PTSD Veterans and Yoga

by Ram

Soldiers by Marc Chagall

On Veterans Day, November 11, we honor the brave men and women for their patriotism and willingness to serve selflessly (aka karma yoga) and who risk their lives for the common good of our country and to protect our freedom. Their selfless service comes at a price: lost limbs, unseen wounds, suicides, PTSD, depression, isolation, and aggression, among others. The statistics speak for themselves: there are a reported 22 veteran suicides each day, 39% alcohol abuse, 19% have traumatic brain injury (TBI), and 20% of Iraq and Afghanistan war veterans and 30% of Vietnam veterans are diagnosed with post-traumatic stress disorder (PTSD).

PTSD is an anxiety disorder that develops typically after an acute trauma, but can also occur after long-term, chronic stress, especially in cases where the person is exposed to a traumatic event. With PTSD, a person’s nervous system is reacting to the traumatic event rather than responding to present circumstances. 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 worsen and become protracted and interfere with daily tasks, the individual may have PTSD. Symptoms may include: recurring flashbacks and nightmares of the event, hyperarousal, severe anxiety, difficulty concentrating, becoming easily startled, insomnia, self-destructive behavior, or withdrawing from social relationship. Women in general are more likely to develop PTSD and war veterans are at particularly high risk for PTSD. 

When we are exposed to a dangerous situation, the inherent 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. The normal treatment for PTSD is psychotherapy in combination with suitable medication, including 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. 

A recent pilot study A Yoga Program for the Symptoms of Post-Traumatic Stress Disorder in Veterans  studied the effectiveness of a yoga program for improving PTSD symptoms among 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 yoga intervention for this study was developed and taught by three certified yoga teachers and was based on the yoga tradition of the Krishnamacharya Healing and Yoga Foundation (KHYF), which employs a therapeutic approach of breath, movement, and a specific meditative focus. This approach was designed to enable the veterans to experience focus, peace, calmness, and self-awareness. The yoga intervention was held for one hour twice a week for six weeks (12 sessions total), and each session was structured to include about 3 minutes for self-awareness by “checking in” with the body, mind and breath, 40 minutes of postures with breath awareness, and 5 to 10 minutes of full body relaxation with a focus on extending the exhale and a guided visualization. At the end of the 12 sessions, participants were tested for several biological and behavioral parameters. The researchers noted a significant improvement in a subset of PTSD symptoms, including anger, hyperarousal symptoms, overall sleep quality, and daytime dysfunction related to sleep.

One may question the significance of the study owing to a small sample size. But more studies reporting similar benefits provided validation for such interventions. Another randomized and controlled (though small) long-term study Breathing-Based Meditation Decreases Posttraumatic Stress Disorder Symptoms in U.S. Military Veterans: A Randomized Controlled Longitudinal Study, which monitored the effects of yoga over the course of a year, provided the scientific support for the benefits of yoga’s breathing techniques. This study focused on the effects of sudarshan kriya yoga, a practice of breathing-based meditation, in war veterans with PTSD. The study included twenty-one male veterans who had served in Iraq or Afghanistan and were diagnosed with PTSD. Eleven of these veterans enrolled in a seven-day program involving daily, three-hour sessions of sudarshan kriya breathing technique, including meditation, stretching, and group discussion, while ten others who served as the control group did not enroll in this program. The PTSD symptoms were assessed one week before the beginning of the program and then a week, a month, and a year after its completion. Seven of the 11 in the active group continued the yoga program even after completing the experimental study. 

The study found that the group who had done yoga demonstrated fewer or less intense PTSD symptoms in comparison to the control group. Those who took part in the yoga sessions showed lower anxiety and lower respiration rates, and performed better in behavioral tests measuring hyper-arousal and emotions. The researchers also noted that despite patients reporting re-experiencing the trauma, the impact of the traumatic memories was far reduced. The researchers concluded that the beneficial effects were due to:

1. The increased ability to focus on breathing and on the present moment.
2. Focusing on the present moments helped to reduce the severity of the negative traumatic thoughts.
3. An increased ability to ignore the rising negative imprints. 

Several other similar studies have shown such remarkable positive results that more VA hospitals have been making yoga classes available for the veterans. In addition, a number of organizations have developed programs to educate teachers on safe and effective yoga practices for veterans. Life after active duty is drawing several veterans to their yoga mats at VA centers around the country. At these VA centers physicians use a “tool box” of psychological assessments to determine the cognitive and emotional status of a veteran to prescribe a most effective and individualized treatment for that individual. And one of those tools could be yoga.

Note from Nina: We're still fundraising this week for the Veterans Yoga Project in honor of both the fallen and surviving veterans. If you want to contribute, we have a page set up just for our Yoga for Healthy Aging community! Go to veteransyogaproject/YogaForHealthyAging, where you can “light a candle” to honor someone by donating any amount. Let’s see what our community can do to support this wonderful organization! 

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