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Monday, July 28, 2014

Post-Traumatic Stress Disorder: Yoga to the Rescue

by Ram

Tokugawa with help from the Jodo monks of the Daijuji temple in Okizaki,
defeats the Ikkō ikki at the battle of Azukizaka by Yoshitoshi
Post-traumatic stress disorder (PTSD) is an anxiety disorder that develops after a person is exposed to a traumatic event. The individual could be either experiencing or witnessing the event.  Generally, people who are exposed to a traumatic event have difficulty adjusting and coping for a while but the symptoms get better with time and good care. However, if the symptoms get worse and protracted and interfere with daily tasks, the individual may have PTSD. Symptoms may include: recurring flashbacks of the event, hyperarousal, nightmares, severe anxiety, difficulty concentrating, feeling "jumpy" or getting easily startled, insomnia, uncontrollable thoughts about the event, self destructive behavior or withdrawing from social relationship. Women in general are more likely to develop PTSD than men, children are less likely to experience PTSD-like symptoms after a traumatic event than adults, especially if they are under ten years of age, and war veterans are at high risk for PTSD.

Anyone who is exposed to a dangerous situation naturally feels frightened.  The fear triggers the Fight or Flight response in the body to defend against the incoming danger or to evade it. This is a normal and healthy response of the body to protect the individual. But in PTSD, the Fight or Flight response is abnormally altered and as a result the individual may feel stressed or frightened even when they’re no longer in danger. Though PTSD was first recognized in war veterans, it can also result from a variety of incidents, including brutal assault, rape, torture, child abuse, abusive relationships, accidents, such as, car crashes, bombings, natural disasters, kidnapping or long-term captivity. The symptoms of PTSD may show up following the traumatic event or, surprisingly, may appear several years after the event. The symptoms cause significant problems at home, work, or in a social situations and can affect the individual’s normal functioning. 

What’s intriguing is why only some people suffer from PTSD. As with most mental health problems, PTSD is probably exacerbated in those who have:

  • inherited some mental health risks (genes that play a role in fear associated-memory formation and acquisition)
  • exposed themselves to frequent episodes of traumatic events
  • dysregulation in the release of chemicals and hormones in response to stress

The primary treatment for PTSD is psychotherapy in combination with suitable medication. This type of combinatorial treatment approach seems to improve the symptoms, help individuals feel better about themselves and enable the individuals to adopt lifestyle changes to manage the symptoms that recur. Medications include antidepressants and/or anti-anxiety medications. The drawback is that these medications have the potential for abuse and patients complain of several non-specific side effects. So non-pharmacological remedies could serve as a perfect add-on treatment. Fortunately, there are now nearly a dozen research studies describing mind-body intervention therapies, including yoga and meditation, for management of PTSD symptoms that arise from exposure to various stress stimuli. See Managing Mental Health Disorders Resulting from Trauma through Yoga: A Review.

Yoga for War Veterans with PTSD: The effectiveness of a yoga program for improving PTSD symptoms was conducted in a pilot study involving twelve war veterans who suffered from military-related PTSD. The veterans participated in a six-week yoga intervention that was held twice a week. The researchers noted a significant improvement only in a subset of PTSD symptoms, including hyperarousal symptoms, overall sleep quality, and daytime dysfunction related to sleep. 

Yoga for Tsunami Survivors: In another study, the effect of a yoga breath program alone or in combination with a trauma-reduction exposure technique was evaluated on the 2004 tsunami survivors who were confirmed to exhibit PTSD symptoms. The 183 tsunami survivors were divided into three groups: 1) yoga breath intervention, 2) yoga breath intervention followed by 3–8 hours of trauma-reduction exposure technique, and 3) six-week wait list that served as a control group. PTSD measures (17-item PTSD checklist and depression) were checked at the start of the study and at 6, 12 and 24 weeks.  Eight months after the 2004 tsunami, survivors who performed the yoga program alone or in combination with the exposure therapy had significantly reduced scores on PTSD symptoms checklist compared with the control group. Additionally, the yoga group alone or in combination with the exposure therapy had significantly reduced scores on depression measurements compared with the control group. The benefits from the yoga program alone or in combination with the exposure therapy were maintained for 24 weeks, even without a regular practice. 

Yoga for Youth Incarcerated in a Correctional Facility: Juvenile delinquency requires interventions to help the youth cope with the stress.  A randomized controlled trial was carried out on 28 girls between 12 and 16 years of age, all of whom had a history of committing legal offences. The 28 girls were divided into two groups:  1) yoga and 2) games. The girls in the yoga group received training in postures and guided relaxation sessions for 60 minutes daily for 5 days a week. At the end of 6 months, both groups’ heart rate and breath rate were assessed to evaluate their physiological stress levels. While both groups showed significantly reduced heart rate, the yoga group also showed a significant decrease in breath rate, suggesting that a combination of yoga and meditation was helpful in combating fear, anxiety and hyper arousal like symptoms associated with PTSD.

Similar mind-body intervention programs were conducted on people exposed to civil wars, tsunami, hurricanes, interpersonal violence, combat, and terrorism in several places, including Kosovo and Sri Lanka. And in all such cases it was noted that yoga and meditation were extremely useful in reducing mental health disorders and other PTSD symptoms. Researchers believe that yoga and meditation may improve the functioning of traumatized individuals by relieving their psychological distress, increasing their mental awareness, and helping them to tolerate physical and sensory experiences associated with fear and helplessness. So if you know of someone who is experiencing PTSD or similar symptoms, kindly roll out the mat and encourage the individual to incorporate yoga and meditation into their lives. Both these practices do not require extensive hospital visits, expensive gear, space or setup and do not have any baggage of side effects. And the benefits are immense. Furthermore the healing power is in its simplicity!

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