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Yoga and Mindfulness for Posttraumatic Stress Disorder (PTSD) in Veterans

RESEARCH

A randomized, clinical trial1published in JAMA in 2015 compared the efficacy of mindfulness- based stress reduction (MBSR) with that of present-centered group therapy (PGCT) for the treatment of PTSD in veterans. The researchers recruited 116 veterans with PTSD; half of the participants received nine sessions (8 weekly 2.5-hour group sessions and a day-long retreat) of MBSR, which focused on teaching participants be mindful of the present moment in a nonjudgmental, accepting manner. The other half of participants attended PCGT, an active- control condition consisting of nine weekly 1.5-hour group sessions focused on dealing with current life problems. After nine weeks, both interventions resulted in improvement in self-reported PTSD symptom severity. However, participants who attended the MBSR sessions saw a 20-percent greater improvement in symptom severity than those who attended group therapy.

A small study2 published in May of 2018 in the journal Military Medicine assessed the efficacy of military-tailored yoga for veterans with diagnostic-level PTSD. Researchers recruited 18 veterans of post-9/11 conflicts to complete a six-week program consisting of one hour-long yoga session each week. The yoga classes were taught by a certified yoga instructor who was also a veteran. Additionally, each class was developed using a trauma-sensitive, military- culture–informed approach approved by two separate veteran advocacy organizations. Elements of trauma-sensitive yoga include no hands-on adjustment of the postures during the classes, avoidance of potentially vulnerable yoga positions, such as “happy baby,” using the English-language name for each yoga pose instead of the Sanskrit name, and allowing participants to keep their eyes open for the duration of the class. This intervention resulted in a decrease in PTSD symptoms, insomnia, depression, and anxiety.

RESOURCES

The United States Department of Veterans Affairs (VA) has developed a mobile app to help veterans and service members learn how to practice mindfulness. The app, called Mindfulness Coach, provides a gradual, self-guided training program designed to help veterans understand and adopt a simple mindfulness practice. Mindfulness Coach also offers a library of information about mindfulness, 12 audio- guided mindfulness exercises, and a catalog of additional exercises available for free download. The app can be downloaded for free in the Apple app store and on Google Play.

Disclaimer: While research on yoga and mindfulness techniques for PTSD has produced promising results and is endorsed by the VA
to improve veteran quality of life, it is still considered a complementary treatment to

be used under the guidance of a healthcare professional. Discuss your options with your healthcare provider if you plan to begin a yoga or mindfulness program while managing PTSD, anxiety, depression, or a physical injury.3

SOURCES

  1. Polusny MA, Erbes CR, Thuras P, et al. Mindfulness-based stress reduction for posttraumatic stress disorder among veterans: a randomized clinical trial. JAMA. 2015;314(5):456–465.
  2. Cushing RE, Braun KL, Alden C-Iayt SW, Katz AR. Military-tailored yoga for veterans with post-traumatic stress disorder. Mil Med. 2018;183(5-6):e223-e231.
  3. The United States Department for Veterans Affairs. Whole health
    for life: introduction to mindful awareness. https://www.va.gov/ PATIENTCENTEREDCARE/Veteran-Handouts/Introduction_to_ Mindful_Awareness.asp. Updated 3 Oct 2018. Accessed 28 Feb2019.

NHR

PTSD Resources

AMERICAN PSYCHIATRIC ASSOCIATION. Help With Posttraumatic Stress Disorder (PTSD). Information on diagnosis and treatment of PTSD, upcoming events related to PTSD, FAQs, resources for people with PTSD and their families dealing with PTSD, and more. www.psychiatry.org/patients-families/ptsd

AMERICAN PSYCHOLOGICAL ASSOCIATION. Clinical Practice Guidelines for the Treatment of Posttraumatic Stress Disorder.Recommended interventions based on scientific evidence for the treatment of PTSD in adults, weighing benefits and harms of interventions, consideration of what is known about patient values and preferences, and consideration of the applicability of evidence across demographic groups and settings. www.apa.org/ptsd-guideline/

BRAINLINE.ORG SITE. All about brain injury and PTSD. Provides information on PTSD specifically as it relates to traumatic brain injury, including social, occupational, and medical issues. www.brainline.org/article/understanding-ptsd-treatment

NATIONAL ALLIANCE ON MENTAL HEALTH (NAMI). Posttraumatic Stress Disorder. Provides information on PTSD treatment options, support groups, and discussion forums. www.nami.org/Learn-More/Mental-Health-Conditions/Posttraumatic-Stress-Disorder/Overview

UNITED STATES DEPARTMENT OF VETERANS AFFAIRS. National Center for PTSD — www.ptsd.va.gov. Offers information and resources for individuals with PTSD, their families, and their healthcare providers, including (but not limited to) the following:

  • Understanding PTSD and PTSD Treatment. Consumer-oriented guide describing PTSD signs, symptoms, and treatment options in an easy-to-read format. www.ptsd.va.gov/publications/print/understandingptsd_booklet.pdf
  • Mobile apps. Offers access to various mobile apps designed to provide self-help, education, and support following trauma for patients, as well as treatment companion apps to use with their healthcare providers. www.ptsd.va.gov/appvid/mobile/
  • Videos. Offers educational videos for patients and healthcare providers regarding PTSD symptoms, how it relates to brain functioning, and treatment options. www.ptsd.va.gov/appvid/video/
  • PTSD Treatment Decision Aid. Provides information on PTSD treatment options to help individuals with PTSD decide which therapy to use for treatment of their symptoms. Videos of providers explain how various treatments work. The individual can build a personalized comparison chart of the various treatments, which can be printed off and shared with his or her physician. www.ptsd.va.gov/apps/decisionaid/
  • PTSD Treatment Programs Locator. Online service locator allows users to search for PTSD treatment programs by state and specialization (e.g., inpatient, outpatient, treatment for women, evaluation, etc). www.va.gov/directory/guide/PTSD

WOUNDED WARRIER PROJECT. Heal your mental wounds: help for combat stress, PTSD
and TBI
. Offers educational resources and outdoor rehabilitation workshops for veterans and service members with combat stress, PTSD, or traumatic brain injury incurred while serving the USmilitary on or after Sep 11, 2001.
www.woundedwarriorproject. org/programs/combat-stress-recovery-program NHR

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