Achieve Optimal Brain Function

Insomnia?

Stress is an inherent component of first responders.  It is an inevitable factor in making this career choice.  We use the physiological definition of stress or the stress response as the increase of norepinephrine, adrenaline, and cortisol. For many years the medical field in our country has been advocating adamantly for stress management.  The reason for this advisement is the known havoc stress plays on the human body, especially the heart.  Being exposed to stress, or the increase of norepinephrine, adrenaline, and cortisol, causes fats in the blood, thus making the heart much more vulnerable to heart attacks.  The number one line of duty death for firefighters up until three years ago was heart attacks. While the brain is the manager of the stress response, it too can fall victim to its consequences.  Researchers have found extensive evidence of how widespread the effects of stress are across various brain regions.  For example, the limbic system, which plays a large role in emotional processing, becomes activated when an individual is stressed to help the body process and prepare for a response.  In cases of chronic stress, however, the prolonged activation of the limbic system may contribute to irrational decision-making and exaggerated emotional reactions to daily stressors.  When a person feels threatened by a stressor the rapid limbic system reacts before the slower prefrontal cortex has a chance to evaluate the stimulus.  Usually, the prefrontal cortex modulates limbic activity and helps to inhibit inappropriate responses, but extreme stress interrupts this usual flow so that the body can respond as quickly as possible, although the response may not be rational or well thought-out in the moment.  Excessive stress hormones also impair the functioning of the prefrontal cortex. In situations of chronic or excessive stress these hormones are overproduced and can cause physical harm. Exposure to large amounts of hormones can damage the central nervous system, hippocampus, and several other organs of the body. It can also age brain cells more rapidly, build fat around the body’s midsection, and cause learning deficits.

Trauma is another factor that the average first responder is exposed to typically every time they are shift.  First responders experience personal trauma, or facing a life and death experience or injury, and they are chronically exposed to vicarious trauma. Many first responders report psychological and physical issues related to the work they do.  While the brain and body are designed to cope with fear, stress, and danger, they’re not designed to stay in these activated states for prolonged periods of time.  For first responders, the exposure to trauma and crises mean that the neurophysiological systems related to keeping an individual safe are constantly in over-drive.  The brain’s stress response system, the hypothalamic-pituitary-adrenal (HPA) axis, is especially thrown out of whack by prolonged, repeated exposure to stress.  The hypothalamus is a gland of the limbic system and the master control switch of the autonomic nervous system, activating both the sympathetic and parasympathetic responses.  It releases a chemical messenger that signals the pituitary gland to secrete a hormone that then travels to the adrenal glands, where stress hormones (e.g. cortisol and adrenaline) are released.  The job of these stress hormones is to prepare the body for fight, flight, or freeze.  However, in the case of chronic stress, the HPA axis is overstimulated and the body secretes too many stress hormones.  Such overexposure can cause brain cells to age more rapidly, contribute to mood disturbances, and cause cognitive impairment. Repeated exposure to traumas can also strongly affect not only brain functioning, but also the size of some cortical structures.  

Brain imaging of those with trauma histories often show increased activity within the amygdala (related to emotions) and a smaller hippocampus (related to learning and memory).  Therefore, an individual may be able to rationally recognize they aren’t in danger, but the emotional, fear-based areas of the brain are essentially over-powering the more logical, thinking areas.  When the sympathetic nervous system is activated, it initiates physiological responses commonly associated with anxiety, like faster heart rate, sweating, and shallow breathing.  For first responders, it can be hard to flip the stress switch off after work and their bodies may remain in these heightened, hypervigilant states even when they’re safe at home or enjoying time with their loved ones.  Not to mention, because areas related to memory and cognitive tasks are affected by trauma and stress, first responders may experience brain fog, have slower reaction times, and have trouble remembering things. Additionally, recent studies have discovered that the areas of the brain involved in stress continue to develop throughout lifespan, and do not cease development, like the rest of the brain, around 23-25 years of age.

How We Can Help!

Our goal is to regulate the brain for first responders, so that it counterbalances the effects of their job, giving them a chance at a more psychologically stable life and career. Our plan of care involves a QEEG brain map on every first responder.  This will give us a 3-D image of their brain, signaling where their brain is firing too fast or too slow, thus causing the mental health issues we are seeing rampant in these industries.  We then implement neurofeedback therapy; we can target the areas of the brain that each first responder has dysregulated.  We can train the anxiety and stress networks in the brain through subconscious operant conditioning, thus regulating a first responders to think clearer, focus, concentrate, regulate mood, reduce impulsivity, increase sleep quantity and quality, reduce self-medicating, just to name a few. First responders sacrifice their lives for perfect strangers’ day in and day out for a total of 25-30 years, with the hope of enjoying their retirement they so deserve.  The latest statistics show that an average first responders’ lifespan after retirement is 6-10 years, less than a third of their career.  We plan on changing these numbers by assisting first responders in regulating their brains in order to increase their quality of life in the present and after they retire.  It is time someone stands up and levels the playing field for these selfless industries.

The Research

• Bracciano, A,G., Chang, W-P., Kokesh, S. (2012). Cranial electrotherapy stimulation in the treatment of posttraumatic stress disorder: A pilot study of two military veterans. Journal of Neurotherapy.
• Currie, C. L., Remley, T. P., & Craigen, L. (2014). Treating trauma survivors with neurofeedback: A grounded theory study. NeuroRegulation, 1(3–4), 219.
• Foster, D. S., & Thatcher, R. W. (2015). Surface and LORETA neurofeedback in the treatment of post-traumatic stress disorder and mild traumatic brain injury. In R. W. Thatcher & D. S. Foster (Eds.), Z score neurofeedback: Clinical applications (pp. 59–92). San Diego, CA: Academic Press.
• Kluetsch, R., Ros, T., Theberge, J., Frewen, P., Schmahl, C., & Lanius, R. (2012). Increased default mode network connectivity following EEG neurofeedback in PTSD. In International Society for Traumatic Stress Studies (ISTSS) 28th Annual Meeting: Innovations to Expand Services and Tailor Traumatic Stress Treatments, November 1-3, 2012, Los Angeles, CA [Abstracts]. International Society for Traumatic Stress Studies (ISTSS). Retrieved from https://doi.org/10.1037/e533652013-382
• Lanius, R. A., Frewen, P. A., Tursich, M., Jetly, R., & McKinnon, M. C. (2015). Restoring large-scale brain networks in PTSD and related disorders: A proposal for neuroscientifically-informed treatment interventions. European Journal of Psychotraumatology, 6. Retrieved from https://doi.org/10.3402/ejpt.v6.27313
• Mills, Z. L. (2012). Neurofeedback experiences of clients with hyperarousal symptoms associated with PTSD. The University of the Rockies. Retrieved from http://gradworks.umi.com/35/44/3544522.html
• Othmer, S., & Othmer, S. F. (2009). Post traumatic stress disorder: The neurofeedback remedy. Biofeedback, 37(1), 24–31.
• Russo, G. M., Novian, D. A. (2014). A Research Analysis of Neurofeedback Protocols for PTSD and Alcoholism. Journal of NeuroRegulation, 1(2), 183-186.