Why Is The Prefrontal Cortex So Important?

The prefrontal cortex area of the brain is to be thank for our ability to think, make choices, predict what might happen in the future, and manage emotions and social relationships. Many view this area of the brain as the part that makes humans different from animals, as it is thought to give us our intelligence and personalities. However, the prefrontal cortex is also known to play a role in mental illness.

Where and what is the prefrontal cortex?

The prefrontal cortex refers to the front part of the brain that sits behind the forehead and eyes. This part of the brain is sometimes called "the personality center," and it tends to fully develop last. The prefrontal cortex plays a large role in higher-order thinking. Specifically, the prefrontal cortex is responsible for:

• Developing a personality
• Developing social skills
• Comparing current information to past experiences
• Planning for the future
• Making decisions
• Setting goals
• Managing emotions
• Deciding what is right or wrong

How does the prefrontal cortex develop?

The brain and nervous system, including the prefrontal cortex, begin developing when an embryo is about three weeks old in the womb. Development starts at the back, where the brain meets the spinal cord, and moves forward. For that reason, the prefrontal cortex is the last part of the brain to fully mature. Usually, the prefrontal cortex finishes developing when a person is in their mid-to-late 20s.

Because the prefrontal cortex isn't fully developed until adulthood, children and teens do not yet have full reach to its abilities. That helps explain why children often act impulsively or have emotional outbursts — the part of the brain that can control these things isn't fully developed yet. Similarly, teenagers may take more risks than adults, because they don't fully think through the potential outcomes of the choices, due to their prefrontal cortex not yet being fully developed. 

The prefrontal cortex and mental disorders

Researchers have found that changes to the way the prefrontal cortex normally connects within itself and to other parts of the brain likely play a role in many mental illnesses, including anxiety disorders, depression, schizophrenia, and bipolar disorder. Since the prefrontal cortex is involved in higher-order thinking, when it goes "offline," other parts of the brain take over. These parts may involve impulsivity and emotional reactivity. Studies show that chronic stress weakens connections in the prefrontal cortex.

Prefrontal cortex and trauma effects

Both physical damage to the prefrontal cortex through injury and the effects of traumatic stress can impact how this part of the brain functions. As a result, both head injuries and emotional trauma may contribute to mental illness. 

Recovering from a frontal lobe injury

Because the prefrontal cortex is in the front of the skull, it is more likely to be damaged as the result of a head injury, compared to parts of the brain that are more safeguarded.

Recovery will look different for everyone, and your doctor should go over aftercare instructions with you thoroughly, but there are a few things to expect:

• Recovery doesn't happen overnight; brain damage is not always something people can recover from 100%.
• Your impulses may be unusual after a brain injury. When your prefrontal cortex is damaged, you can lack good judgment and reasoning skills. You may feel uninhibited and do things you wouldn't have normally done before.
• Brain injuries often require many doctor's visits. When you have a traumatic brain injury, the injury must be handled with care, as must the recovery. You will have guided rehabilitation, possibly with more than one therapist.

One of the best assets for recovery is having a support system. Someone with a brain injury needs to surround themselves with people who understand what they are going through and are willing to be helpful and supportive. Family and friends will have to adjust to any emotional or personality changes occurring post-brain injury. Sometimes, people with prefrontal cortex damage are aware that their behavior or personality has changed, and they may have trouble coping. 

How to parent teenagers with developing prefrontal cortexes

Since teenagers' prefrontal cortexes aren't yet fully developed, they may engage in behaviors or make decisions that seem risky or not well thought out. If you have a teenager and feel bothered by their behavior, think in terms of their still-developing prefrontal cortex. Since this part of the brain is undergoing rapid development during adolescence, your parenting could majorly impact your teen's development.

• Talk to your teen about consequences and being responsible for their actions. Help them connect their impulsive behaviors to consequences, so their brain can make these connections more quickly over time.
• Remind your teen that they can make good decisions. Help build their confidence in their decision-making by letting them know when they have made good decisions.
• Explain to your teen that the front of the brain often goes "off-line" during moments of high stress, so those aren't the best times to make big decisions.
• Stay engaged with who your teen is becoming. Have an open-door policy so that your teen understands the importance of coming to talk to you about their feelings or thoughts.
• When talking with your teenager, ask them if they would like you to listen or if they want your feedback. Sometimes the best way to help teens is not to give advice but to let them vent without working toward a solution immediately.

All teenagers are different, and some may be experiencing mental health issues that go beyond the regular ups and downs of adolescence. If you notice your teen has had a mood or behavior shift that lasts longer than two weeks, or if they begin to exhibit signs of aggression, violence, depression, or isolation, make them an appointment with a mental health professional.

Need support? Therapy can help

If you've experienced a brain injury or suspect you're experiencing mental health challenges, there are people who can help you navigate your feelings and identify steps forward.

Online therapy through platforms like BetterHelp can provide many benefits, making it a good option when you need support. When therapy occurs online, you don’t have to worry about getting to a therapist's office or being put on a waiting list for an appointment. With online treatment, you are matched with a therapist who can start seeing you right away. You can attend sessions from anywhere you have an internet connection, and some people may find it easier to open up from behind the safety and distance of a screen. 

Research shows that online therapy is effective for treating multiple conditions. One study found that online treatment led to a 50% improvement in symptoms of generalized anxiety disorder, social anxiety disorder, panic disorder, obsessive-compulsive disorder, and depression after 8 to 15 weeks of treatment, on average.