Experiencing assaults, abuse, accidents, disasters, and other dangerous events can cause an abnormal reaction to stress, known as post-traumatic stress disorder (PTSD). When you consider what military veterans who have served in combat have endured, it’s no surprise they are at high risk for the condition. Seeing a buddy wounded or killed and coming close to death yourself are all situations that can trigger PTSD.
According to the U.S. Department of Veterans Affairs’ (VA) National Center for PTSD, between 11 and 20 percent of veterans of the Iraq and Afghanistan wars have PTSD in a given year, and about 30 percent of Vietnam vets have had PTSD in their lifetime. Symptoms of this serious anxiety disorder include nightmares, “flashbacks” (vividly recalling traumatizing events), sleep disturbances, feeling emotionally numb, loss of interest in activities that once were enjoyable, crowd avoidance, and avoidance of activities, people, or places that bring back painful memories. People with PTSD also may feel stressed, frightened, and angry even when there is no obvious danger – a condition known as hyperarousal. The result can be disrupted personal relationships, difficulty working, and other serious problems, including drug and alcohol abuse from attempts to self-medicate emotional pain.
However, researchers have are investigating a promising side-effect free treatment that offers hope for veterans with PTSD. Mindfulness exercises that teach acceptance of thoughts and emotions and calming meditation can help veterans with combat-related post-traumatic stress disorder find relief from their symptoms, according to J. Douglas Bremner, director of mental health research at the Atlanta VA Medical Center (VAMC).
Bremner, who is also director of the Emory Clinical Neuroscience Research Unit (ECNRU) at Emory University School of Medicine, is conducting extensive research into how a mindfulness-based stress reduction program incorporating a series of classes on meditation techniques and how to use mindfulness in daily life can help veterans plagued with PTSD symptoms.
“A large component of PTSD is anxiety – worrying about things that might happen in the future and what happened in the past,” Bremner explains. “What mindfulness does is teach people to observe and be aware of their thoughts in a non-judgmental way. So a veteran thinking about what happened in Viet Nam or Iraq can watch those thoughts come through and go away, rather than becoming preoccupied with traumatic memories and having an anxiety reaction.”
For his research, which involved veterans at VA sites in Atlanta, Charleston, and Tuscaloosa, Bremner and his colleagues looked at levels of depression and anxiety in PTSD sufferers before and after the research subjects used mindfulness strategies on a daily basis. Levels of stress chemicals known as catecholamines produced in the body during times of hyperarousal were also measured.
“We have found mindfulness to be safe and effective in reducing specific symptoms of PTSD,” Bremner says. “It’s especially effective for people who are motivated and engaged in the concept of the treatment and how it works.”
A collaborative pilot study from the University of Michigan Health System and the VA Ann Arbor Healthcare System also found that veterans with PTSD who completed a mindfulness-based group treatment plan, which concentrated on positive experiences and nonjudgmental acceptance of thoughts and emotions, showed a significant reduction in symptoms.
The mindfulness class exercises included “body scanning” (becoming aware of where there’s pain and tension in the body); mindful movement and stretching; eating very slowly while paying attention to the sensations; and "mindfulness meditation,” focusing on the breath and emotions. The veterans also practiced mindfulness exercises at home.
At the end of eight weeks, the symptoms of 73 percent of the PTSD sufferers in the mindfulness group had improved dramatically, including a decrease in feelings of self-blame and less fear of the world in general.
"Part of the psychological process of PTSD often includes avoidance and suppression of painful emotions and memories, which allows symptoms of the disorder to continue," says University of Michigan psychiatrist Anthony P. King, who headed the research. "Through the mindfulness intervention, however, we found that many of our patients were able to stop this pattern of avoidance and see an improvement in their symptoms."
Another recent study from the University of California, San Diego, School of Medicine and Naval Health Research Center found that practicing mindfulness training before exposure to stress, involving both meditation and body awareness exercises may help U.S. Marines more effectively deal with stress. The techniques help them prepare for and recover from traumatic combat situations before symptoms develop, potentially helping them avoid the abnormal stress reactions that can lead to PTSD.
The VA has created a free mobile app, the Mindfulness Coach, to help veterans experiencing PTSD-related emotional distress, and for those wanting to maintain healthy coping practices using mindfulness techniques. Although it’s not intended to replace professional care, the app provides information about the benefits of mindfulness, mindfulness exercises to practice on your own or with others, and a log to track progress. Other apps are also available to help.
March 02, 2015
Christopher Nystuen, MD, MBA