Yoga Now Standard Treatment for Vets with PTSD

Yoga's not usually the first thing that springs to mind when thinking about treatment for post traumatic stress disorder in veterans. But from the Veterans Administration to the Pentagon, yoga classes are becoming not just commonplace, but in some rehabilitation programs mandatory.

One of the places in the forefront of change is the Newington Yoga Center, in Newington, Connecticut.

About 20 veterans train to become yoga teachers. Suzanne Manafort of the Veterans Yoga Project, said what began as a small project has burgeoned into programs across the country. Manafort taught yoga for years before using it as a treatment for PTSD. She said she had no idea she might need to make adjustments to her teaching, until she made mistakes.

"Touching is a mistake. In yoga classes we touch all the time. But to somebody whose been sexually assaulted that's a huge violation. Walking behind them is a huge mistake because it feels like they have to pay attention to what's going on in the room instead of just practicing their yoga practice," Manafort said.

She said ultimately it was veterans themselves that guided her, in some cases just by the courage it took simply to stay in class.

"Some of the men and women that I work with are Vietnam Veterans so they've been at home suffering for 40 years," said Manafort. "And when they come into this treatment program and they're told they have to do yoga, 'they're like are you kidding me?'"

"I thought it was a joke," said Vietnam veteran Paul Gryzwinski. "And I remembered actually laughing out loud and they said no we're really not kidding you're going to be going to yoga."

Gryzwinski is training to teach yoga to veterans. Many years after returning from the war, PTSD hit him hard. He ended up turning to the VA. Where he first encountered yoga.

"And I just thought of myself in like, tights with you know a bunch of women. And I know that sounds sexist — and I'm not, so forgive me — but it was such an alien concept to me," Gryzwinski said with a chuckle.

And Gryswinski's early misperceptions are one reason that Dan libby, a co-founder of the Veterans Yoga Project, said the 12 week yoga training for treating vets with PTSD tries to strip all the new-agey stuff out.

"We really emphasize, 'leave all the Sanskrit names at home, right. Leave the candles at home, don't talk about you know moonbeams and chakras and all these things,'" he said. "It's really just about learning about your body and your experience; learning to breathe."

Lt. Col Melinda Morgan deployed right after 9-11 and started teaching yoga to those who had served and those who were preparing to go to Afghanistan.

"So I started teaching veterans 10 years ago and one of those veterans that I taught became an instructor himself. And so in 2007 when he was in Iraq and I was in another location, he writes me a note that said, 'I have to teach yoga and I don't think I can.' So I'm like, 'yes you can.' I wrote it down all of the poses, emailed it to him and helped him on his way to become a certified teacher," Morgan said.

Today, Morgan teaches at the Pentagon, and she said classes once sparsely attended are now full every day. But despite an increased demand for yoga paired with a growing number of alternative treatment programs in the military and the VA, there's scant hard science about why yoga or most of the other alternative programs work.

Yoga instructor Dan Libby hopes the government does some studies soon, because without more data, returning troops won't take the programs seriously.

This article originally appeared on pri.org
Host Marco Werman
Reporter Susan Kaplan

Links

Yoga Therapy: Why Doctors Are Prescribing The Ancient Practice

In 2011, Jacquelyn Jackson had the most traumatizing year of her life. On a beautiful morning in Tucson, she was just 25 feet away when her former boss, Congresswoman Gabrielle Giffords, and 18 others were shot in a grocery store parking lot. In the weeks that followed, as Jackson began suffering symptoms of post-traumatic stress disorder (including chronic anxiety and difficulty sleeping), she turned to a psychotherapist. The sessions helped “tremendously,” she says but 11 months later, when her seemingly healthy younger brother died suddenly from a brain tumor. “the trauma was so great I felt like I needed something more.”

Desperate, Jackson looked online for support and stumbled upon yoga therapy, an emerging treatment for people struggling with anxiety, grief, and trauma. Long practiced in India, yoga therapy was introduced in the United States some three decades ago but has begun gaining popularity only in the past five years or so. (Membership in the International Association of Yoga Therapists [IAYT] has quadrupled since 2004, to about 3,200, and next year the IAYT plans to begin accrediting yoga schools to offer a standardized certification program.)

“It’s not just postures,” says yoga therapist Janice Gates. “We use all the tools of yoga — breath work, sound, visualization, and meditation — and tailor them to a client’s specific health condition.” One of Gates’s clients was a woman in her 40s who was experiencing serious depression and anxiety but couldn’t tolerate psychiatric medication. While a doctor oversaw the medical issues, Gates worked with the client weekly to manage her moods. On days when she was anxious, Gates led her through exercises like standing poses and forward bends (to help her feel more grounded) and exhalation breath work (to calm her down). When the woman was depressed, she did back bends and inhalation exercises, designed to give her energy. Six months later, the woman’s crippling dark moods, once a thrice-weekly occurrence, now overtake her only a few times each month. With her newfound energy — and time — she’s teaching art classes to children.

Though research on the efficacy of yoga therapy is ongoing, traditional doctors are taking notice — and finding it, in some cases, to be a valuable complement to the work they’re already doing. “Yoga therapy can be extremely helpful for people who need a way to work through what they’re experiencing, not just in their minds but in their bodies,” says psychotherapist Jack Obedzinski, MD, of Corte Madera, California. “Often, it allows my patients to experience a feeling of calm in a way they couldn’t in talk therapy.” And, he says, this calmness can bring more clarity and awareness to their traditional sessions.

For Jackson, one-on-one yoga appointments with Amy Weintraub, a pioneer in the field and author of Yoga for Depression, proved transformative. In their first session, Jackson “was practically hyperventilating with anxiety,” says Weintraub, who created a program that included “stair-step” breathing, building up to deeper and deeper breaths. “What the yoga did was provide a slow, gradual path to help her manage her moods and not immediately react when grief arose.” After just a few sessions, Jackson no longer used medication to help her sleep at night. “Working with Amy was like doing emotional Roto-Rooter-ing,” she says. “I had so much stress in my body, and she was able to help dislodge it — and clear it out.”

This article originally appeared on huffingtonpost.com and was written By Laura Hilgers.

Check out our UPCOMING MENTAL WELLNESS WORKSHOPS with Shari Arial: Yoga for Anxiety, Stress & Trauma.

Yoga for anxiety and depression.

Studies suggest that this practice modulates the stress response.

Since the 1970s, meditation and other stress-reduction techniques have been studied as possible treatments for depression and anxiety. One such practice, yoga, has received less attention in the medical literature, though it has become increasingly popular in recent decades. One national survey estimated, for example, that about 7.5% of U.S. adults had tried yoga at least once, and that nearly 4% practiced yoga in the previous year.

Yoga classes can vary from gentle and accommodating to strenuous and challenging; the choice of style tends to be based on physical ability and personal preference. Hatha yoga, the most common type of yoga practiced in the United States, combines three elements: physical poses, called asanas; controlled breathing practiced in conjunction with asanas; and a short period of deep relaxation or meditation.

Many of the studies evaluating yoga's therapeutic benefits have been small and poorly designed. However, a 2004 analysis found that, in recent decades, an increasing number have been randomized controlled trials — the most rigorous standard for proving efficacy.

Available reviews of a wide range of yoga practices suggest they can reduce the impact of exaggerated stress responses and may be helpful for both anxiety and depression. In this respect, yoga functions like other self-soothing techniques, such as meditation, relaxation, exercise, or even socializing with friends.

Taming the stress response

By reducing perceived stress and anxiety, yoga appears to modulate stress response systems. This, in turn, decreases physiological arousal — for example, reducing the heart rate, lowering blood pressure, and easing respiration. There is also evidence that yoga practices help increase heart rate variability, an indicator of the body's ability to respond to stress more flexibly.

A small but intriguing study further characterizes the effect of yoga on the stress response. In 2008, researchers at the University of Utah presented preliminary results from a study of varied participants' responses to pain. They note that people who have a poorly regulated response to stress are also more sensitive to pain. Their subjects were 12 experienced yoga practitioners, 14 people with fibromyalgia (a condition many researchers consider a stress-related illness that is characterized by hypersensitivity to pain), and 16 healthy volunteers.

When the three groups were subjected to more or less painful thumbnail pressure, the participants with fibromyalgia — as expected — perceived pain at lower pressure levels compared with the other subjects. Functional MRIs showed they also had the greatest activity in areas of the brain associated with the pain response. In contrast, the yoga practitioners had the highest pain tolerance and lowest pain-related brain activity during the MRI. The study underscores the value of techniques, such as yoga, that can help a person regulate their stress and, therefore, pain responses.

Improved mood and functioning

Questions remain about exactly how yoga works to improve mood, but preliminary evidence suggests its benefit is similar to that of exercise and relaxation techniques.

In a German study published in 2005, 24 women who described themselves as "emotionally distressed" took two 90-minute yoga classes a week for three months. Women in a control group maintained their normal activities and were asked not to begin an exercise or stress-reduction program during the study period.

Though not formally diagnosed with depression, all participants had experienced emotional distress for at least half of the previous 90 days. They were also one standard deviation above the population norm in scores for perceived stress (measured by the Cohen Perceived Stress Scale), anxiety (measured using the Spielberger State-Trait Anxiety Inventory), and depression (scored with the Profile of Mood States and the Center for Epidemiological Studies Depression Scale, or CES-D).

At the end of three months, women in the yoga group reported improvements in perceived stress, depression, anxiety, energy, fatigue, and well-being. Depression scores improved by 50%, anxiety scores by 30%, and overall well-being scores by 65%. Initial complaints of headaches, back pain, and poor sleep quality also resolved much more often in the yoga group than in the control group.

One uncontrolled, descriptive 2005 study examined the effects of a single yoga class for inpatients at a New Hampshire psychiatric hospital. The 113 participants included patients with bipolar disorder, major depression, and schizophrenia. After the class, average levels of tension, anxiety, depression, anger, hostility, and fatigue dropped significantly, as measured by the Profile of Mood States, a standard 65-item questionnaire that participants answered on their own before and after the class. Patients who chose to participate in additional classes experienced similar short-term positive effects.

Further controlled trials of yoga practice have demonstrated improvements in mood and quality of life for the elderly, people caring for patients with dementia, breast cancer survivors, and patients with epilepsy.

Benefits of controlled breathing

A type of controlled breathing with roots in traditional yoga shows promise in providing relief for depression. The program, called Sudarshan Kriya yoga (SKY), involves several types of cyclical breathing patterns, ranging from slow and calming to rapid and stimulating.

One study compared 30 minutes of SKY breathing, done six days a week, to bilateral electroconvulsive therapy and the tricyclic antidepressant imipramine in 45 people hospitalized for depression. After four weeks of treatment, 93% of those receiving electroconvulsive therapy, 73% of those taking imipramine, and 67% of those using the breathing technique had achieved remission.

Another study examined the effects of SKY on depressive symptoms in 60 alcohol-dependent men. After a week of a standard detoxification program at a mental health center in Bangalore, India, participants were randomly assigned to two weeks of SKY or a standard alcoholism treatment control. After the full three weeks, scores on a standard depression inventory dropped 75% in the SKY group, as compared with 60% in the standard treatment group. Levels of two stress hormones, cortisol and corticotropin, also dropped in the SKY group, but not in the control group. The authors suggest that SKY might be a beneficial treatment for depression in the early stages of recovery from alcoholism.

Potential help for PTSD

Since evidence suggests that yoga can tone down maladaptive nervous system arousal, researchers are exploring whether or not yoga can be a helpful practice for patients with post-traumatic stress disorder (PTSD).

One randomized controlled study examined the effects of yoga and a breathing program in disabled Australian Vietnam veterans diagnosed with severe PTSD. The veterans were heavy daily drinkers, and all were taking at least one antidepressant. The five-day course included breathing techniques (see above), yoga asanas, education about stress reduction, and guided meditation. Participants were evaluated at the beginning of the study using the Clinician Administered PTSD Scale (CAPS), which ranks symptom severity on an 80-point scale.

Six weeks after the study began, the yoga and breathing group had dropped their CAPS scores from averages of 57 (moderate to severe symptoms) to 42 (mild to moderate). These improvements persisted at a six-month follow-up. The control group, consisting of veterans on a waiting list, showed no improvement.

About 20% of war veterans who served in Afghanistan or Iraq suffer from PTSD, according to one estimate. Experts treating this population suggest that yoga can be a useful addition to the treatment program.

Researchers at the Walter Reed Army Medical Center in Washington, D.C., are offering a yogic method of deep relaxation to veterans returning from combat in Iraq and Afghanistan. Dr. Kristie Gore, a psychologist at Walter Reed, says the military hopes that yoga-based treatments will be more acceptable to the soldiers and less stigmatizing than traditional psychotherapy. The center now uses yoga and yogic relaxation in post-deployment PTSD awareness courses, and plans to conduct a controlled trial of their effectiveness in the future.

Cautions and encouragement

Although many forms of yoga practice are safe, some are strenuous and may not be appropriate for everyone. In particular, elderly patients or those with mobility problems may want to check first with a clinician before choosing yoga as a treatment option.

But for many patients dealing with depression, anxiety, or stress, yoga may be a very appealing way to better manage symptoms. Indeed, the scientific study of yoga demonstrates that mental and physical health are not just closely allied, but are essentially equivalent. The evidence is growing that yoga practice is a relatively low-risk, high-yield approach to improving overall health.

This article originally appeared on www.health.harvard.edu

 

For more information about yoga for mental wellness, visit our website.
Upcoming yoga workshop for Anxiety, Stress & Trauma register online.
 

Revive yourself: Yoga and Acupuncutre Workshop

Spring is the perfect time to stop, pause and reassess your life.  Come regroup, revive and restore yourself emotionally, physically and spiritually through this unique offering of Yoga Therapy and Acupuncture.

Phoenix Rising Yoga Therapist, Shari Arial; & Acupuncturist, Vanessa Groshong present:

The Yoga and Acupuncture Workshop


What’s involved :

-       Three 2 hour workshops, offered in a series of once per week focusing on energetic pathways in the body, accessing them through embodied yoga movement, internal dialogue promoting a self-inquiry approach to awareness, and acupuncture points;
 

-        (1) the mind – we will acknowledge the mind and explore the power it has over our daily thoughts, feelings, emotions and reactions.   Acupuncture points will be used to retune the mind and return us to the center of our body.

 

-       (2) body – we will explore the relationship with our body, which is our greatest teacher in life, learning to love ourselves more.  Acupuncture points will be used to imprint love and compassion for ourselves.

 

-       (3) spirit – we will honor the deep wisdom that resides within each of us, learning to harness that energy and how use it to make powerful changes in our lives.  Acupuncture points will be used to continue to open us up to our spirit, freeing us from past habitual patterns and allowing us to move forward in life.

 

What it looks like:

-       75 minute mindful yoga practice with internal dialogue focusing on the weekly theme

-       30 minutes of acupuncture performed during savasana focusing on weekly theme

-       15 minutes of integrating and further imprinting what you may have noticed

 

Investment:

-       Sign up for one - $90 per workshop; or,

-       Sign up for all three - $250.

REGISTER YOUR SPOT: therapythruyoga@hotmail.com

There is the potential for insurance reimbursement for the acupuncture portion of the workshops

($45 receipt will be provided for each workshop).