Depression, Stress | September 29, 2017 | Author: Naturopath
PTSD stands for post-traumatic stress disorder. It is quite normal to feel scared during or after a stressful situation or event. This event might be a serious accident, physical or sexual assault, war or torture, or a natural disaster such as a bushfire or a flood. The body’s reaction to stress involves the release of several hormones which affect the brain, more specifically the hypothalamus and pituitary glands, and the autonomic nervous system. The brain releases hormones into the blood stream; they travel to the adrenal glands, completing the hypothalamic-pituitary adrenal (HPA) axis. Once there, the release of epinephrine, cortisol, and norepinephrine is triggered.
When the system that releases these hormones fails to shut down as the stressful situation winds down, these excess hormones can cause physical damage within the body including high blood pressure and immune system suppression.
As well as being very upsetting, the symptoms interfere with the person’s ability to carry on their everyday life, work and relationships. Not only do people with PTSD experience debilitating symptoms of PTSD, but they also have a higher prevalence of other psychiatric and physical co-morbid conditions such as depression and drug and alcohol abuse.
It is important for anyone with PTSD to be treated by a mental health professional who is experienced with PTSD. The complex psychopathology and frequency of co-morbid conditions often makes PTSD difficult to treat. The main treatments are psychotherapy, medications, or both. Trauma-focused psychotherapy has the strongest evidence for PTSD treatment. Yet, a high percentage of individuals do not engage in or drop-out prematurely from these treatments because of chronic patterns of avoidance and an inability to tolerate the intense emotions often experienced with this type of treatment. The military has spent in excess of two billion dollars on pharmaceutical medications for the treatment of PTSD since 2001.
Prior to the Iraqi War, soldiers were sent into battle with a six month supply of pharmaceuticals based on the assumption that the situations they are placed in would require some form of treatment.
If someone with PTSD is living through an ongoing trauma, such as being in an abusive relationship, both of the problems need to be addressed. Other ongoing problems can include panic disorder, depression, substance abuse, and feeling suicidal. Research shows that support from family and friends can be an important part of recovery.
Most complementary and Alternative modalities engage the healing process without trauma recall, and are thus, not trauma-focused. The most commonly used complimentary modalities were herbs and supplements, deep breathing, meditation, chiropractic, massage, yoga, diet-based therapies, progressive relaxation, guided imagery, and homeopathic treatment.
There has been one published randomized clinical trial of acupuncture as a treatment for PTSD. In that study, acupuncture was superior to waitlist and comparable to the cognitive behavioural therapy group for PTSD in a non-Veteran sample. Although the effect size was large, the sample was small. A recent systematic review described the evidence for the effectiveness of acupuncture for PTSD as encouraging, but concluded that further trials are needed.
Several studies have evaluated different meditative practices.
A recent randomized controlled trial found that a six-week group intervention that provided training in mantram repetition (silent repetition of a spiritually meaningful word) in conjunction with treatment as usual (medication and case management) had a small to moderate effect on PTSD symptoms among Veterans with chronic PTSD as compared to treatment as usual alone.
More recently, a randomized controlled pilot study compared Mindfulness Based Stress Reduction (MBSR) plus usual care to usual care alone. Both groups had improved PTSD symptoms at post-treatment.
One randomly controlled trial compared an adjunctive, 12-session yoga intervention to an assessment control in a sample of Veteran and civilian women. There were significant decreases in PTSD symptoms, specifically re-experiencing and hyperarousal symptoms.
The use of natural therapies, including herbal formulations, may provide an alternative, free from side effects, to pharmaceutical medications.
Nervine herbs are herbs that have an affinity for the Central Nervous System (CNS) and are available in three primary categories:
Lesser categories include:
These classes of herbs build up the whole body’s resistance to stress, instead of having an affinity for just one body system or organ; they restore balance to bodily functions, no matter where the disruption began. Nervine and adaptogenic herbs help to bring the physical and mental aspects of the body back into balance. Unlike pharmaceuticals currently prescribed for PTSD, the majority of nervines and adaptogens are generally regarded as safe when taken according to directions and unlike pharmaceuticals prescribed based on average statistics, herbal formulas can be made to meet each individual’s needs.
Over 180 phytochemical, clinical and pharmacological studies have been published, since 1960, on the adaptogenic properties of Rhodiola (Rhodiola rosea) confirming its ‘health-promoting’ qualities. Rhodiola has the ability to increase serotonin in the mid-brain and hypothalamus parts of the brain.
A three week, placebo-controlled, double-blind crossover study with 60 participants participated in a water based Kava kava (Piper methyscum) extract. The results of the study determined that aqueous extracts of kava provided noteworthy antidepressant and anti-anxiety action without the safety concerns of kava extracts in an alcohol base.
A literature review seeking out preclinical and clinical trial data on plant based medicines for anxiety, from the review fifty-three plants were identified in the 1,525 papers with 21 of the plants having human clinical trial evidence. The clinical trial evidence identified Chamomile (Chamaemelum nobile), Ginkgo (Ginkgo biloba), Skullcap (Scutellaria laterifolia), Milk Thistle (Silybum marianum), Astragalus (Astragalus membranaceus), Passionflower (Passiflora incarnata), Gotu kola (Centella asiatica) and Lemon balm (Melissa officinalis) effective with continued use for the treatment of anxiety.
Depression and anxiety, at varying levels, are measured on the Hamilton Depression Scale (HAM-D). Herbs commonly used to treat stress induced depression, potentially through the HPA axis, include American ginseng (Panax quinquefolius) and Korean Ginseng (Panax ginseng), Schisandra (Schisandra chinensis), St. John’s wort (Hypericum perforatum) and Oats (Avena sativa).
Additional herbs, specific for the category identified as stagnant depression, which includes PTSD and chronic situational depression, include Rosemary (Rosmarinus officinalis) and Holy Basil (Ocimum sanctum). Severe symptoms with a score over 20 on the HAM-D scale may require the addition of a nervine or adaptogenic herbs, including Siberian ginseng (Eleutherococcus senticosus), Licorice (Glycyrrhiza glabra), St. John’s wort (Hypericum perforatum) and/or Ashwagandha (Withania somnifera).
Herbs with an affinity for anxiety include Valerian (Valeriana officinalis), Kava kava (Piper methysticum), St. John’s wort (Hypericum perforatum), Oats (Avena sativa), Bacopa (Bacopa monnieri), and Gotu kola (Centella asiatica).
Complementary and alternative medicine for post-traumatic stress disorder symptoms: A systematic review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4177524/