# Exercise as it relates to Disease/Exercise and its relation to Post Traumatic Stress Disorder
## Background To PTSD

Post traumatic stress disorder (PTSD) is a type of mental anxiety disorder that affects people that have witnessed or experienced traumatic situations. The Australian Bureau of statistics show that PTSD prevalence in Australia is quite high, with 6.4% of the population aged between 16-85 having experienced PTSD symptoms in the 12 months prior to the National Survey of Mental Health and Wellbeing being carried out in 2007.
General symptoms include, but are not limited to, occurrences of:
* Recollections or dreams of the event that are intrusive, with the possibility of reliving the event
* Psychological distress from recollections or mental cues relating to the event
* Persistent avoidance of stimuli related to the event, e.g. conversations, settings
* Feeling of detachment from others
* Decreased interest in significant activities
* Anger outbursts
* Difficulty sleeping
* Lack of concentration
* Startled easily
Presently, numerous treatments are available for sufferers. The methods most popularly used include:
| Cognitive Behavioural Therapy | Trauma Desensitisation |
| Exposure Therapy | Relapse Prevention Therapy |
| Hypnotherapy | Interpersonal Therapy |
| Pharmacotherapy |

## How PTSD Can Effect Exercise

The effect of PTSD not only has a mental effect, but a physical effect. Those diagnosed with PTSD were seen to rate themselves as less active than others, in comparison to those without a diagnosed PTSD. It was also reported that after being diagnosed with PTSD there was a significant decrease in activity from previous activity habits. This is an issue because a lack of physical activity leads correlates with poorer health, such as an increased risk of cardiovascular disease, in conjunction with an increase of high risk behaviours such as smoking that lead to poorer health. De Assis et al. (2008) suggests that this lack of exercise is caused by a trending issue to lack of motivation. As the Diagnostic and Statistical Manual of Mental Disorders (IV) suggests, a lack of interest in activities is a symptom of PTSD and accordingly one can suggest that this reduces the sufferers motivation to exercise.

## How Exercise Can Reduce PTSD Symptoms

Commonly, exercise is used as a compliment or an alternative to traditional treatment of PTSD. Two advantages can be taken from exercise as treatment:
    Physiological
Aerobic exercise has been known to relax the sympathetic nervous system through the release of beta-endorphins, as well as regular exercise being a catalyst for an increase in serotonin in the brain. PTSD has found to be correlated with low levels of serotonin, and as such exercise can mimic the effect of SSRI pharmacological treatment of PTSD. As well as this, it can be effective in the combating of co-morbidities that come hand in hand with PTSD, such as Cardiovascular disease.
    Psychological
Exercise can act as a distractor from negative thoughts, as well as being associated with positive moods and outlooks in individuals.

## Recommendations

* Practitioners, family and friends should be aware of the signs and symptoms of PTSD (mentioned above) in patients and loved ones.
* Consult the APA DSM-IV for specifics of diagnosis, and seek an official diagnosis from a qualified mental health professional.
* Be aware of the numerous treatment options that include psychological interventions, pharmacological interventions and exercise interventions.
* Exercise interventions are most effective in combination with psychological/pharmacological interventions, however caution must be taken when undertaking any type of treatment for PTSD due to its nature. Always pre-screen before exercise.
* PTSD can cause a decrease in activity levels, and hence it is in important to try to continue exercise not only to reduce comorbidity factors but also as a possible treatment.
* Further research is required to determine how effective exercise is in reducing PTSD symptoms, as a larger sample size is needed to confirm validity of the findings found so far.

## Further reading

For further information about PTSD, visit the Beyond Blue website on PTSD, linked with a comprehensive fact sheet. If you believe you are experiencing PTSD or experiencing similar symptoms, please do not hesitate to contact Lifeline on 13 11 14.

## References

* ↑ Seides, R. (2010). Should the current DSM-IV-TR definition for PTSD be expanded to include serial and multiple microtraumas as aetiologies?. Journal Of Psychiatric & Mental Health Nursing, 17(8), 725-731. doi:10.1111/j.1365-2850.2010.01591.x
* ↑ Australian Bureau Of Statistics (2007). National Survey of Mental Health and Wellbeing. Canberra, Australia.
* 1 2 3 American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
* ↑ 4. Imel, Z. E., Laska, K., Jakupcak, M., & Simpson, T. L. (2013). Meta-analysis of dropout in treatments for posttraumatic stress disorder. Journal Of Consulting And Clinical Psychology, 81(3), 394-404. doi:10.1037/a0031474
* 1 2 3 Ottati, A., & Ferraro, F. (2009). Combat-Related PTSD Treatment: Indications for Exercise Therapy. Psychology Journal, 6(4), 184-196.
* 1 2 3 Zen, A. L., Whooley, M. A., Zhao, S., & Cohen, B. E. (2012). Post-traumatic stress disorder is associated with poor health behaviors: Findings from the Heart and Soul Study. Health Psychology, 31(2), 194-201. doi:10.1037/a0025989
* 1 2 de Assis, M. A., de Mello, M. F., Scorza, F. A., Cadrobbi, M. P., Schooedl, A. F., da Silva, S. G., . . . Arida, R. M. (2008). Evaluation of physical activity habits in patients with posttraumatic stress disorder. Clinics (SaoPaulo), 63,473–478
* 1 2 3 Dedert, E. A., Calhoun, P. S., Watkins, L. L., Sherwood, A., & Beckham, J. C. (2010). Posttraumatic Stress Disorder, Cardiovascular, and Metabolic Disease: A Review of the Evidence. Annals Of Behavioral Medicine, 39(1), 61-78. doi:10.1007/s12160-010-9165-9
* 1 2 Libby, D. J., Pilver, C. E., & Desai, R. (2013). Complementary and alternative medicine use among individuals with posttraumatic stress disorder. Psychological Trauma: Theory, Research, Practice, And Policy, 5(3), 277-285. doi:10.1037/a0027082
* ↑ Brosse, A. L., Sheets, E. S., Lett, H. S., & Blumenthal, J. A. (2002). Exercise and the treatment of clinical depression in adults: recent findings and future directions. / Exercice et therapie de la depression chez les adultes: resultats actuels et orientations pour l ' avenir. Sports Medicine, 32(12), 741-760.
* ↑ Callaghan, P. (2004). Exercise: a neglected intervention in mental health care?. Journal Of Psychiatric & Mental Health Nursing, 11(4), 476-483. doi:10.1111/j.1365-2850.2004.00751.x
* ↑ Mata, J., Hogan, C. L., Joormann, J., Waugh, C. E., & Gotlib, I. H. (2013). Acute exercise attenuates negative affect following repeated sad mood inductions in persons who have recovered from depression. Journal Of Abnormal Psychology, 122(1), 45-50. doi:10.1037/a0029881