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Wednesday, 11 August 2021

Ayurvedic Treatment for Post-traumatic Stress Disorder -PTSD

Post-traumatic stress disorder (PTSD) is a mental state caused by a terrifying event. It can be developed either by experiencing it or witnessing it. It can have a significant impact on the person’s day-to-day life. In most cases, the symptoms develop during the first month after a traumatic incident. But in a minority of cases, there may be a delay of months or even years before symptoms manifest.  They manifest variedly like flashbacks, nightmares and severe anxiety, along with uncontrollable thoughts about the event.

Most people will have temporary difficulty after a traumatic incident, but with time, they usually get better. If the symptoms get worse, last for an abnormally long time, and cause disturbances in daily life, PTSD should be considered.

Getting effective treatment is very crucial in PTSD to reduce symptoms and improve function.

Signs and symptoms

Re-experiencing

Re-experiencing is the most important sign when the patient involuntarily and vividly reliving the traumatic event in the form of:

flashbacks

nightmares

repetitive and distressing images or sensations

physical sensations, such as pain, sweating, feeling sick or trembling

Avoidance and emotional numbing

Trying to avoid being reminded of the traumatic event is a part of PTSD. This usually means avoiding certain people or places that remind the patient of the trauma. They usually avoid talking to anyone about the experience. Many people try to distract themselves voluntarily with hobbies and other activities. Others try not to feel anything at all. This is called emotional numbing. This can cause isolation and withdrawal, may lead to depression.

Hyperarousal

PTSD patients are always anxious and they find it difficult to relax. They are more alert always and easily startled. This state of mind is called hyperarousal. It often leads to:

  • irritability
  • angry outbursts
  • sleeping problems like insomnia
  • difficulty in concentrating

Other problems

Many people with PTSD also have several other problems, including:

  • other mental health problems, such as depression, anxiety or phobias
  • self-harming or destructive behaviour, such as drug misuse or alcohol misuse
  • other physical symptoms, such as headaches, dizziness, chest pains and stomach aches

PTSD sometimes leads to work-related problems and the breakdown of relationships.

Causes

Post-traumatic stress disorder (PTSD) can be manifested after a single event that is very stressful, frightening or distressing. It can also develop after a prolonged traumatic experience. Types of events that can lead to PTSD include:

  • serious accidents
  • physical or sexual assault
  • abuse, including childhood or domestic abuse
  • exposure to traumatic events at work, including remote exposure
  • serious health problems, such as being admitted to intensive care
  • childbirth experiences, such as losing a baby
  • war and conflict
  • torture

PTSD is present in almost roughly about 33% of people who experience severe trauma.

Pathophysiology

The exact pathophysiology of PTSD is not known, but many possible reasons have been suggested.

Survival mechanism

It is an instinctive mechanism to help the person survive further traumatic experiences.  The alertness of hyperarousal can be helpful to react quickly in another crisis. But they kill the present and reality because the person cannot process and move on from the traumatic experience.

High adrenaline levels

Abnormal levels of stress hormones are found in people with PTSD. This “fight or flight” reaction, helps to deaden the senses and dull pain in danger. People with PTSD continue to produce high amounts of fight or flight hormones even when there’s no danger.

Changes in the brain

In people with PTSD, changes in the brain are found, such as the hippocampus appears smaller in size. It may be related to fear and anxiety, memory problems and flashbacks. The malfunctioning hippocampus may prevent flashbacks and nightmares from being properly processed, so the anxiety continues for a long.

Diagnosis

Physical examination

Psychological evaluation

Treatments

Psychological therapies

Cognitive behavioural therapy (CBT), especially Trauma-focused CBT

Eye movement desensitisation and reprocessing (EMDR)

Group therapy and counselling sessions

Medication

Antidepressants, such as paroxetine, sertraline, mirtazapine, amitriptyline or phenelzine

Prognosis

Usually, people with PTSD get better within a few weeks without treatment. It’s also possible for PTSD to be successfully treated many years after the traumatic event or events occurred.

Complications

Complex PTSD:

  • feelings of shame or guilt
  • difficulty controlling emotions
  • periods of losing attention and concentration (dissociation)
  • physical symptoms, such as headaches, dizziness, chest pains and stomach aches
  • self-created isolation from friends and family
  • relationship problems
  • destructive or risky behaviour, such as self-harm, alcohol misuse or drug abuse
  • suicidal thoughts

Ayurvedic Concept of Post-traumatic Stress Disorder -PTSD

All problems related to the mind are attributed with the name manoroga or unmada in Ayurveda. As the thridoshas cause the diseases of both body and mind, manorogas also come under the doshic vitiation. Other than very important bodily functions, Vaata controls the mind & thoughts too. PTSD happens when there is Vaatakopa due to fear or shock, which deviates mental stability. It is seen mostly in Vaata prakruti people who are highly unstable.

Ayurvedic Nidana of Post-traumatic Stress Disorder -PTSD

Physical

Dry, cold and old food items

Excess travelling & exertion

Trauma/injury

Exposure to wind

Loss of sleep

Psychological

            Trauma (physical or emotional)

grief

            Fear

            Anxiety

            Stress

Ayurvedic Purvaaroopa of Post-traumatic Stress Disorder -PTSD

Not mentioned

Ayurvedic Samprapti of Post-traumatic Stress Disorder -PTSD

Due to the causative factors, Vaatadosha vitiates and move irregularly all over the body and cause an imbalance in circulation & metabolism. Afterwards, it enters the manovahasrotas and causes the development of disease in the mind.

Ayurvedic Lakshana of Post-traumatic Stress Disorder -PTSD

Delusions

Instability in thoughts & opinions

            Fear

Lack of confidence

Insomnia or disturbed sleep

And other disorders of mind and body

Ayurvedic Divisions of Post-traumatic Stress Disorder -PTSD

        Not mentioned

Ayurvedic Prognosis of Post-traumatic Stress Disorder -PTSD

        Yaapya

Ayurvedic Chikithsa of Post-traumatic Stress Disorder -PTSD

        Ayurvedic treatment of mental disorders are divided into three compartments, Yuktivyapasraya (medicines etc), daivavyapasraya (religious offerings, worship etc.) and sattwavajaya (techniques to strengthen the mind). When all these are done together, the person feels better.

Samana

Abhyangam

Moordhapichu

Brumhanam

Sodhana

Snehapanam

Swedanam

Snehavasti

Kashayavasti

Commonly used Ayurvedic medicines for Post-traumatic Stress Disorder -PTSD

                Mridweekadi kashayam

                        Brahmeedrakshadi kashayam

                        Drakshadi kashayam

                        Brahmarasayanam

                        Chyavanaprasam

                        Kallyanakaghrutam

                        Saaraswataghrutam

Brands available

AVS Kottakal

AVP Coimbatore

Vaidyaratnam oushadhasala

SNA oushadhasala

Home remedies for Post-traumatic Stress Disorder -PTSD

        Practising meditation and auto-suggestion techniques at home           

Diet for Post-traumatic Stress Disorder -PTSD

  • To be avoided

Heavy meals and difficult to digest foods – cause indigestion.

Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine

Carbonated drinks – makes the stomach more acidic and disturbed digestion

Refrigerated and frozen foods – causes weak and sluggish digestion by weakening agni (digestive fire)

Curd – causes vidaaha and thereby many other diseases

  • To be added

Light meals and easily digestible foods

Green gram, soups, buttermilk boiled with turmeric, ginger and curry leaves

Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc

Behaviour:

Better to avoid exposure to excessive sunlight wind rain or dust.

Avoid a sedentary lifestyle. Be active.

Maintain a regular food and sleep schedule.

Avoid bath in cold water immediately after exercise. Allow the body to be at normal temperature.

Yoga for Post-traumatic Stress Disorder -PTSD

Stretching exercises, meditation for relaxation and following a specific Yogacharya with yoga asanas like suryanamaskara, pavanamuktasana, vajrasana, etc are recommended for improving circulation and digestion.

Regular exercise helps improve the bioavailability of the medicine and food ingested and leads to positive health.

Yoga can maintain harmony within and with surroundings.

Suryanamaskara

Pavanamuktasana

Vajrasana

All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.

Research articles of Post-traumatic Stress Disorder -PTSD

  • PMID: 30529244

Objective: A substantial amount of individuals with substance use disorders (SUD) also meet criteria for posttraumatic stress disorder (PTSD). Prolonged Exposure (PE) is an effective, evidence-based treatment for PTSD, but there is limited data on its use among individuals with current alcohol or drug use disorders. This study evaluated the efficacy of an integrated treatment that incorporates PE (Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure or COPE) among veterans.

Method: Military veterans (N = 81, 90.1% male) with current SUD and PTSD were randomized to 12 sessions of COPE or Relapse Prevention (RP). Primary outcomes included the Clinician-Administered PTSD Scale (CAPS), PTSD Checklist-Military version (PCL-M), and the Timeline Follow-back (TLFB).

Results: On average, participants attended 8 out of 12 sessions and there were no group differences in retention. Intent-to-treat analyses revealed that COPE, in comparison to RP, resulted in significantly greater reductions in CAPS (d = 1.4, p < .001) and PCL-M scores (d = 1.3, p = .01), as well as higher rates of PTSD diagnostic remission (OR = 5.3, p < .01). Both groups evidenced significant and comparable reductions in SUD severity during treatment. At 6-months follow-up, participants in COPE evidenced significantly fewer drinks per drinking day than participants in RP (p = .05).

Conclusions: This study is the first to report on the use of an integrated, exposure-based treatment for co-occurring SUD and PTSD in a veteran sample. The findings demonstrate that integrated, exposure-based treatments are feasible and effective for military veterans with SUD and PTSD. Implications for clinical practice are discussed.

  • PMID: 29893182

In the present study, we explored the influence on symptoms of PTSD among Iranian veterans of the Iran-Iraq war of mindfulness-based cognitive therapy (MBCT) as an add-on to standard treatment with citalopram. Forty-eight male veterans with PTSD (mean age: 52.97 years) took part in this eight-week intervention study. Standard treatment for all patients consisted of citalopram (30-50 mg/day at therapeutic dosages). Patients were randomly assigned either to the treatment or to the control condition. Treatment involved MBCT delivered in group sessions once a week. Patients in the control condition met at the hospital with the same frequency and duration for socio-therapeutic events. At baseline and study completion, patients completed questionnaires covering symptoms of PTSD, depression, anxiety, and stress. At study completion after eight weeks, scores for PTSD (re-experiencing events, avoidance, negative mood and cognition, hyperarousal), depression, anxiety, and stress were lower, but more so in the intervention than in the control group. Data suggest that, as an adjuvant to standard SSRI medication, MBCT is an effective intervention to significantly reduce symptoms of PTSD, depression, anxiety, and stress among veterans.

*These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake. All the Ayurveda Supplements mentioned here are in the Indian Market with GMP Certification from India

Writer:
Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.

Dr. Nair offers consultation at two busy clinics in and around Haripad, Alleppey, Kerala, the southern state famous worldwide for authentic ayurvedic treatment and physicians. While offering consultation on all aspects of ayurvedic treatments Dr. Nair has a special interest in Panchkarma, Yoga, and Massage.

Through Ayurvedaforall Dr. Nair offers online consultation to patients worldwide and has served hundreds of patients over the last 20 years. In addition to his Ayurvedic practice, he is the chief editor of ayurveda-amai.org, the online portal of Ayurveda Medical Association of India, and the state committee member of Ayurveda Medical Association of India.

Dr. Nair is a regular speaker at Ayurveda-related conferences and has visited Germany to propagate Ayurveda. You can write directly to him-
rajesh@ayurvedaforall.com

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source https://ayurvedapc.blog/2021/08/12/ayurvedic-treatment-for-post-traumatic-stress-disorder-ptsd/

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