The following post appeared on the DCoE blog on March 29, 2013.
By Dr. James Bender
U.S. Army photo by Sgt. Jennifer Spradlin
If you keep up with the DCoE Blog or national news, it’s likely you’ve heard of posttraumatic stress disorder (PTSD), an anxiety disorder that some people develop after being exposed to a traumatic experience, like combat. If so, you might be wondering what treatments are available.
While evidenced-based treatments such as prolonged exposure and cognitive processing therapy have been successful in many patients with PTSD, the scientific community continues to research other helpful treatments. The Departments of Defense and Veterans Affairs, hospitals and universities are among those investigating options ranging from injections to reduce PTSD symptoms to smartphone apps developed to support those in psychological treatment.
Determining if a treatment works, however, can be tricky. You need multiple studies of hundreds of people, and you have to consider that many factors may obscure results (some people improve without treatment; some treatments work better with people of a certain age or gender, etc.). It takes time and effort to sort all this out and confirm that the treatment works.
Despite these challenges and the complexity of PTSD, there are promising new therapies being studied. Here are four:
Virtual Reality Iraq/Afghanistan
Virtual reality is a technology being used to address PTSD in returning service members and veterans and one place it’s being studied is at the Naval Medical Center-San Diego. Patients are equipped with a head-mounted visual display and exposed to a virtual world in which they experience the sights, sounds and even smells of combat in order to confront their trauma in a safe and controlled environment. By gradually exposing the patient to memories of the traumatic event, they’re able to deal with emotions that the memories bring up. A 2009 study by the center and researchers at the University of Southern California and Emory University, found that virtual reality technology yielded an 80 percent success rate in treating combat-related PTSD.
Yoga Intervention for PTSD
A 10-week yoga program funded by the U.S. Army included twice-weekly yoga interventions with an assigned daily home practice. This particular program was built on considerable evidence that yoga, which focuses on calming sympathetic nervous system (SNS) activity, can be effective for PTSD. The SNS activates when someone is very stressed or fearful and is responsible for associated physical responses (increased heart rate, tense muscles, stomach churning, etc.). People with PTSD have trouble regulating these responses and yoga helps them to regain control. The yoga program was found to be as effective as medication in treating PTSD.
Stellate Ganglion Block
In this potential treatment, an anesthetic is administered through the neck into a collection of nerves called the stellate ganglion. These nerves are connected to the amygdala, the “fear center” of the brain, which becomes very active in many people with PTSD. The shot calms down the amygdala and other brain areas responsible for the feelings of anger and high anxiety that are core symptoms of PTSD. A small study published in 2012 of nine military patients found that seven of them saw significant reduction in PTSD symptoms after receiving the injection. There have been a few other small studies showing similar results.
Fishing Therapy
In other places, some veterans are taking up fishing to ease the symptoms of PTSD. Piscatorial therapy, meaning “related to fishing,” suggests there are health benefits to fishing. Further research is needed, but findings from the University of Southern Maine, University of Utah and the Salt Lake City Veterans Affairs medical center showed significant improvement in perceptual stress, PTSD symptoms and sleep quality for veterans who took part in a two-day, three-night residential fly fishing retreat.
Check out the National Center for PTSD website for more information and resources. You can also request information related to PTSD or psychological health from the DCoE Outreach Center 24/7 at 866-966-1020 or resources@dcoeoutreach.org. If you think you might have PTSD, I encourage you to get checked out — contact your medical provider — or look into these resources for psychological health care.
Dr. James Bender is a former Army psychologist who deployed to Iraq as the brigade psychologist for the 1st Cavalry Division 4th Brigade Combat Team out at Fort Hood, Texas. During his deployment he travelled through Southern Iraq, from Basra to Baghdad. he writes a monthly post for the DCoE Blog on psychological health concerns related to deployment and being in the military.
