Post-Traumatic Stress Disorder (PTSD) – Ayurvedic Treatment, Diet, Exercises, Research Papers, Yoga & Pranayama

Post-Traumatic Stress Disorder (PTSD) is a mental health condition that’s triggered by a terrifying event — either experiencing it or witnessing it. (PTSD) can have a significant impact on your day-to-day life. In most cases, the symptoms develop during the first month after a traumatic event. But in a minority of cases, there may be a delay of months or even years before symptoms start to appear.  Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.

Most people who go through traumatic events may have temporary difficulty adjusting and coping, but with time and good self-care, they usually get better. If the symptoms get worse, last for months or even years, and interfere with daily life, PTSD should be ruled out.

Getting effective treatment after PTSD symptoms develop can be critical to reduce symptoms and improve function.

Signs and symptoms

Re-experiencing

Re-experiencing is the most typical symptom of PTSD. This is when a person involuntarily and vividly relives 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 another key symptom of PTSD. This usually means avoiding certain people or places that remind the patient of the trauma, or avoiding talking to anyone about the experience. Many people with PTSD try to push memories of the event out of their mind, often distracting themselves with work or hobbies. Some people attempt to deal with their feelings by trying not to feel anything at all. This is known as emotional numbing. This can lead to the person becoming isolated and withdrawn, and they may also give up pursuing activities they used to enjoy.

Hyperarousal

Someone with PTSD may be very anxious and find it difficult to relax. They may be constantly aware of threats and easily startled. This state of mind is known as hyperarousal. It often leads to:

  • irritability
  • angry outbursts
  • sleeping problems (insomnia)
  • difficulty concentrating

Other problems

Many people with PTSD also have a number of 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 develop after a very stressful, frightening or distressing event, or 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 develops in about 1 in 3 people who experience severe trauma.

Pathophysiology

Exact pathophysiology of PTSD is not known, but a number of possible reasons have been suggested.

Survival mechanism

One suggestion is that the symptoms of PTSD are the result of an instinctive mechanism intended to help you survive further traumatic experiences. For example, the flashbacks many people with PTSD experience may force you to think about the event in detail so you’re better prepared if it happens again. The feeling of being “on edge” (hyperarousal) may develop to help you react quickly in another crisis. But while these responses may be intended to help you survive, they’re actually very unhelpful in reality because you cannot process and move on from the traumatic experience.

High adrenaline levels

Studies have shown that people with PTSD have abnormal levels of stress hormones. Normally, when in danger, the body produces stress hormones like adrenaline to trigger a reaction in the body. This reaction, often known as the “fight or flight” reaction, helps to deaden the senses and dull pain. People with PTSD have been found to continue to produce high amounts of fight or flight hormones even when there’s no danger. It’s thought this may be responsible for the numbed emotions and hyperarousal experienced by some people with PTSD.

Changes in the brain

In people with PTSD, parts of the brain involved in emotional processing appear different in brain scans. One part of the brain responsible for memory and emotions is known as the hippocampus. In people with PTSD, the hippocampus appears smaller in size. It’s thought that changes in this part of the brain may be related to fear and anxiety, memory problems and flashbacks. The malfunctioning hippocampus may prevent flashbacks and nightmares being properly processed, so the anxiety they generate does not reduce over time.

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

Disease & Ayurveda

All problems related with 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 of them. 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.

Nidana

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

Purvaaroopa

Not mentioned

Samprapti

Due to the causative factors, Vaatadosha vitiates and move irregularly all over the body and cause imbalance in circulation & metabolism. Afterwards it enters the manovahasrotas and causes the development of disease in the mind.

Lakshana

Delusions

Instability in thoughts & opinions

            Fear

Lack of confidence

Insomnia or disturbed sleep

And other disorders of mind and body

Divisions

        Not mentioned

Prognosis

        Yaapya

Chikithsa

        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 medicines

                Mridweekadi kashayam

                        Brahmeedrakshadi kashayam

                        Drakshadi kashayam

                        Brahmarasayanam

                        Chyavanaprasam

Mridwikadi Leham

                        Kallyanakaghrutam

                        Saaraswataghrutam

Brands available

AVS Kottakal

AVP Coimbatore

Vaidyaratnam oushadhasala

SNA oushadhasala

Home remedies

        Practising meditation and auto-suggestion techniques at home           

Diet

  • 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 sedentary lifestyle. Be active.

Maintain a regular food and sleep schedule.

Avoid bath in cold water immediately after exercise. Allow body to be in normal temperature.

Yoga

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 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

  • 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 add-on to a 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 at 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 the control group. Data suggest that, as adjuvant to standard SSRI medication, MBCT is an effective intervention to significantly reduce symptoms of PTSD, depression, anxiety, and stress among veterans.

These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake.

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.

Dr. Nair offers consultation at two busy clinics in and around Haripad, Alleppey, Kerala, the southern state famous worldwide for authentic ayurvedic treatment and physicians. While offering consultation on all aspects of ayurvedic treatments Dr. Nair has a special interest in Panchkarma, Yoga, and Massage.

Through Ayurvedaforall Dr. Nair offers online consultation to patients worldwide and has served hundreds of patients over the last 20 years. In addition to his Ayurvedic practice, he is the chief editor of ayurveda-amai.org, the online portal of Ayurveda Medical Association of India, and the state committee member of Ayurveda Medical Association of India.

Dr. Nair is a regular speaker at Ayurveda-related conferences and has visited Germany to propagate Ayurveda. You can write directly to him-
rajesh@ayurvedaforall.com

Whatsapp – +91 9446918019, +91 8075810816

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