Post Traumatic Stress Disorder (PTSD) - Yoga can help – Scientific studies reveal

The PTSD Epidemic

On 19 June 2016 there was report on ABC (Australia) on how a group of military veterans are using Yoga to manage PTSD [1]. A former soldier who suffers from PTSD started using Yoga as a coping mechanism and now offers Yoga classes to others. At any given time, 1.4 million Australians (6.4 % of the total population) suffer from PTSD, according to the Bureau of Statistics. Quite often the condition is not properly diagnosed and the families suffer terribly. It is estimated that approximately 8.3% of the Australian Defence Force personnel have experienced PTSD. It is a serious problem that needs to be addressed. 

Systematic research based evidence is accumulating to support the view that Yoga can be an effective adjunctive or an alternative intervention to PTSD. In this blog the core idea of using Yoga for PTSD is summarised.

Yoga is ideally suited to help PTSD patients

Extreme trauma, caused by events such as sexual abuse, domestic violence, extreme physical stress, systemic discrimination such as racism, is often followed by dysfunction in stress response and emotion regulation, leading to PTSD. The common symptoms of PTSD include, amongst other things, muscle tightness, rapid heartbeat, difficulty in breathing, chronic pain, mood swings, rapid thoughts, hyper arousal, substance abuse, gambling addiction, inability to relax, low self-esteem and a belief that they are not in control of themselves.  Traumatic memories are often stored in the body (somatic) [11]. In Yoga it is understood that one of the effective ways to the mind is through the body. PTSD is a mind-body disorder and as Yoga is essentially an endeavour to create mind-body-breath harmony, it is ideally suited to help PTSD sufferers.  The traditional therapy for PTSD involves top-down approach promoted from outside, while Yoga approach is bottom up, utilising body and breath experience to influence the mind using self-discovery.

It is claimed, based on scientific research, that just one hour of Yoga, two to three times a week can improve one’s mood and health. Here Yoga includes all branches of Yoga, such as pranayama (breathing techniques), meditation and hatha Yoga [3].  Innes, Bourguignon and Taylor (2005) [6] have reviewed studies conducted between 1970 and 2005 on the effects of Yoga on cardio-vascular disease and they found that eighty-five percent of the studies demonstrated that Yoga reduces sympathetic activation (fight or flight response) and increases parasympathetic activation (nourishing and calming response).

Yoga techniques need to be tailored for PTSD patients

The popular types of Yoga such as power Yoga, hot Yoga, yoga at gyms and even Iyengar Yoga, which insists on highly regimented asanas, are not suitable. The emphasis is on being gentle, empowering and, promoting self-acceptance and self-esteem.  Different protocols on developing Yoga approaches for helping PTSD patients are currently available. For example Emerson, 2015, [5] describes “Trauma Sensitive Yoga”, which includes hatha Yoga, breathing techniques that are gentle, sensitive and empowering to trauma patients.   Jindani et.al.,2015, [7] from the Center for Addiction and Mental Health, Toronto, have demonstrated using a randomised trial that Kundalini Yoga helped PTSD sufferers improve significantly the measures such as sleep, stress, anxiety and resilience.  Shannahoff-Khalsa, 2004 [10] has presented Kundalini Meditation specific for the treatment of psychic disorders.  Kirlin, 2010, [8] has documented that Yoga helped Latina Women in coping with PTSD.

In a pilot study conducted by Nassif et.al. (2014) [9] demonstrated that iRest ® protocol ( a form of Yoga Nidra) clearly helps with the self-managing of chronic pains. In this study the self-management skill is developed through empowerment by acquiring cognitive, behavioural and emotional skills.

Although the above studies have consistently demonstrated the effectiveness of Yoga in helping PTSD patients more definitive studies involving larger samples are needed. Meanwhile, the Yoga community can play a significant role in developing Yoga sets and protocols that are beneficial to PTSD patients in collaboration with the clinical psychology/medical communities. Recognition of these latest research findings by the health departments, various government bodies and health-funds will assist the cause of PTSD patients, and help the communities emotionally and financially.

Further Reading

[1] http://www.abc.net.au/news/2016-06-19/military-veterans-turn-to-Yoga-class-brisbane-run-to-ease-ptsd/7466410

[2] https://www.irest.us/research  on iRest Yoga Nidra  research program and publications

[3] http://harvardguidetoYoga.com/

[4] https://www.irest.us/sites/default/files/Yoganidra%20Birch%20and%20Hargreaves.pdf   on historical perspective on Yoga Nidra

[5] Emerson, D. and Hopper, E., 2015, Overcoming Trauma through Yoga: Reclaiming Your Body . North Atlantic Books. Kindle Edition.

[6] Innes, K.E., Bourguignon, C., Taylor, A.G.,2005, Risk indices associated with the insulin resistance syndrome, cardiovascular disease, and possible protection with Yoga: A systematic review. Journal of the American Board of Family Practice, 18, 491-519

[7] Jindani, F., Turner N. and Khalsa, S.B.S., 2015, A Yoga Intervention for Posttraumatic Stress:A Preliminary Randomized Control Trial, Evidence-Based Complementary and Alternative Medicine, v.2015, Article ID 351746.

[8] Kirlin, M.,2010, Yoga as an Adjunctive Treatment for PTSD in Latina Women: A Review of the Evidence and Recommendations for Implementation (Master's thesis, Pacific University). Retrieved from: http://commons.pacificu.edu/spp/133

[9] Nassif, TH, Norris, DO, Soltes, KL, Sandbrink, F. Blackman, MR, Chapman, JC. 2014. Using Mindfulness Meditation to Improve Pain Management in Combat Veterans with Traumatic Brain Injury.Society of Behavioral Medicine Annual Meeting. (available at https://www.irest.us/sites/default/files/SBM%20Poster%20Final%20Nassif.pdf)

[10] Shannahoff-Khalsa, D.,2004, An introduction to Kundalini Yoga Meditation techniques that are specific for the treatment of Psychic Disorders, The J. of Alternative and Complementary Medicine,10 (1) pp.91-101.

[11] van der Kolk, B. A. 1994, The Body Keeps the Score,” Harvard Review of Psychiatry 1 (1994): 253– 265