17 May 2009

Meditation Helps Veterans with PTSD

Dr. David Kearney, standing, a veterans-hospital physician, conducts a mindfulness-based stress-reduction class that uses meditation and yoga techniques to combat chronic pain, depression, anxiety and post-traumatic stress disorder. In front is Stephen Brakus. Photo: Courtney Blethen, Seattle Times.

Seattle hospital teaches meditation to troubled vets
By Michelle Ma / May 17, 2009

The Seattle veterans hospital is teaching patients a form of meditation to ease their post-traumatic stress disorder. The technique called mindfulness-based stress reduction helps patients deal with anxiety, chronic pain and other health issues.

After four combat tours — two in Iraq and two in Afghanistan — normal life seemed impossible for one Seattle Army veteran.

His heart raced when driving under an overpass, and he had trouble breathing when stuck in snarled traffic. As a soldier in combat, he wouldn't dare slow down for fear of being bombed or shot.

Crowded rooms were just as bad. He locked himself away at home and drank instead of facing large groups or loud, sudden noises. He responded to the slightest sense of threat with all-out aggression.

Last summer, the 34-year-old sergeant sought help at the Seattle veterans hospital, enrolling in group and individual therapy and starting medication to treat what doctors diagnosed as post-traumatic stress disorder (PTSD).

He also practices a form of meditation he learned through the VA Puget Sound Health Care System that has eased the horrific memories that bombarded his mind.

The technique, called mindfulness-based stress reduction, seeks to help patients deal with anxiety, chronic pain and other health issues through meditation, yoga and deep-breathing exercises.

"It's like the thoughts lost their hook," the Seattle veteran said. "Before, they were just ripping me. With mindfulness, it opens up the blinders, and you realize (those thoughts) are not the totality of your existence forever."

He asked not to be named because he's looking for a job and worries employers won't hire him if they know about his PTSD.

Dr. David Kearney, a veterans-hospital physician and associate professor at the University of Washington, has offered veterans the eight-week course in mindfulness-based stress reduction for more than a year.

Kearney is running the first study of its kind to determine whether the course is effective in treating PTSD among veterans. Those taking classes this spring and summer will contribute to Kearney's study, which is funded by Puget Sound Partners for Global Health, a local research consortium funded by the Gates Foundation.

Mindfulness treatment asks participants to be aware of their thoughts and physical pain without judgment. It's easy to stew over negative thoughts, which can cause more stress and frustration.

By simply pausing to pay attention, people can notice patterns in their thinking and put thoughts into perspective to improve their lives. Deep breathing, meditation and yoga help with this process.

Scientific studies have shown the technique can help patients with a range of issues, including anxiety, depression, chronic pain and rheumatoid arthritis. Kearney hopes to add PTSD to that list.

"I quickly found that people with PTSD sought out the class to find additional ways of dealing with this problem," he said. "We've had many patients report to us the ability to be present in the actual moment helped their PTSD."

Lessens anxiety

PTSD is an anxiety disorder caused by traumatic experiences such as war or sexual assault. At the local veterans hospital, psychologists estimate 10-20 percent of combat veterans have the disorder.

Matthew Brazerol of Bremerton recently retired after serving 20 years in the U.S. Coast Guard. He enrolled in the VA's mindfulness class last spring after chronic pain and PTSD became debilitating.

"I came in with an open mind willing to try anything," he said.

Brazerol's responsibilities included recovering bodies and rescuing people. He said those cumulative experiences probably contributed to his anxiety. As the years progressed, Brazerol, 47, felt jumpy and anxious, and he would flinch at the sound of footsteps from anyone he couldn't identify.

After completing the mindfulness course, Brazerol said, his symptoms are less frequent. Practicing the meditation throughout the day helps him adjust his reaction to a painful memory, and he isn't as anxious.

"If you incorporate this into your life, it will help you regardless of what's going on," Brazerol said.

Not based on religion

Mindfulness treatment uses some Buddhist meditation principles, but the course isn't based on religious teachings. The classes were designed several decades ago by a physician at the University of Massachusetts Medical School.

In the last decade, mindfulness treatment has spread to hundreds of hospitals and clinics. In Seattle, Swedish Medical Center, Evergreen Healthcare and the veterans hospital are among those offering the technique.

Studies show that our thoughts can initiate a stress response in our bodies. First, we start thinking about a problem or concern. As we ruminate on these thoughts, the brain can send stress-response signals to other parts of the body, causing a faster heartbeat, shallow breathing and tense muscles. Prolonged stress can cause health problems.

But if we train ourselves to pause when that first thought enters the mind, we can largely control our physical response, studies have shown. Exercises such as deep breathing and meditation also help calm the body.

"The story we tell ourselves has a lot to do with the whole unfolding of the actual situation," said Dr. Jeff Brantley, director of the mindfulness program at Duke Integrative Medicine at Duke University Health System.

Wary of yoga mats

For people with PTSD, sounds and situations resembling a past traumatic event can trigger an anxious reaction. Kearney says his patients usually don't forget their traumatic experiences but can learn to live comfortably without having those memories take charge.

In other types of PTSD treatment, patients talk through painful memories and immerse themselves in experiences that cause the anxiety. While that form of therapy can be successful, veterans typically have a 25 percent dropout rate, said Matthew Jakupcak, a psychologist at the local VA's deployment health clinic.

In Seattle, the mindfulness classes have steadily drawn more interest among veterans — though many at first are wary of the yoga mats and meditation.

"It works, but I was skeptical," said Herb Washington, 46, who completed the course last year. The Oak Harbor resident fought in the first Gulf War and has suffered from chronic pain and diabetes. Washington was born with a foot condition that became aggravated in the military.

His pain isn't gone, but he doesn't depend so much on pain medication. He said he feels anger and frustration slip away when he does his mindfulness routine.

"It's a structured discipline," Washington said. "That's why I think it'll be effective for veterans."

More information

Mindfulness-based stress reduction

University of Massachusetts Center for Mindfulness: www.umassmed.edu/content.aspx?id=41252

Swedish Medical Center: www.swedish.org/body.cfm?id=1207

VA Puget Sound Health Care System mindfulness course: 206-277-1721

PTSD information

National Center for Post Traumatic Stress Disorder: www.ncptsd.va.gov/ncmain

Copyright © 2009 The Seattle Times Company

Source / Seattle Times

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