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Ptsd and mindfulness


The Science of How Mindfulness Relieves Post Traumatic Stress

Pain, loss and traumatic events are part of the human experience, yet most of us don’t talk about that part of our lives. According to a Health Care Policy report from Harvard Medical School, approximately 60% of North Americans experience at least one traumatic event in their lifetime. Some of these individuals may go on to develop post-traumatic stress disorder (PTSD), a condition marked by intense, disturbing thoughts and feelings related to a traumatic experience that last long after the traumatic event has ended. A recent review of the research finds that mindfulness-based programs such as Mindfulness-based Stress Reduction (MBSR) may provide relief from post-traumatic symptoms such as anxiety, sleep disturbance, and difficulty concentrating.

Understanding Post-Traumatic Stress Disorder (PTSD)


Post-traumatic stress and PTSD may occur after experiencing or witnessing a shocking or dangerous event. During the event, fear triggers a cascade of hormones like cortisol and adrenaline that flood the nervous system and mobilize the body’s defenses. Once the threat subsides, the nervous system usually “resets,” initiating the healing and recovery process. 

In some cases, or when stress is chronic, the system does not reset, and the physical and psychological effects of acute or prolonged stress manifest as symptoms of traumatic stress. Not everyone who survives a trauma develops PTSD, and not everyone with PTSD has experienced or observed a life-threatening event. Sudden, unexpected death or loss, or persistent environmental threat can also lead to a person developing post-traumatic stress symptoms. 

It is important to note that post-traumatic stress symptoms are not, in and of themselves, pathological. They represent the mind and body’s natural process of recovery following severe, often painful life experiences. Often more chronic and extremely traumatic events require longer periods of healing and repair.

As resilience builds, symptoms often lessen and eventually subside altogether. For some, however, post-traumatic symptoms can be accompanied by significant depression, anxiety, panic, and thoughts of suicide. In these cases, evidence-based treatment approaches under the care of a medical professional may be necessary to help alleviate the impacts of trauma. 

The Symptoms of PTSD


Although there are many causes of trauma, people with PTSD have a great deal in common. According to non-profit Anxiety and Depression Association of America, PTSD is characterized by three primary symptoms: 

  1. Repeating or reimagining the experience — Most have intrusive memories or bad dreams that occur in combination with physical symptoms like a racing heart and shortness of breath. 
  2. Avoidance— Individuals also tend to avoid objects, places, or events that trigger recollection of the initial experience, and learn to numb physical and emotional sensations when under duress.  
  3. Hyperactivity — The combination of unresolved nervous system hyperactivity and emotional distress can result in tension, anger, irritability, a tendency to startle easily, or difficulties coping with life events. This is often accompanied by difficulties sleeping, eating, and concentrating, and a tendency toward sadness, depression, social isolation, guilt, and a lack of trust in others and the world. 

How Traumatic Stress Affects the Brain


Acute and persistent traumas are also known to impact the structure and function of the brain and nervous system. Human and animal studies find that traumatic stress is associated with decreased volume in the hippocampus, anterior cingulate cortex, and left amygdala; brain regions that are highly sensitive to environmental threat. 

The hippocampus, part of the brain’s emotion processing center (limbic system), plays an important role in learning, memory, and emotion processing. It is particularly vulnerable to stress, and tends to be smaller in volume in those with PTSD.

The anterior cingulate links the limbic system to the prefrontal cortex—often referred to as the brain’s “thinking center.” It plays an important role in emotional regulation and cognitive flexibility. 

All told, these brain signaling anomalies may be related to greater difficulty regulating and coping with negative thoughts, feelings, and memories — a hallmark of post-traumatic stress.

The amygdala, another hub for cognitive and emotional processing, has also been found to be smaller in those with a history of trauma, although there doesn’t appear to be a connection between the size of the amygdala and the severity of PTSD symptoms. Researchers do believe that decreased regulation of the amygdala may be associated with an increased risk of developing post-traumatic symptoms or a diagnosis of PTSD. 

All told, these brain signaling anomalies may be related to greater difficulty regulating and coping with negative thoughts, feelings, and memories — a hallmark of post-traumatic stress.

But traumatic stress is not inevitable. For some, social support such as friends, family, or a support group, and a nervous system that is able to reset after a highly stressful event can reduce the odds of developing PTSD. For those with repeated exposure to extreme stressors, a history of adverse childhood events, a lack of social support, a history of psychological problems, or prolonged or chronic environmental threat, treatment is often a viable option to move from trauma to wellbeing. 

The Impact of Mindfulness-Based Treatment on PTSD


Historically, cognitive forms of psychotherapy with or without medication were the first line of treatment for PTSD. But many with PTSD avoid therapy due to social stigma, cost, guilt, shame, or an inability to seek help. In response to the need for alternative forms of treatment, more providers and trauma sufferers are turning to mindfulness-based interventions.

There is some debate among professionals as to whether mindfulness-based interventions for PTSD are effective. Some suggest that an increase in mindfulness may help individuals to better cope with intrusive thoughts and memories, and be more equipped to handle emotional distress. Correlational studies, which examine the relationship between two or more factors, show that higher levels of dispositional mindfulness are associated with fewer concurrent PTSD symptoms in survivors of natural disasters, victims of sexual abuse or assault, and firefighters.

Others suggest that mindfulness-based practices like meditation may cause considerable distress for some practitioners. For example, in a study of 60, adult meditators (43% female) and 32 meditation experts (25% female), 88% of participants reported “challenging or difficult meditation experiences [that] bled over into daily life…” that ranged from a few days to more than 10 years.

We have yet to understand what types of practices may, or may not exacerbate symptoms in those with a history of traumatic exposure. In addition, there are a number of well-researched conventional approaches such as cognitive therapy, eye movement desensitization and reprocessing (EMDR), and medications shown to reduce PTSD symptoms. There is some skepticism as to whether mindfulness alternatives are appropriate first-line therapies for PTSD. 

Do Mindfulness-Based Therapies Reduce Trauma Symptoms?


A meta-analysis of 18 studies compared the effects of mindfulness-based interventions to those of a randomized control group in reducing the psychological symptoms of traumatic stress and PTSD. This study included data on 1,219 participants. Researchers found that individuals who participated in the mindfulness-based interventions demonstrated significantly lower levels of PTSD symptoms following treatment than various control group members.

They also found that the longer the mindfulness intervention, the greater the reduction in traumatic stress symptoms. Additionally, individuals who received mindfulness-based interventions reported higher levels of mindfulness at the end of treatment compared to control group members.

Researchers found that individuals who participated in the mindfulness-based interventions demonstrated significantly lower levels of PTSD symptoms following treatment than various control group members.

The review also uncovered some important caveats. Among them was the discovery that increased mindfulness following an intervention was not linked to fewer PTSD symptoms after treatment. Although this finding may have been the result of methodological problems in the research, it appears that becoming more mindful does not necessarily translate to experiencing less traumatic stress. 

The severity of PTSD symptoms at the onset of an intervention was also not related to changes in mindfulness or a reduction of symptoms following treatment. Those with and without a PTSD diagnosis responded similarly to mindfulness-based therapies.

Finally, although researchers anticipated that trauma-specific mindfulness-based interventions would outperform traditional programs like mindfulness-based stress reduction (MBSR), results from these programs have been found to be comparable, suggesting that mindfulness training on its own may be impactful.

Although these findings are encouraging, the review’s authors note of a potential source of bias known as the file drawer problem: the possible over-inflation of positive results that may occur when only studies with positive or significant statistical effects are published. It is important to not overlook the possibility that studies with negative outcomes are underreported or tossed out altogether.

Indeed, in recent years, contemplative scientists have called into question whether the negative or harmful effects of meditation have been suppressed in the research literature. This is of particular importance when considering the use of mindfulness-based therapies with those with a trauma history, for whom meditation and contemplation may exacerbate an already unstable nervous system. This thorny dilemma will require additional, high-quality studies to be resolved.

How Mindfulness-Based Therapies May Change Brain Structure


Brain imaging studies provide another promising research avenue that may inform our understanding of how mindfulness-based therapies aid in trauma recovery. In one study, 23 male Iraq and Afghanistan combat veterans were randomly assigned to either a Mindfulness-Based Exposure Therapy (MBET) group, which combines mindfulness with traditional exposure therapy, or a present-centered group therapy (PCGT), which encourages acceptance of thoughts and emotions as they occur in the present moment.

Functional magnetic resonance imaging (fMRI) brain scans performed before and after treatment showed that those receiving MBET had significantly more connections between the default mode network (DMN), which is associated with mind wandering and rumination, and the dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC).

This implies that mindfulness training may enable those experiencing post-traumatic stress to be better able to inhibit or reduce the pernicious cycle of negative thoughts, feelings, and memories that accompany traumatic stress. MBET group participants also had fewer symptoms of post-traumatic stress, however, their symptom reduction was not significantly different from those in the PCGT group.

Findings from this study of veterans with PTSD parallel those conducted with adults without PTSD in which meditation has been found to benefit physical and mental health and change the structure and function of the DMN, amygdala, and hippocampus, affecting our impulses and decision-making.

Although many questions remain unanswered, including whether or not these brain changes translate to greater health, happiness, and well-being, they suggest that mindfulness may be beneficial for healing from adversity.

Mindfulness-based treatments for posttraumatic stress disorder: a review of the treatment literature and neurobiological evidence

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ᐈ PTSD Diagnosis ~【Post Traumatic Stress Disorder】

Post-traumatic stress disorder, or PTSD, is a severe mental condition that progresses as a result of a single or recurring event that has a negative impact on a person's mental health. Symptoms of PTSD can appear immediately or several months after the injury.

The likelihood of developing post-traumatic stress disorder is the same for patients of different age groups. The main risk factor is the severity of the injury, the initial state of the psyche, psychological and biological predisposition.

Classification

In the modern classification, 4 types of post-traumatic syndrome are distinguished:

Acute.
Appears in the first days after a stressful situation. Symptoms appear very brightly within 2-3 months.

Chronic.
Characterized by a gradual increase in signs of pathology, exhaustion of the nervous system, changes in character and interests.

Deformation.
Manifested in patients with a long-term chronic mental disorder. Progress leads to the formation of phobias, neuroses, feelings of anxiety.

Delayed.
The clinical picture becomes apparent 3-6 months after the injury. Various external stimuli can provoke the progress of PTSD.

There are also 3 stages of PTSD: acute, chronic and delayed.

In the first case, this is the period of the beginning of an extreme situation. The state is saved until it ends. Characterized by excessive anxiety for one's own life, lethargy, confusion.

A chronic condition occurs after the trigger has been removed if the patient feels restless. It is possible that the clouding of the mind persists, the person does not understand what happened. Often there are changes in speech and motor functions.

In some cases, with PTSD, the stages of such a plan are not observed, a delayed form appears, that is, the characteristic symptoms appear after a few months, and before that the patient feels normal.

This medical problem also varies in severity. With a mild course of post-traumatic syndrome, the patient's state of health remains unchanged, the ability to work professionally and the ability to communicate with other individuals is preserved. With a severe degree of damage, chronic mental disorders are diagnosed, schizophrenia is possible. With prolonged progress, PTSD leads to malfunctions of the brain, affects the functioning of the endocrine and nervous systems.

Post-traumatic syndromes are characterized by diverse signs, depending on which the division into clinical types is provided:

  • asthenic - the nervous system is exhausted, interest in life is lost, the patient begins to feel his own inferiority;
  • dystrophic - isolation, patients try to avoid others, inexplicable aggression often appears;
  • somatoform - manifests itself against the background of delayed PTSD, accompanied by malfunctions in the cardiovascular, nervous systems, gastrointestinal tract.

    • When detecting post-traumatic stress disorder, the main task of a specialist is to correctly differentiate the diagnosis by establishing the type and type.

    The main causes of PTSD

    The main factor provoking post-traumatic stress disorder is a tragic event, a traumatic situation.

    Causes of PTSD include:

    • fighting and armed conflicts;
    • terrorist acts, natural and man-made disasters;
    • physical and psychological abuse;
    • attacks, beatings, torture, robbery;
    • kidnapping;
    • incurable diseases found in the patients themselves and their immediate relatives;
    • death of loved ones;
    • miscarriages or premature births in women.

    A psychologically healthy person can face PTSD, but the course of the disease will be easier for him than for a person with a shaken psyche. In all cases, the syndrome has an undulating course, often leading to a permanent change in personality. There is a reassessment of one's own ideals, one's importance in life, a change in old ideas.

    Clinical symptoms of PTSD

    The list of PTSD symptoms includes the following changes:

    • anxiety-phobic conditions;
    • constant immersion in the events of the past;
    • intrusive memories;
    • memory and sleep disorders;
    • apathy, unwillingness to live;
    • feeling of tension and anxiety;
    • antisocial behavior;
    • any signs of CNS depletion;
    • dulling of emotions;
    • narrowing of consciousness;
    • lack of pleasure, joy of life;
    • social alienation.

    PTSD in children: features

    According to statistics, the disease in children is detected no more often than in adults, but experts in the field of psychotherapy assure that the disorder in children progresses faster. Children are a risk group due to an increased predisposition to post-traumatic stress syndrome, impressionability and sensitivity. The reasons for the development of the problem in children are psychological trauma, unfavorable social conditions and individual developmental characteristics.

    Pathology is diagnosed by a child psychiatrist. The doctor determines what traumatic event occurred and what changes in the nervous system it provoked. During the diagnosis, the patient's reaction to the impact of stimuli is assessed, the presence of memories reproduced in a dream, during a game or in stories is clarified. A consultation with a child psychologist will allow you to establish the type of disorder, determine the scheme of influence and establish a prognosis for recovery.

    Treatment of PTSD in children is a long-term work with a child psychologist or psychotherapist. Complex therapy requires the combined use of several techniques. The patient is shown cognitive-behavioral correction, psychotherapy and drug treatment aimed at stabilizing the work of the central nervous system.

    Complications

    The diagnosis of PTSD should not be ignored. Over time, the problem can worsen and lead to irreversible complications. Only acute disorders can be corrected, after the transition to a chronic form, therapy is complicated, a pathological change in personality is observed. A person manifests pronounced narcissistic qualities, the development of alcoholism and drug addiction is not excluded. Together, these factors are unfavorable signs, and therefore aggravate the prognosis for recovery.

    Diagnostics

    Post-traumatic stress disorder is established on the basis of the patient's complaints about psychological trauma, tragic events in the past. Diagnosis of PTSD is provided with the help of special questionnaires confirming the presence of criteria similar to the disease.

    Self-testing for PTSD is not always accurate because some factors may be hidden. Often the psychiatrist recommends an additional consultation in the presence of relatives or people from close circle. This allows you to differentiate the diagnosis and exclude the presence of other, symptomatically similar diseases.

    Treatment

    The treatment of PTSD is determined individually, taking into account the characteristics of the patient, the type of pathology and the presence or absence of concomitant disorders. The most effective are cognitive behavioral therapy and hypnotherapy. According to the indications, psychotherapy is combined with medication. Treatment of PTSD often requires the use of adrenergic blockers, antidepressants, tranquilizers, neuroleptics. As auxiliary methods, therapeutic massage is used.

    Prevention of PTSD

    A rehabilitation doctor or psychotherapist can help prevent the development of serious problems. The main task is to start the impact immediately after the injury, to work out the event in a quality manner in order to prevent the problem from becoming chronic. Also, to prevent the development of post-traumatic stress disorder will help:

    • proper nutrition;
    • creation of comfortable living conditions;
    • Refusal of alcohol and drugs.

    The doctor should explain to the patient that an acute reaction to stress is normal for the human body. Another prevention of PTSD is to avoid possible stress and maintain mental balance.

    The article is for informational purposes only. Please remember: self-medication can harm your health.

    Sources

    • Ministry of Health of Ukraine
    • Centers for Disease Control and Prevention
    • Medscape

    The author of the article:

    Kulik Maria Sergeevna

    Doctor-psychologist of the second category

    Which doctor treats PTSD?

    If a problem is found, the patient should consult a psychiatrist. If signs of PTSD are found in a child, consultation with a child psychiatrist or psychologist is necessary. The consequences of PTSD can be irreversible, so it is very important to undergo a full examination, determine the type of pathology, establish the cause and work out a treatment regimen.

    Specialists of the MEDICOM clinic working with the latest techniques will help you to undergo high-quality diagnostics and treatment of PTSD in Kyiv. You can seek help and take a test for PTSD at the clinic's subdivisions located in Obolon and Pechersk. Mental health requires careful attention, so it is better to contact professionals!

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    Reviews

    10/23/2021 18:14

    Alexander

    To the author. Definitely, PTSD is really serious. Skoda, which doctors know, do not outperform neither sick nor relatives. I broke my ankle for 3 years: 4 operations, then 3 fates in the police, fear that I would become disabled, depression, and the pressure of my relatives simply made me crazy. I don’t show how self-tapping can come in. Obov'yazkovo idit to the psychologist.

    11.09.2021 20:40

    Galina Andriivna Sinyavska

    She licked on the wet bed near the kitchen. I had a compression fracture of the ridge, I wanted to die. I had to visit a psychologist. Without її help, I would not have run into it. The psychologist gave a reason to overcome fears and come to the solution of the problem.

    07/30/2021 10:47

    Valentina

    Thank you majesty, that important article was written with grace. I learned a lot of new things. At once, I’ll lie on the knight with a fracture, I’ll be respectful to the new. I would not have thought before that about the mental state of a person after a serious injury, you also need to be turbulent.

    15.06.2021 18:26

    Vitaly

    Thank you for the information and help. Kulik Maria Sergeevna is a very good specialist. So far, we have come to the consultation without the child, in order to reconnoiter the situation, so to speak. The doctor was very friendly, asked a lot of questions, then gave recommendations on how to behave with our son after being beaten by classmates at school. He is very closed, and we are slowly slipping into despair. Now the only hope is for Maria Sergeevna.

    05/22/2021 11:55

    Olga

    I thank Kulik Mariya Sergievna for help. We have fired houses, it became late at night. Thank you to relatives from Kiev, who gave them a seat. Alesina became unrecognizable. The axis of infection from Sergiyk seems to be a psychologist, who at night finds uncontrollable panic on him, and it is unrealistic to calm down. Already after the third session, I remembered the progress.

    05/01/2021 12:21

    Mikhailo Valentinovich

    Thank you for the information. Children are especially susceptible to mental trauma at a time. Recently, my team died of cancer, I can’t know the language of the child, although earlier we were closer. At the nearest future, I will turn to her for help to a psychologist.

    04/11/2021 13:32

    Leonid

    I like a good article and service, I often look in when something hurts for information on symptoms and diseases. But I'm interested in PTSD. How did we experience stress in our childhood without psychologists and corrective methods? Like normal grew.

    12/16/2020 18:16

    Grigory Titov

    Very good service, they cover a lot of relevant topics, and most importantly, they immediately write which specialist you can contact for help. We went to MEDIKOM to Maria Sergeevna, a cool psychologist. The child stuttered and was very complex about this. But with the joint efforts of a speech therapist and a psychologist, the situation was corrected. Nikita is now studying, and successfully, in the 8th grade. He became very cheerful and sociable.

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    What is PTSD syndrome and why is it dangerous?

    Prolonged exposure to severe stressors can lead to the formation of a traumatic mental disorder. We tell you what leads to the appearance of PTSD and what to do if you find its signs in yourself?

    Anna Zalesskaya

    Getty Images

    Daria Milay

    clinical psychologist, psychotherapist, author of books and innovative psychotherapeutic methods

    What is PTSD syndrome?

    symptoms, signs, stages

    PTSD is a delayed reaction to a severe, stressful event or situation that happened in the past. A person cannot overcome what happened, his attention is focused on a psycho-traumatic episode, which makes him live the worst moments and the emotions, feelings and experiences that accompany them again and again.

    There are several stages:

    • Acute (lasts about 6 weeks after the traumatic event). A person experiences pronounced anger, fear, irritability, anxiety. At this moment, the timely help of a specialist and the support of loved ones is needed.
    • Chronic (lasts from 7 weeks to 6 months). The appearance of various kinds of phobias, behavioral disorders, a feeling of eternal fatigue, unwillingness to live. The victim has a low chance of a full recovery.
    • Delayed (several years after the events). There is an exacerbation of the symptoms of PTSD, a person tries to escape from reality, may succumb to various kinds of addictions or fall into the deepest depression. A cure at this stage is almost impossible; what remains is control and maintenance of an acceptable state.

    Symptoms:

    • dissociation - constant thoughts about what happened, involuntary vivid memories, emotions about the traumatic factor;
    • avoidance - attempts to repress, forget traumatic events, refusal to talk about them, apathy, lack of interest in the present, loneliness, feeling of uselessness;
    • physiological hyperactivity - a subconscious desire to always “run away” somewhere, anger, irritability, excitability, sleep problems.

    Types of PTSD

    Anxious

    A person cannot sleep peacefully, his mood fluctuates, he is unable to adapt in society - and all because of attacks of high anxiety for no reason.

    Asthenic

    Complete indifference to what is happening around, a sense of inadequacy, lack of appetite.

    Dysphoric

    High level of irritability, aggression, often after a surge of negative emotions a person feels satisfaction or, conversely, shame.

    Somatomorphic

    Clinical disorders of various body systems or internal organs appear. The person begins to experience the fear of death.

    What causes PTSD and how does it develop?

    PTSD develops gradually. Trauma occurs immediately at the moment of exposure to a traumatic factor and two more days after. PTSD is formed in a week due to the concentration on the events that have occurred and their consequences. Extremely rarely, PTSD can be caused by domestic problems - divorce, lawsuits, a big loss, loss of housing.

    Internal causes of PTSD:

    age;
    low level of intelligence;
    increased level of emotionality, anxiety;
    taking drugs and alcohol;
    sociopathy;
    old psychotrauma or mental problems.

    In this case, the syndrome can develop not only among the direct participants in the events, but also among observers.

    Who is at risk?

    There are several categories of people at risk of developing PTSD:

    Representatives of law enforcement agencies - they are most often at risk of developing a disorder.
    Women. Highly emotional, as well as those who often endure violence.
    Children and teenagers.

    Learn more