talk therapy being one of the most common forms. According to U.S. Department of Veterans Affairs' National Center for PTSD, cognitive behavioral therapy appears to be the most effective type of counseling for PTSD patients. Other options include exposure therapy, which focuses on reducing the patient's fear about memories, and eye movement desensitization and reprocessing (EMDR) — focusing on eye movements, sounds, or hand taps while thinking or talking about memories. Medication is, of course, another common treatment, with antidepressants typically used.
The Hungarian scientists suggest that their findings are important, mostly because they show that talk therapy can have an effect not only on mental well-being but also changes in gene expression and brain structure — all of which may be related.
Source: Einat Levy-Gigi, Csilla Szabó, Oguz Kelemen, Szabolcs Kéri. Association Among Clinical Response, Hippocampal Volume, and FKBP5 Gene Expression in Individuals with Post-traumatic Stress Disorder Receiving Cognitive Behavioral Therapy. Biological Psychiatry, 2013.