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 This can lead to the person becoming isolated and withdrawn, and they may also give up pursuing activities they used to enjoy.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
Chyavanaprasam
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
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