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Additional and Supplemental Treatments for PTSD

Written by Onaolapo Adeyemi. Posted in Alternative Trauma, ptsd

With the goal of helping readers to navigate the growing literature on CAM, below we briefly review the current evidence for the most well-established mind-body therapies for PTSD: acupuncture, relaxation training, and meditation.

Based on that evidence, we make recommendations as to the next appropriate steps in pursuing the development of these interventions.

Acupuncture

ptsd_acupunctureAcupuncture, a modality of Chinese medicine, encompasses a group of therapies in which needles are inserted into subcutaneous tissue in order to restore balance within body systems. For those interested, Hollifield (2011) provides an accessible summary of the conceptual rationale and proposed biological mechanisms in support of the potential efficacy of acupuncture for PTSD.

One good-quality study identified in the Strauss et al. (2011) review found that improvement in PTSD following 12 weeks of biweekly, 60-minute acupuncture sessions was comparable to a group CBT and greater than waitlist control in a predominantly male, non-Veteran sample (Hollifield, Sinclair-Lian, Warner, & Hammerschlag, 2007). Treatment gains following acupuncture were retained at the 24-month follow-up.

Although the study was methodologically rigorous, strong conclusions cannot be drawn from a single RCT. This study also highlights the challenge of selecting an adequate comparison condition for these novel interventions. The control that was used, a group intervention that included psychoeducation, CBT skills (e.g., behavioral activation, activity planning, cognitive restructuring), and exposure exercises, may have been selected to provide a comparison to treatment as usual or minimal good treatment.

Nonetheless, it does not control for critical features of the technique, such as the application of needles. To understand whether or not study results could be driven by different expectations about the treatments, a control such as placing needles in sham sites would be necessary. Thus, we believe that proof-of-concept has been established for acupuncture, but recommend withholding judgment about its effectiveness for PTSD until additional controlled trials have been conducted.

Read more information here

Relaxation

Strauss et al. (2011) identified three relatively small RCTs of relaxation techniques; they did not demonstrate significant clinical improvement relative to active comparators (Echeburúa, de Corral, Sarasua, & Zubizarreta, 1996; Vaughan et al., 1994; Watson, Tuorila, Vickers, Gearhart, & Mendez, 1997). In each case, interpretation of study findings was hampered by significant methodological flaws, including ambiguous reporting of randomization and treatment of missing data, nonblinded group assignment and/or assessments, and inadequate statistical power. In some cases, lack of clarity about differences between components of the intervention and active comparator further complicate the picture. Additionally, the Echeburúa et al. (1996) study compared a CBT intervention that included instruction in progressive muscle relaxation (PMR) to PMR alone, but the differences in “dosing” and the introduction of PMR within these protocols was not specified. Of note, the Strauss et al. (2011) review of relaxation studies was limited to those in which the intervention was conceptualized as an active treatment and described in sufficient detail to understand the key components.

Five additional studies, in which relaxation showed modest effects and performed less well than active comparators, were excluded
from that review based on these criteria. Relaxation likely has a role to play in helping to manage the arousal associated with PTSD, but relaxation alone is unlikely to be sufficient to reduce other types of symptomatology for many people with PTSD.

Meditation

The first studies of meditation techniques for PTSD involved mantra meditation (including transcendental meditation and mantra my repetition), a type of meditation that involves intensely focusing attention on an object or word. Studies of these techniques have shown some positive effects but are limited by small sample sizes, enrollment of exclusively male Veterans, and lack of follow-up (Bormann, Thorp, Wetherell, & Golshan, 2008; Brooks & Scarano, 1985). Thus, these studies primarily demonstrate the feasibility of enrolling and retaining Veterans in mediation group interventions.

More recently, Bormann et al. (2012) compared the addition of mantra my repetition to usual care (i.e., medication and case management) to usual care alone, and found modest improvements in symptoms of depression and PTSD. Without a control for nonspecific aspects of the group meetings, however, it is difficult to definitively attribute these gains to use the man tram approach. Work is ongoing to more definitely answer this question. Kearney and colleagues (2012) conducted an uncontrolled study of mindfulness-based stress reduction (MBSR) as an adjunct to usual care for Veterans with PTSD.

MBSR is a group intervention that incorporates mindfulness practices, including meditation and yoga. The authors reported a medium effect size in the change in PTSD, depression, and functioning in those who took part in the group. Although mechanisms of change could not be determined by this uncontrolled study design, it is notable that changes were mediated by changes in mindfulness. Because MBSR is a well-established intervention with some demonstrated effectiveness for treatment of anxiety more generally, additional empirical evaluation of MBSR is indicated.

A struggle for those who undertake such studies will be the selection of appropriate controls. For example, it may be appropriate to compare mindfulness to relaxation, to establish that observed changes are attributable to something more than a quiet pause in one’s day. Alternately, it may be important to compare a mindfulness-based approach to other commonly used coping skills, such as cognitive-behavioral anxiety management techniques.

Lang et al. (2012) recently reviewed the theoretical basis for three types of meditation as an intervention for PTSD. Based on the extant literature in this area, it appears that there could potentially be different mechanisms underlying different types of meditative practice. The literature on cognitive changes related to mindfulness suggests that through the practice of shifting attention and assuming a nonjudgmental stance, patients may learn to be less reactive to intrusive or ruminative thoughts. Mantra meditation has more commonly been linked to decreasing physiological arousal.

For patients with PTSD, this may be a good coping strategy for times when memories are intentionally (as in exposure-based therapy) or unintentionally triggered. Compassion meditation, which involves directing feelings of warmth and compassion towards others, has been linked to increases in positive emotion and social connectedness. Given the deficits in positive emotion and feelings of connection with others that are characteristic of PTSD, compassion meditation is a promising strategy but is without empirical application to PTSD. It is also possible that there are nonspecific factors common to all of these types of meditation. Future research should evaluate these approaches and attempt to understand the mechanisms by which they create change.

Conclusions

In summary, CAM is widely requested and used by consumers for a variety of complaints and conditions, and the relevant research base is rapidly evolving. The umbrella of CAM modalities includes a broad range of approaches, not all of which may hold the same level of promise for the treatment of PTSD.

Preliminary findings, albeit mixed, suggest that CAM treatments merit consideration. At this point, there is very limited empirical evidence of their effectiveness, so they may be best applied as an adjunct to other PTSD treatments or as a gateway to additional services for patients who initially refuse other approaches.

Overall, the current evidence base does not support the use of CAM interventions as an alternative to current empirically-established approaches for PTSD, or as first-line interventions recommended within evidence-based clinical guidelines.

 

This article was originally published by National Center for PTSD
VA Medical Center (116D)
215 North Main Street
White River Junction
Vermont 05009-0001 USA
http://www.ptsd.va.gov/professional/newsletters/ptsd-rq.asp

Originally posted 2013-03-16 23:52:08.

Strategies to Assist you in Coping with Adrenal Fatigue

Written by Onaolapo Adeyemi. Posted in Alternative Trauma

Adrenal FatigueAdrenal Fatigue – You could be wondering what has gotten you feeling that way if you feel you have started suffering from Adrenal Fatigue. Everyone responds in a different way to tension and poor eating patterns but chances are that those are your major causes. What you need to do now is find a means to get yourself out of this rut. Check out the pointers in this article as the info will help you begin moving in the right way.

Talk to your boss, let your boss know that you have been clinically determined with adrenal fatigue and that part of the cure consists in standing up and shaking your legs and arms for 3 mins every hour. Bend both your legs very slightly and then straightens them switching legs, as quick as you can. It is an excellent exercise for heating you up, for toning legs, upper legs, and abs and for giving your brain a bit of oxygen.

Adrenal Fatigue is additionally called hyponatremia and it occurs when the adrenal glands are exhausted and will not handle the production of the bodily hormones requested by the body. One’s body goes on a downward spiral as not one of the organs get the hormones they require to operate correctly.

Adrenal Fatigue is mainly an anxiety related disorder. High and constant levels of mental and emotional anxiety could cause your adrenal glandular to begin malfunctioning. From a biochemical viewpoint, nutritional insufficiencies could be accountable as well as the buildup of contaminants in the body through the usage of food additives and reduced quality drinking water.

Nutrition plays an important function in protecting the adrenal glandular in excellent shape. The primary enemies of the glands are white sugar and flour. This stresses the adrenal glandular and could eventually lead to full blown adrenal fatigue.

If you are suffering from adrenal fatigue, use the blood pressure to gauge which phase of compensation the adrenals are in when standing up rapidly. If a seasoned doctor could do the test for you, you will require a sphygmomanometer and stethoscope more than the digital equipment and it would be best. You will need to take a standard BP whilst sitting, then again whilst be lying down then standing up quickly. When the drop is greater than 20mm on last reading, adrenal fatigue can be a cause.

When you suffer from adrenal fatigue your eyes are sensitive to light. You could do this examination. If your pupils are reluctant to contract, or if they have difficulty holding the contraction, adrenal fatigue could possibly be the source.

In Traditional Chinese Medicine the “kidney yang” represents the strength of the adrenal glands. When you go to a professional of TCM you can quickly and effectively learn if you are suffering from adrenal fatigue by undergoing an easy “reading of the rhythm”.

Once you have actually started suffering from adrenal fatigue it can appear impossible to get back into a healthy physical and psychological state. Adrenal fatigue could be hard to conquer however with assistance from this write-up and time and perseverance you will manage.

Originally posted 2013-03-03 19:52:36.

Using Brain Supplements

Written by Onaolapo Adeyemi. Posted in EMDR

Study and Work Better Using Brain Supplements

by Onaolapo Adeyemi

You will find many reasons why many individuals take supplements. Many others want to enjoy having more energy to do their chores. Some just want to add vitamins to their day by day diet regime.

Brain_supplements

Scanning of a human brain by X-rays

There are some supplements formulated especially for those that want to be mentally alert. You might wonder why others who use dietary supplements do not simply eat a better diet instead. But the food we consume in daily life does not always supply all the vitamins we need.

Physical stress reduces the body’s ability to take up vitamins from food. Pressure can also mess up your digestion, preventing you from correctly getting the vitamins you need from food. In this case, our bodies may go through lessened efficiency at purifying vitamins from food.

If you’re wondering what the secret of successful others is, it’s this: brain food. Food for the brain means supplements imbued with the best vitamins that can enhance the thinking process. The brain is the most well-worn organ in the system as it is in charge of so many functions. Brain action takes on a greater importance for the day by day tasks. Without good brain action, we will not be able to work or do chores.

Multi-tasking and management demand brain power. In particular, students and personnel are at their best when they have proper brain action. Allow me to share some explanations why you must take supplements for the brain.

Using Brain Supplements For Management Tasks

A good memory will make you more creative in your work as a director or business proprietor. This means thinking about the others in your team and the odd jobs assigned to every single person. The distinction between someone who is stressed out and someone who is well-organized is obviously the way he can memorize these things.

To Fight Off Pressure in Everyday Living

The most effective supervisors are those who can handle pressure well. This also is true if you’re running the everyday jobs that need doing in the home. The arch nemesis of output is stress. Focusing on quite a lot of things at once is hard if your brain is not functioning well. If your brain is healthy, you can continue to action even when the anxiety is tremendous. Brain nutritional vitamin supplements and those that help you fight stress go hand in hand. A few of these nutritional vitamin supplements are produced by Herbs GAIA.

Better Comprehension

To really understand all you’re reading, your brain should preserve information effortlessly. Reading information sources calls for comprehension. If your brain cannot address the overload of information, you often forget a number of the things you have just read. Studying at the last minute during critical reviews becomes bad only when your brain is not up to the task of processing quite a lot of information simultaneously.

Superior Body Capabilities

Normal body action is an additional task that your brain has to bear. Use of vitamins is reliant on whether your brain is healthy or not. Even swallowing calls for a particular quantity of brain energy for the reason that your brain must also manage the task of enzyme production and mastication.

Originally posted 2013-02-26 10:57:37.




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