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Yoga for PTSD

Exercise has been shown to help improve a variety of  mental health conditions (1, 2).

A recent study wanted to see if  yoga can help with  Post traumatic stress disorder, also known as PTSD (3).

What is PTSD (4)?

According to the National Institute of Mental health (PTSD) (4):

What was the study (3)?

After filtering through over 12,000 results, a review of 66 studies and 24 controlled studies were meta-analyzed.

What were the results (3)?

  • The review showed that both mindfulness and YOGA benefited ptsd symptoms regardless of the type of trauma experienced (3).
  • Benefit was greater if yoga or mindfulness was done more than 8 weeks (3).

How much and how often should yoga be done to benefit ptsd?

There is evidence supporting yoga done 1-2 times per week for 60 to 75 minutes per session to benefit PTSD (5).

What are some caveats?

  • There are many forms of yoga.  Students may find some forms of yoga more helpful than others.
  • Check with your healthcare provider to make sure that doing yoga is safe and appropriate for you.

Additional resources regarding Yoga:

  • Yoga classes through your school
  • Online resources for yoga
  • Yoga classes in the community such as:  gym, health and fitness club, yoga center or YMCA, community or religious organization, etc.

What are some precautions?

  • It may be best to check with your healthcare provider to make sure it’s safe for you’re to start an exercise program.
  • Individuals with a history of disordered eating or disordered exercise should check with their health professional before exercising.
  • It may be wise to stop exercise and seek professional help if you notice:
    • Increased depression, disordered eating, and other mental health concerns due to exercise.
    • Injury, pain, or decreased motivation
    • Obsessive behaviors
    • Other symptoms.
  • Exercise may not help without proper nutrition, so it may be wise to learn about proper nutrition and proper exercise technique, and exercise/nutrition plans, before starting to exercise.
  • It may be helpful to gradually start exercising to give yourself time to adjust to an active lifestyle.
  • It might take weeks months or longer for some people to get used to and enjoy the minimum activity guidelines.
  • Occasional weeks without exercise or light activity may be important to prevent injury.
  • Figuring out what works best for you may give you lasting benefits.

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By Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. Patel R. Mental Health For College Students Chapter 9: Exercise strategies to improve mental health
  2. https://u.osu.edu/emotionalfitness/category/exercise-and-mental-health/
  1. Taylor, J., McLean, L., Korner, A., Stratton, E., & Glozier, N. (2020). Mindfulness and yoga for psychological trauma: systematic review and meta-analysis. Journal of Trauma & Dissociation, 21(5), 536–573. https://doi.org/10.1080/15299732.2020.1760167.
  2. https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd
  3. Yoga for the Treatment of Post-Traumatic Stress Disorder, Generalized Anxiety Disorder, Depression, and Substance Abuse: A Review of the Clinical Effectiveness and Guidelines [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2015 Jun 22. SUMMARY OF EVIDENCE. Available from: https://www.ncbi.nlm.nih.gov/books/NBK304564/

Venting to manage anger? This might work better

We can all feel angry from time to time and people often think that venting anger will help us.  This might not be the case.  A recent study looked at what worked better to manage anger: activities that increased arousal (venting) or activities that decreased arousal (calming activities).

What was the study? (1)

Bushman and Kjærvik reviewed 154 studies including 184 independent samples involving 10,189 participants.

What were the results? (1)

The authors found that effects calming activities were more effective at managing anger than venting activities.

What are examples of calming and venting activities in this study? (1)

Examples of calming activities that helped manage anger, or activities that decreased arousal were: deep breathing, mindfulness, meditation.

Examples of activities that increased arousal that did NOT help manage anger were: hitting a bag, jogging, cycling.

What are some caveats? (1)

  • See the full study for further details (1).
  • The authors found that the results were stable over time for participants of different genders, races, ages, and cultures (1)
  • It also did not matter how the activities were delivered or taught:  (e.g., digital platforms, researchers, therapists),  group or individual sessions, field, or laboratory settings (1).
  • This means that one could teach themselves calming activities to help manage anger or learn it from technology or others, including professional settings (1).

Where or how can I learn these calming techniques? (1)

Check out previous posts or this link (3).

If you would like to be notified of a new post (usually once per month), please subscribe by entering your email, its free!

By Ryan S Patel DO, FAPA

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. Kjærvik SL, Bushman BJ. A meta-analytic review of anger management activities that increase or
    decrease arousal: What fuels or douses rage? Clinical Psychology Review
    Volume 109, April 2024, 102414.  https://doi.org/10.1016/j.cpr.2024.102414
  2. https://news.osu.edu/breathe-dont-vent-turning-down-the-heat-is-key-to-managing-anger/?sfmc_key=0032E00002tKfusQAC
  3. Mental Health: Proven Techniques (lifehacks, biohacks) and Expert insights  for specific tools and techniques to learn calming strategies such as deep breathing, mindfulness, meditation, etc.

Mindfulness meditation vs escitalopram for anxiety

Mindfulness meditation has been shown to have various mental health benefits. For example, a review of 13 studies showed improvement in ADHD symptoms with mindfulness meditation (1).

Also, 41 trials show mindfulness meditation helped improve stress related outcomes such as anxiety, depression, stress, positive mood, etc. (2)

A review of 14 clinical trials shows meditation being more effective than relaxation techniques for anxiety (3).

A recent study looked at whether mindfulness based stress reduction (MBSR) was as effective as an anti-anxiety medication Lexapro (escitalopram) (4).

Who was in the study? (4)

  • 102 participants in MBSR and 106 participants in the escitalopram group, with a mean age of 33 years (4).
  • Participants were mostly female (4).

How was anxiety measured (4)?

  • Clinical Global Impression of Severity scale (CGI-S) was performed by blinded clinical interviewer at baseline, week 8 end point, and follow-up visits at 12 and 24 weeks (4).
  • Primary patient reported measure was the Overall Anxiety Severity and Impairment Scale (OASIS) (4).

What was the intervention? (4)

  • Participants were randomized 1:1 to 8 weeks of the weekly MBSR course or the antidepressant escitalopram, flexibly dosed from 10 to 20 mg (4).
  • MBSR group was taught MBSR as a manualized 8-week protocol with 45 minute daily home practice exercises, weekly 2.5-hour long classes, a day-long retreat weekend class during the fifth or sixth week (5).
  • Participants were taught several forms of mindfulness meditation, such as breath awareness (focusing attention on the breath and other physical sensations), a body scan (directing attention to one body part at a time and observing how that body part feels), and mindful movement (stretching and movements designed to bring awareness to the body and increase interoceptive awareness) (4,5).

What were the results? (4)

Participants who completed the trial at week 8 showed noninferiority for CGI-S score improvement with MBSR compared with escitalopram (4)—meaning MBSR was as effective as escitalopram.

What are some caveats?

  • This is the first study to compare MBSR to medication (4).
  • The study did not use commonly used instruments to measure anxiety in clinical settings such as GAD-7, Hamilton rating scale for anxiety or the Beck anxiety inventory, etc.
  • Participants had any anxiety disorder, not a specific type of anxiety disorder such as generalized anxiety disorder, panic disorder etc (4) which make it difficult to generalize results for other populations.
  • Participants (4) were mostly female in the 30’s which makes it difficult to generalize results for other populations.
  • MBSR is a specific type of manualized meditation taught by qualified instructors (5) and it may be difficult to find qualified instructors or qualified classes in your area.
  • In addition to work, school, and life obligations, people may find it difficult to schedule 45 minutes of daily meditation plus 2.5 hours of weekly class plus a day long retreat.
  • Different people may benefit from different types of meditation, and this area is being further researched.
  • Practicing meditation regularly may lead to improved benefits, and some people may see benefits with shorter duration of meditation.
  • Some people may find that mindfulness or too much mindfulness may worsen their symptoms (6), so you should check with your mental health professional if MBSR is appropriate for you.
  • Some mental health conditions may not be appropriate for MBSR, check with your mental health professional.

Want to learn more about meditation?

If you would like to be notified about future posts on strategies to improve your mental health, enter your email above.

By R. Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. Poissant, H., Mendrek, A., Talbot, N., Khoury, B., & Nolan, J. (2019). Behavioral and Cognitive Impacts of Mindfulness-Based Interventions on Adults with Attention-Deficit Hyperactivity Disorder: A Systematic Review. Behavioural neurology, 2019, 5682050. doi:10.1155/2019/5682050
  2. Goyal M, Singh S, Sibinga EMS, et al. Meditation Programs for Psychological Stress and Well-Being [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2014 Jan. (Comparative Effectiveness Reviews, No. 124.)Available from: https://www.ncbi.nlm.nih.gov/books/NBK180102/
  3. Montero-Marin, J., Garcia-Campayo, J., Pérez-Yus, M., Zabaleta-del-Olmo, E., & Cuijpers, P. (n.d.). Meditation techniques v. relaxation therapies when treating anxiety: A meta-analytic review. Psychological Medicine,1-16. doi:10.1017/S0033291719001600
  4. Hoge, Elizabeth A et al. “Mindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults With Anxiety Disorders: A Randomized Clinical Trial.” JAMA psychiatry, e223679. 9 Nov. 2022, doi:10.1001/jamapsychiatry.2022.3679
  5. Santorelli  SF, Kabat-Zinn  J, Blacker  M, Meleo-Meyer  F, Koerbel  L. Mindfulness-Based Stress Reduction (MBSR) Authorized Curriculum Guide. Center for Mindfulness in Medicine, Health Care, and Society at the University of Massachusetts Medical School. Revised 2017. Accessed December 14, 2017. https://www.bangor.ac.uk/mindfulness/documents/mbsr-curriculum-guide-2017.pdf
  6. Britton, W. B., Lindahl, J. R., Cooper, D. J., Canby, N. K., & Palitsky, R. (2021). Defining and Measuring Meditation-Related Adverse Effects in Mindfulness-Based Programs. Clinical Psychological Science, 9(6), 1185–1204. https://doi.org/10.1177/2167702621996340