Exercise as it relates to Disease/Exercise and its relation to Post Traumatic Stress Disorder

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Background To PTSD[edit]

Post traumatic stress disorder (PTSD) is a type of mental anxiety disorder that affects people that have witnessed or experienced traumatic situations[1]. The Australian Bureau of statistics show that PTSD prevalence in Australia is quite high, with 6.4% of the population aged between 16-85 having experienced PTSD symptoms in the 12 months prior to the National Survey of Mental Health and Wellbeing being carried out in 2007[2].


General symptoms include, but are not limited to, occurrences of[3]:

  • Recollections or dreams of the event that are intrusive, with the possibility of reliving the event
  • Psychological distress from recollections or mental cues relating to the event
  • Persistent avoidance of stimuli related to the event, e.g. conversations, settings
  • Feeling of detachment from others
  • Decreased interest in significant activities
  • Anger outbursts
  • Difficulty sleeping
  • Lack of concentration
  • Startled easily

Presently, numerous treatments are available for sufferers. The methods most popularly used include[4]:

Cognitive Behavioural Therapy Trauma Desensitisation
Exposure Therapy Relapse Prevention Therapy
Hypnotherapy Interpersonal Therapy
Pharmacotherapy[5]

How PTSD Can Effect Exercise[edit]

The effect of PTSD not only has a mental effect, but a physical effect. Those diagnosed with PTSD were seen to rate themselves as less active than others, in comparison to those without a diagnosed PTSD[6]. It was also reported that after being diagnosed with PTSD there was a significant decrease in activity from previous activity habits [6][7]. This is an issue because a lack of physical activity leads correlates with poorer health, such as an increased risk of cardiovascular disease[8], in conjunction with an increase of high risk behaviours such as smoking[6] that lead to poorer health. De Assis et al. (2008) suggests that this lack of exercise is caused by a trending issue to lack of motivation[7]. As the Diagnostic and Statistical Manual of Mental Disorders (IV) suggests, a lack of interest in activities is a symptom of PTSD[3] and accordingly one can suggest that this reduces the sufferers motivation to exercise.


How Exercise Can Reduce PTSD Symptoms[edit]

Commonly, exercise is used as a compliment or an alternative to traditional treatment of PTSD[9]. Two advantages can be taken from exercise as treatment[5]:


Physiological

Aerobic exercise has been known to relax the sympathetic nervous system through the release of beta-endorphins[10], as well as regular exercise being a catalyst for an increase in serotonin in the brain. PTSD has found to be correlated with low levels of serotonin[11], and as such exercise can mimic the effect of SSRI pharmacological treatment of PTSD[5]. As well as this, it can be effective in the combating of co-morbidities that come hand in hand with PTSD, such as Cardiovascular disease[8].

Psychological

Exercise can act as a distractor from negative thoughts[9], as well as being associated with positive moods and outlooks in individuals[12].


Recommendations[edit]

  • Practitioners, family and friends should be aware of the signs and symptoms of PTSD (mentioned above) in patients and loved ones.
  • Consult the APA DSM-IV[3] for specifics of diagnosis, and seek an official diagnosis from a qualified mental health professional.
  • Be aware of the numerous treatment options that include psychological interventions, pharmacological interventions and exercise interventions.
  • Exercise interventions are most effective in combination with psychological/pharmacological interventions, however caution must be taken when undertaking any type of treatment for PTSD due to its nature. Always pre-screen before exercise.
  • PTSD can cause a decrease in activity levels, and hence it is in important to try to continue exercise not only to reduce comorbidity factors[8] but also as a possible treatment.
  • Further research is required to determine how effective exercise is in reducing PTSD symptoms, as a larger sample size is needed to confirm validity of the findings found so far.


Further Reading[edit]

For further information about PTSD, visit the Beyond Blue website on PTSD, linked with a comprehensive fact sheet. If you believe you are experiencing PTSD or experiencing similar symptoms, please do not hesitate to contact Lifeline on 13 11 14.

References[edit]

  1. Seides, R. (2010). Should the current DSM-IV-TR definition for PTSD be expanded to include serial and multiple microtraumas as aetiologies?. Journal Of Psychiatric & Mental Health Nursing, 17(8), 725-731. doi:10.1111/j.1365-2850.2010.01591.x
  2. Australian Bureau Of Statistics (2007). National Survey of Mental Health and Wellbeing. Canberra, Australia.
  3. a b c American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
  4. 4. Imel, Z. E., Laska, K., Jakupcak, M., & Simpson, T. L. (2013). Meta-analysis of dropout in treatments for posttraumatic stress disorder. Journal Of Consulting And Clinical Psychology, 81(3), 394-404. doi:10.1037/a0031474
  5. a b c Ottati, A., & Ferraro, F. (2009). Combat-Related PTSD Treatment: Indications for Exercise Therapy. Psychology Journal, 6(4), 184-196.
  6. a b c Zen, A. L., Whooley, M. A., Zhao, S., & Cohen, B. E. (2012). Post-traumatic stress disorder is associated with poor health behaviors: Findings from the Heart and Soul Study. Health Psychology, 31(2), 194-201. doi:10.1037/a0025989
  7. a b de Assis, M. A., de Mello, M. F., Scorza, F. A., Cadrobbi, M. P., Schooedl, A. F., da Silva, S. G., . . . Arida, R. M. (2008). Evaluation of physical activity habits in patients with posttraumatic stress disorder. Clinics (SaoPaulo), 63,473–478
  8. a b c Dedert, E. A., Calhoun, P. S., Watkins, L. L., Sherwood, A., & Beckham, J. C. (2010). Posttraumatic Stress Disorder, Cardiovascular, and Metabolic Disease: A Review of the Evidence. Annals Of Behavioral Medicine, 39(1), 61-78. doi:10.1007/s12160-010-9165-9
  9. a b Libby, D. J., Pilver, C. E., & Desai, R. (2013). Complementary and alternative medicine use among individuals with posttraumatic stress disorder. Psychological Trauma: Theory, Research, Practice, And Policy, 5(3), 277-285. doi:10.1037/a0027082
  10. Brosse, A. L., Sheets, E. S., Lett, H. S., & Blumenthal, J. A. (2002). Exercise and the treatment of clinical depression in adults: recent findings and future directions. / Exercice et therapie de la depression chez les adultes: resultats actuels et orientations pour l ' avenir. Sports Medicine, 32(12), 741-760.
  11. Callaghan, P. (2004). Exercise: a neglected intervention in mental health care?. Journal Of Psychiatric & Mental Health Nursing, 11(4), 476-483. doi:10.1111/j.1365-2850.2004.00751.x
  12. Mata, J., Hogan, C. L., Joormann, J., Waugh, C. E., & Gotlib, I. H. (2013). Acute exercise attenuates negative affect following repeated sad mood inductions in persons who have recovered from depression. Journal Of Abnormal Psychology, 122(1), 45-50. doi:10.1037/a0029881