What is PTSD?

First, let’s talk about what Post Traumatic Stress Disorder (PTSD) is, since it is sometimes misunderstood. It is a complicated mental disorder that develops after exposure to or experiencing a single or repeated traumatic event. It’s often associated with military service, but also occurs in individuals who witness or experience things like abuse, car accidents, or natural disasters (among many others). Not everyone will develop PTSD after witnessing or experiencing a traumatic event. However, the individuals that do develop PTSD develop changes in their mental and emotional states that can severely impact their quality of life, relationships, employment, other daily aspects of their lives, and their emotional well-being. Individuals suffering from PTSD experience some or all of the following:

• PTSD often occurs alongside other mental health disorders, such as anxiety disorders and/or depression, substance abuse disorders, and memory problems.
• Physical problems may occur as well (your body holds onto trauma, and it can manifest in pain, fatigue, feeling unwell, and other more serious physical problems). 
• Intrusive thoughts or memories, including flashbacks, nightmares, and thoughts that are difficult to control and may happen with or without outside stimuli.

• Avoidance of situations, places, or thoughts that remind them of the trauma they experienced (sometimes directly related to the traumatic event, while sometimes less related). 
• Changes in mood and overall cognition, including feelings of detachment from situations, people, and places, negative thoughts about self, negative thoughts about others or the world, and memory loss surrounding the events of the traumatic experience. 
• They may also experience higher levels of emotional and physical reactivity and arousal to situations, events, and people that remind them of their trauma. This includes feeling on edge, startling more easily, problems sleeping, and angry outbursts (that may seem inappropriate to others). 
• People with PTSD are often hypervigilant of their environment, constantly “keeping their head on a swivel,” keeping them in a constant fight or flight mode that leads to increased anxiety, inability to function in social situations, negative views of the self and those around them, and inability to relax. 
• Sometimes, dissociation occurs. Derealization (he feeling that life is not real; the individual may describe feeling like they are in a movie or in a dream) and depersonalization (the feeling that one is outside of their body) are both dissociative symptoms. 

Symptoms of PTSD can begin directly following the event, or they can emerge days, weeks, or even months or years later. In order to be diagnosed with PTSD, symptoms must cause significant distress or problems in the individual’s daily functioning. 

Ultimately, PTSD looks different in everyone, and symptoms vary in severity. Some may experience symptoms that do not prevent them from executing daily functions and might appear “normal” from the outside but still experience significant distress, while others may experience symptoms severe enough that they are unable to function in their daily lives. The first and most important course of treatment is meeting with a mental health professional and seeking therapy. Medication may also be needed. Read more here about treatment and support for those with PTSD. 

Exercise and PTSD

Many studies show that exercise helps reduce symptoms of PTSD, especially when combined with other interventions. Since it is free, it has a multitude of other physical and mental health benefits, and has been shown to improve quality of life in those experiencing PTSD; it is often recommended alongside (or after) treatment. We already know that PTSD helps to reduce anxiety and depression, two conditions that are often comorbid with PTSD, so regular exercise is already a great addition to other treatment modalities. Sleep is also improved with exercise, and sleep disturbances are a common occurrence with PTSD that often compounds existing symptoms. 

One study shows that any regular physical activity improves symptoms of PTSD, including weight training, resistance training, yoga (or any mind-body connection exercises), HIIT, and other aerobic exercises; although the more exercise, the better. Another study found that multimodal exercise programs (exercise programs that incorporate stretching, cardio, resistance and weight training, and functional training) benefited individuals with PTSD the most, improving their quality of life overall. That study goes on to explain that:

• Exercise may improve exposure and desensitization to internal arousal cues (helping individuals control and mitigate negative emotions). 
• Improve cognitive function, 
• Create exercise-induced neuroplasticity (the brain’s ability to reorganize and adapt) and normalize hypothalamic–pituitary axis function (leading to changes in stress hormone levels and improving the axis’s resilience and responsiveness).
• Exercise also strengthens the individual’s belief in their ability to achieve a better physical and psychological recovery. Belief in one’s own recovery is a central part of therapy. 
• Increasing mindfulness may help reduce symptoms when trauma-sensitive yoga is practiced, due to the meditation and mind-body connection established in practicing yoga. However, this did not impact depressive symptoms in any clinically significant way. 
• Regardless of the type of exercise, exercises that the individual enjoys (and therefore are more likely to practice regularly and long-term) provide the most symptom relief, although integrating multiple types of exercise is generally the best practice. 
• Exercising three times a week for at least 30-80 minutes produced significant symptom relief over the course of 8-12 weeks. 

A study that focused on HIIT and PTSD suggests that HIIT is particularly beneficial for symptom reduction due to its ability to increase brain-derived neurotrophic factor (BDNF), a protein that is likely important for synaptic plasticity and the formation of memory. It plays an important role in the development of PTSD, and Individuals with PTSD usually show decreased BDNF levels in serum. Compared to individuals who did lower intensity training, those who did HIIT significantly increased BDNF levels after a single 20-minute session. This effect was found to be transient, although more research is needed to control for other factors that increase the mean BDNF levels in specific populations and the lasting effects of temporarily increasing levels. In contrast to this, in the low intensity group, no increase was found in mean serum BDNF levels following the training session.

Research is ongoing relating to exercise and its effects on PTSD symptom management. One thing is clear, though. Exercise improves the quality of life in those with PTSD, and is effective, when combined with treatment from a mental health professional, at reducing symptoms and empowering individuals to believe in their ability to recover!