Guset blog via Simon Rosenbaum @simon_rosenbaum
PhD Candidate, The George Institute for Global Health, University of Sydney, Australia
November 11th marks the anniversary of the end of the First World War, and in recent times Remembrance or Armistice Day, has been dedicated to the memory of those who have died or suffered in armed conflicts around the world.
Whilst there are often physical injuries associated with armed conflict, the psychological wounds can be equally as debilitating, and are often less likely to be diagnosed or receive adequate treatment, with the prevalence of posttraumatic stress disorder (PTSD) among veterans of the wars in Afghanistan and Iraq, estimated to be between 10-20% (Richardson., 2010).
Similar to other mental health conditions, PTSD is associated with a decline in physical health including, obesity, high blood pressure, high cholesterol and insulin resistance, together known as the risk factors comprising metabolic syndrome. People with PTSD are also less likely to be physically active and more likely to have substance use disorders including alcohol dependence, further exaggerating the physical health problems (Boscarino., 2004).
The role of exercise as a key part of treatment for other mental health conditions such as depression and even schizophrenia has steadily been gaining traction and interest among mental health clinicians, with known anti-depressive and anxiolytic (anti-anxiety) effects of even short bouts of physical activity. The potential role that exercise may play in helping those with PTSD has not been well investigated, however anecdotal and preliminary evidence suggest it may a worthwhile addition to usual care, especially when we consider that the majority of those affected are likely to have come from a physically active background e.g. defense or police.
Social withdrawal, isolation, and avoidance of previously enjoyable activities are all parts of PTSD that structured exercise has the potential to improve, either directly or indirectly. For example in a recent trial of exercise and the effects on PTSD (article currently under review; protocol can be found here http://www.biomedcentral.com/1471-244X/11/115), we often heard stories of participants who commenced a basic exercise program that in turn resulted in more regular walking and other exercise, perhaps even with partners, and in some cases was the catalyst for participants to pick up the golf clubs or dust off the push-bike, arguably an invaluable step forward on the path of recovery. Sleep disturbances are also a common aspect of PTSD that can have a debilitating impact, yet may benefit from regular exercise.
As health clinicians we are accustomed to promoting the "Exercise Works!" message for common conditions such as back pain, high blood pressure and obesity. Perhaps this Remembrance Day we can also consider how the "Exercise Works!" medicine could benefit those openly and silently suffering with PTSD.
Lest we forget........
every consult, help the service personnel, past and present, to access quality exercise advice and support...
Blog moderated by Ann Gates BPharm(Hons) MRPharmS, Founder of Exercise Works!