Post-traumatic stress disorder (PTSD) is a mental state caused by a terrifying event. It can be developed either by experiencing it or witnessing it. It can have a significant impact on the person’s day-to-day life. In most cases, the symptoms develop during the first month after a traumatic incident. But in a minority of cases, there may be a delay of months or even years before symptoms manifest. They manifest variedly like flashbacks, nightmares and severe anxiety, along with uncontrollable thoughts about the event.
Most people will have temporary difficulty after a traumatic incident, but with time, they usually get better. If the symptoms get worse, last for an abnormally long time, and cause disturbances in daily life, PTSD should be considered.
Getting effective treatment is very crucial in PTSD to reduce symptoms and improve function.
Signs and symptoms
Re-experiencing
Re-experiencing is the most important sign when the patient involuntarily and vividly reliving the traumatic event in the form of:
flashbacks
nightmares
repetitive and distressing images or sensations
physical sensations, such as pain, sweating, feeling sick or trembling
Avoidance and emotional numbing
Trying to avoid being reminded of the traumatic event is a part of PTSD. This usually means avoiding certain people or places that remind the patient of the trauma. They usually avoid talking to anyone about the experience. Many people try to distract themselves voluntarily with hobbies and other activities. Others try not to feel anything at all. This is called emotional numbing. This can cause isolation and withdrawal, may lead to depression.
Hyperarousal
PTSD patients are always anxious and they find it difficult to relax. They are more alert always and easily startled. This state of mind is called hyperarousal. It often leads to:
- irritability
- angry outbursts
- sleeping problems like insomnia
- difficulty in concentrating
Other problems
Many people with PTSD also have several other problems, including:
- other mental health problems, such as depression, anxiety or phobias
- self-harming or destructive behaviour, such as drug misuse or alcohol misuse
- other physical symptoms, such as headaches, dizziness, chest pains and stomach aches
PTSD sometimes leads to work-related problems and the breakdown of relationships.
Causes
Post-traumatic stress disorder (PTSD) can be manifested after a single event that is very stressful, frightening or distressing. It can also develop after a prolonged traumatic experience. Types of events that can lead to PTSD include:
- serious accidents
- physical or sexual assault
- abuse, including childhood or domestic abuse
- exposure to traumatic events at work, including remote exposure
- serious health problems, such as being admitted to intensive care
- childbirth experiences, such as losing a baby
- war and conflict
- torture
PTSD is present in almost roughly about 33% of people who experience severe trauma.
Pathophysiology
The exact pathophysiology of PTSD is not known, but many possible reasons have been suggested.
Survival mechanism
It is an instinctive mechanism to help the person survive further traumatic experiences. The alertness of hyperarousal can be helpful to react quickly in another crisis. But they kill the present and reality because the person cannot process and move on from the traumatic experience.
High adrenaline levels
Abnormal levels of stress hormones are found in people with PTSD. This “fight or flight” reaction, helps to deaden the senses and dull pain in danger. People with PTSD continue to produce high amounts of fight or flight hormones even when there’s no danger.
Changes in the brain
In people with PTSD, changes in the brain are found, such as the hippocampus appears smaller in size. It may be related to fear and anxiety, memory problems and flashbacks. The malfunctioning hippocampus may prevent flashbacks and nightmares from being properly processed, so the anxiety continues for a long.
Diagnosis
Physical examination
Psychological evaluation
Treatments
Psychological therapies
Cognitive behavioural therapy (CBT), especially Trauma-focused CBT
Eye movement desensitisation and reprocessing (EMDR)
Group therapy and counselling sessions
Medication
Antidepressants, such as paroxetine, sertraline, mirtazapine, amitriptyline or phenelzine
Prognosis
Usually, people with PTSD get better within a few weeks without treatment. It’s also possible for PTSD to be successfully treated many years after the traumatic event or events occurred.
Complications
Complex PTSD:
- feelings of shame or guilt
- difficulty controlling emotions
- periods of losing attention and concentration (dissociation)
- physical symptoms, such as headaches, dizziness, chest pains and stomach aches
- self-created isolation from friends and family
- relationship problems
- destructive or risky behaviour, such as self-harm, alcohol misuse or drug abuse
- suicidal thoughts
Ayurvedic Concept of Post-traumatic Stress Disorder -PTSD
All problems related to the mind are attributed with the name manoroga or unmada in Ayurveda. As the thridoshas cause the diseases of both body and mind, manorogas also come under the doshic vitiation. Other than very important bodily functions, Vaata controls the mind & thoughts too. PTSD happens when there is Vaatakopa due to fear or shock, which deviates mental stability. It is seen mostly in Vaata prakruti people who are highly unstable.
Ayurvedic Nidana of Post-traumatic Stress Disorder -PTSD
Physical
Dry, cold and old food items
Excess travelling & exertion
Trauma/injury
Exposure to wind
Loss of sleep
Psychological
Trauma (physical or emotional)
grief
Fear
Anxiety
Stress
Ayurvedic Purvaaroopa of Post-traumatic Stress Disorder -PTSD
Not mentioned
Ayurvedic Samprapti of Post-traumatic Stress Disorder -PTSD
Due to the causative factors, Vaatadosha vitiates and move irregularly all over the body and cause an imbalance in circulation & metabolism. Afterwards, it enters the manovahasrotas and causes the development of disease in the mind.
Ayurvedic Lakshana of Post-traumatic Stress Disorder -PTSD
Delusions
Instability in thoughts & opinions
Fear
Lack of confidence
Insomnia or disturbed sleep
And other disorders of mind and body
Ayurvedic Divisions of Post-traumatic Stress Disorder -PTSD
Not mentioned
Ayurvedic Prognosis of Post-traumatic Stress Disorder -PTSD
Yaapya
Ayurvedic Chikithsa of Post-traumatic Stress Disorder -PTSD
Ayurvedic treatment of mental disorders are divided into three compartments, Yuktivyapasraya (medicines etc), daivavyapasraya (religious offerings, worship etc.) and sattwavajaya (techniques to strengthen the mind). When all these are done together, the person feels better.
Samana
Abhyangam
Moordhapichu
Brumhanam
Sodhana
Snehapanam
Swedanam
Snehavasti
Kashayavasti
Commonly used Ayurvedic medicines for Post-traumatic Stress Disorder -PTSD
Drakshadi kashayam
Brahmarasayanam
Chyavanaprasam
Kallyanakaghrutam
Saaraswataghrutam
Brands available
AVS Kottakal
AVP Coimbatore
Vaidyaratnam oushadhasala
SNA oushadhasala
Home remedies for Post-traumatic Stress Disorder -PTSD
Practising meditation and auto-suggestion techniques at home
Diet for Post-traumatic Stress Disorder -PTSD
- To be avoided
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening agni (digestive fire)
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Green gram, soups, buttermilk boiled with turmeric, ginger and curry leaves
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Better to avoid exposure to excessive sunlight wind rain or dust.
Avoid a sedentary lifestyle. Be active.
Maintain a regular food and sleep schedule.
Avoid bath in cold water immediately after exercise. Allow the body to be at normal temperature.
Yoga for Post-traumatic Stress Disorder -PTSD
Stretching exercises, meditation for relaxation and following a specific Yogacharya with yoga asanas like suryanamaskara, pavanamuktasana, vajrasana, etc are recommended for improving circulation and digestion.
Regular exercise helps improve the bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within and with surroundings.
Suryanamaskara
Pavanamuktasana
Vajrasana
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles of Post-traumatic Stress Disorder -PTSD
- PMID: 30529244
Objective: A substantial amount of individuals with substance use disorders (SUD) also meet criteria for posttraumatic stress disorder (PTSD). Prolonged Exposure (PE) is an effective, evidence-based treatment for PTSD, but there is limited data on its use among individuals with current alcohol or drug use disorders. This study evaluated the efficacy of an integrated treatment that incorporates PE (Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure or COPE) among veterans.
Method: Military veterans (N = 81, 90.1% male) with current SUD and PTSD were randomized to 12 sessions of COPE or Relapse Prevention (RP). Primary outcomes included the Clinician-Administered PTSD Scale (CAPS), PTSD Checklist-Military version (PCL-M), and the Timeline Follow-back (TLFB).
Results: On average, participants attended 8 out of 12 sessions and there were no group differences in retention. Intent-to-treat analyses revealed that COPE, in comparison to RP, resulted in significantly greater reductions in CAPS (d = 1.4, p < .001) and PCL-M scores (d = 1.3, p = .01), as well as higher rates of PTSD diagnostic remission (OR = 5.3, p < .01). Both groups evidenced significant and comparable reductions in SUD severity during treatment. At 6-months follow-up, participants in COPE evidenced significantly fewer drinks per drinking day than participants in RP (p = .05).
Conclusions: This study is the first to report on the use of an integrated, exposure-based treatment for co-occurring SUD and PTSD in a veteran sample. The findings demonstrate that integrated, exposure-based treatments are feasible and effective for military veterans with SUD and PTSD. Implications for clinical practice are discussed.
- PMID: 29893182
In the present study, we explored the influence on symptoms of PTSD among Iranian veterans of the Iran-Iraq war of mindfulness-based cognitive therapy (MBCT) as an add-on to standard treatment with citalopram. Forty-eight male veterans with PTSD (mean age: 52.97 years) took part in this eight-week intervention study. Standard treatment for all patients consisted of citalopram (30-50 mg/day at therapeutic dosages). Patients were randomly assigned either to the treatment or to the control condition. Treatment involved MBCT delivered in group sessions once a week. Patients in the control condition met at the hospital with the same frequency and duration for socio-therapeutic events. At baseline and study completion, patients completed questionnaires covering symptoms of PTSD, depression, anxiety, and stress. At study completion after eight weeks, scores for PTSD (re-experiencing events, avoidance, negative mood and cognition, hyperarousal), depression, anxiety, and stress were lower, but more so in the intervention than in the control group. Data suggest that, as an adjuvant to standard SSRI medication, MBCT is an effective intervention to significantly reduce symptoms of PTSD, depression, anxiety, and stress among veterans.
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Writer:
Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.
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