Trauma resulting from combat, car accidents, natural disasters, domestic violence, sexual assault or child abuse can leave a deep imprint on both the brain and body. The effects of these experiences can be incredibly variable. For some, the disruption may be relatively brief, with disturbing dreams or heightened emotional responses resolving within weeks. For others, symptoms that emerge after trauma eventually become chronic, disrupting daily life, work, and relationships.

Healing is a very intimate process, and what heals one may not heal the other. Survivors must, therefore, find treatments that resonate with them and embark on their journey of self-discovery to alleviate symptoms and be in control again.

PTSD is a testament to the adaptability of the brain and its drive to protect us. It can empower survivors to seek help while creating a compassionate support network around them. Time, resources, and care can be put to use to move toward healing, bringing life back from the trauma.

This article reviews the complex interaction between trauma and the brain, providing insight into how traumatic experience re-configures neural structures and contributes to the development of post-traumatic stress disorder (PTSD).

How the Brain Reacts to Trauma

Brain is a marvelous organ, designed with a definitive purpose in mind-safety or survival. As we negotiate the complexity of human existence, the brain enlists experience in memory so that we can differentiate between agents of either good or evil. Trauma makes this mechanism hyperactive, for the safety instinct overrules everything else.

After a traumatic event, the brain is compelled to overuse past experiences in predicting dangers which might be present at the moment, but long gone. Hypervigilance and an inability to discriminate between threats of past times and those of the current time define individuals with PTSD.

Cognitive Response of the Triune Brain to Trauma

Paul D. MacLean's Triune Brain model offers a framework to understand how trauma affects the functioning of the brain. The model divides the brain into three main regions:

The Reptilian Brain: This is the most primitive part of the brain, responsible for survival instincts and autonomic processes like heart rate and breathing.

The Mammalian Brain: Includes the limbic system, which processes emotions and regulates attachment and reproduction.

Neomammalian Brain: Processes sensory information, learns, memorizes, and makes decisions and complex problems-solving.

The brain suppresses higher cognitive functions and favors the functions of the reptilian and mammalian brains when faced with trauma. This shift will automatically trigger the "fight, flight, freeze, or fawn" response, which sends out stress hormones like cortisol throughout the body.

Normally, the parasympathetic nervous system will rebalance once the threat is gone; however, people with PTSD are stuck in survival mode, causing a state of chronic stress.

Key Brain Regions Affected by Trauma

Amygdala

The amygdala, responsible for detecting danger, becomes overactive in individuals with PTSD. It often misinterprets harmless stimuli as threats, causing persistent feelings of anxiety, hypervigilance, and fear. This heightened response can lead to emotional outbursts, difficulty relaxing, and an ongoing sense of unease.

Hippocampus

The hippocampus, which is used in learning and memory, atrophies in people who suffer from PTSD. Shrinkage of this particular region makes the brain have difficulties distinguishing between past and present events, resulting in flashbacks, intrusive thoughts, and an inability to recall the specifics. The diminished function of the hippocampus also interferes with problem-solving and regulation of emotions.

Prefrontal Cortex

Trauma reduces activity in the prefrontal cortex, which controls decision-making and logical thinking. This reduction in activity makes it difficult to contextualize and process fear responses, leaving people prone to overreaction to perceived threats.

Nervous System

The nervous system's constant activation in PTSD diminishes a person's capacity to handle stress. Even minor challenges may provoke intense reactions, as the brain remains primed for danger.

Symptoms of PTSD

The effects of PTSD are not confined within the brain, having an impact on every part of daily life. The American Psychiatric Association states the following common symptoms include:

• Intrusive thoughts
• Flashbacks, and nightmares
• Heightened irritability
• Rage
• Anxiety
• Difficulty with memory, concentration, and decision-making
• Panic attacks
• Insomnia
• Emotional numbing

All this symptoms of trauma often interfere with a patient's personal relationships, professional skills, and general well-being, making the survivors more and more isolated and misunderstood.

Healing the Trauma Brain

The changes, however, that trauma triggers in the brain are of such magnitude that recovery from this is possible through targeted intervention. Treatments often come in the form of psychotherapy, including:

Cognitive behavioural therapy (CBT): Identifies and helps in altering negative thought patterns.

Cognitive Processing Therapy (CPT): Helps reshape belief patterns based on trauma.

Prolonged Exposure Therapy (PE): Helps develop resistance to triggers through gradual exposure.

Eye Movement Desensitization and Reprocessing (EMDR): Facilitates processing trauma with bilateral stimulation, creating new, healthier associations.

A particular type of cough could offer an important clue about whether you have Covid or flu this winter. The NHS has outlined how the two illnesses can be told apart.

Why Do Respiratory Illnesses Rise In Winter?

As winter arrives, a noticeable increase in seasonal illnesses is expected. Conditions such as the common cold, respiratory syncytial virus (RSV), COVID-19, and influenza tend to spread more easily during colder months. This happens because viruses thrive in lower temperatures and people spend longer periods indoors, often in close proximity to others.

Why Covid and Flu Can Be Hard To Tell Apart

Distinguishing between these infections is not always easy, as many symptoms overlap. According to guidance published by the NHS, the following symptoms are commonly seen in both Covid and flu:

• A high temperature
• A sore throat
• Feeling tired or extremely fatigued
• A headache
• Diarrhoea
• Feeling sick or vomiting
• Loss of appetite
• Coughing is another symptom shared by both conditions, though the nature of the cough can differ.

Cough

Flu and Covid are among the illnesses that become more common during the winter months. If you have influenza, the NHS explains that the cough is usually dry and may develop suddenly, often alongside other symptoms that appear quickly.

In contrast, Covid may cause what the NHS describes as a “new, continuous cough.” This refers to coughing frequently for more than an hour, or experiencing three or more coughing episodes within a 24-hour period.

This distinction is supported by Dr Rupa Parmar, a GP and medical director at Midland Health. In previous comments, she noted that coughs linked to colds are generally mild, while flu tends to cause a dry cough.

“With Covid, the cough is often dry and persistent,” she explained. “Many people cough continuously for long periods or have repeated coughing fits throughout the day.”

Ways To Differentiate Between Covid and Influenza

The type of cough is not the only sign that may help identify which illness you have. A reduced or altered sense of smell or taste is commonly reported in people with Covid and is much less frequent in flu cases.

Breathlessness is another symptom recognised by the NHS as being associated with Covid. While flu can sometimes lead to breathing difficulties, this usually occurs only if the illness becomes severe.

What to do if you have symptoms:

For both Covid and flu, the NHS advises staying at home and limiting contact with others if you or your child have symptoms and either:

• Have a high temperature
• Do not feel well enough to attend work, school, childcare, or carry out normal activities
• The guidance states that normal routines can be resumed once symptoms improve and the temperature returns to normal.

When to seek urgent medical advice:

The NHS recommends contacting your GP or NHS 111 urgently if:

• You are worried about Covid symptoms in yourself or your child and are unsure what to do
• Symptoms are worsening or not improving
• You or your child develop additional signs of illness, such as a rash, poor appetite, or weakness
• A high temperature lasts for five days or more, or does not come down after taking paracetamol
• A baby under three months has a temperature of 38C or above, or is suspected to have a fever
• A child aged three to six months has a temperature of 39C or above, or is suspected to have a fever
• You or your child have flu-like symptoms and you are over 65, pregnant, living with a long-term health condition, have a weakened immune system, or symptoms have not eased after seven days

The NHS has released a warning for people who take levothyroxine to manage thyroid conditions. With an estimated 33 million prescriptions issued every year across the UK, levothyroxine is among the most frequently prescribed medicines provided by the NHS.

Levothyroxine is mainly used to treat an underactive thyroid, a condition medically known as hypothyroidism. Depending on a patient’s needs and a GP’s assessment, the medicine is usually prescribed either as a tablet or as a liquid taken by mouth.

What Is Levothyroxine?

The NHS website explains that while most adults and children can safely take levothyroxine, there are specific situations where it may not be recommended. These restrictions are based on a person’s medical history and current health conditions.

People Who May Not Be Able to Take Levothyroxine

According to NHS guidance, levothyroxine may not be suitable if any of the following apply:

1. You have a heart condition such as angina, heart disease, or heart failure
2. You have a condition that affects your adrenal glands
3. You have previously suffered a heart attack
4. You have an overactive thyroid that produces excess thyroid hormone, known as thyrotoxicosis
5. You have diabetes
6. You have had an allergic reaction to levothyroxine or another medicine in the past
7. You have high blood pressure
8. Patients are advised to inform their GP or specialist about any of these conditions before starting treatment.

Levothyroxine: Possible Side Effects to Be Aware Of

Levothyroxine can cause a range of side effects, some of which may require urgent medical attention. Common side effects associated with the medication include:

• Flushing or excessive sweating
• Feeling restless, anxious, or overly energetic
• Difficulty sleeping
• Nausea
• Headaches
• Vomiting
• Shaking or trembling
• Diarrhoea
• Muscle cramps

The NHS notes that this is not a complete list, and other side effects may occur. Patients are advised to read the information leaflet included with their medication for full details.

Levothyroxine: When to Seek Medical Help

Although these side effects can be unpleasant, they are usually mild and do not typically require a hospital visit. If symptoms persist or become troublesome, the NHS recommends speaking to a doctor or pharmacist for advice.

However, certain symptoms should not be ignored. If you notice a fast or irregular heartbeat while taking levothyroxine, you should contact a doctor or call NHS 111 as soon as possible.

More serious symptoms require immediate action. Anyone experiencing chest pain while on levothyroxine is advised to call 999 without delay, as this could signal a medical emergency.

Disclaimer: This article is for general information only and is not a substitute for medical advice. Levothyroxine should be taken only as prescribed by a qualified healthcare professional. Do not start, stop, or change your medication without consulting your doctor. If you experience severe symptoms or a medical emergency, seek immediate medical attention or call emergency services.

Delhi, on Wednesday morning, woke up to 'very poor' air. The visibility was low and, in fact, the India Meteorological Department (IMD) issued an orange alert for dense fog between 8.30am and 10am. Visibility remained low, and as per the 24-hour average Air Quality Index, Delhi stood at 384, as confirmed by the data from the Central Pollution Control Board (CPCB). In certain areas, including Anand Vihar, AQI remained under 'severe' level, at 452.

This has resulted in cancellation of t least 148 flights and over 150 flights were delayed at the Delhi airport.

However, there may be a silver lining, in an interview with TOI, Tarun Kumar Pithode, who took charge as the new full-time member secretary of the Commission for Air Quality Management (CAQM) said that Delhi can expect "more blue-sky days over next 3-4 years".

How Does The Commission for Air Quality Management Plan To Bring Delhi's Pollution Down?

Delhi’s fight against air pollution is set to intensify over the next few years, with the CAQM outlining a multi-pronged plan aimed at delivering “more blue-sky days” for the capital. Rather than relying on emergency measures alone, the strategy focuses on long-term, structural fixes across transport, industry, energy and regional coordination.

Cutting Emissions at the Source

One of CAQM’s core priorities is reducing pollution from vehicles, which remain a major contributor to Delhi’s poor air quality. The plan pushes for faster adoption of electric vehicles, tighter checks on polluting commercial vehicles, and a stronger public transport network. Scrapping old, high-emission vehicles and discouraging diesel use through stricter enforcement are seen as key steps to curb everyday emissions, not just during winter spikes.

Cleaning Up Industry and Power Generation

Industrial pollution is another major target. CAQM has stressed a shift away from coal and other dirty fuels toward cleaner energy sources. Industries operating in and around Delhi are being pushed to adopt cleaner fuels such as natural gas, along with better emission-control technologies. Power plants in the region are also under scrutiny, with stricter norms to ensure they do not become pollution hotspots during peak winter months.

Tackling Dust and Construction Pollution

Construction dust and road dust significantly worsen Delhi’s air quality, especially during dry months. CAQM’s plan includes stricter enforcement of dust-control norms at construction sites, better mechanised road sweeping, and regular water sprinkling on major roads. Authorities are also being asked to improve urban planning to reduce exposed soil and unpaved areas that contribute to dust pollution.

Managing Seasonal Pollution and Stubble Burning

A major part of Delhi’s pollution problem comes from outside the city, particularly crop residue burning in neighboring states. CAQM has emphasized regional coordination, working with states like Punjab, Haryana and Uttar Pradesh to reduce stubble burning. This includes promoting alternative methods for crop residue management, providing financial incentives, and ensuring accountability when violations occur.

Data-Driven and Year-Round Action

Unlike earlier approaches that focused largely on winter emergencies, CAQM’s plan relies on year-round monitoring and data-driven action. Expanded air-quality monitoring, better forecasting, and early interventions are expected to prevent pollution levels from spiralling out of control. The aim is to move from reactive crisis management to consistent prevention.

A Long Road Ahead

CAQM officials acknowledge that Delhi’s pollution problem will not disappear overnight. However, with coordinated action across sectors and states, they believe the capital can see steady improvement over the next three to four years. The promise of more blue-sky days hinges not just on policy, but on strict enforcement and sustained public cooperation.