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Healing Wounds of the Psyche

March 17th, 2010 No comments

There’s this phenomenon called Post Traumatic Stress Disorder.  A pilot study funded by the National Institutes of Health suggest Acupuncture may be of use for it.  Again, this is something that Chinese medicine practitioners have known for quite a while now.

According to the National Institute of Mental Health’s Website (http://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-ptsd/index.shtml), PSTD can be defined as “…an anxiety disorder that some people get after seeing or living through a dangerous event.”  Kinda like watching the 3-D version of Avatar without 3-D glasses.  Not like I’ve tried.

The website has a great way of explaining the situation to laymen:

When in danger, it’s natural to feel afraid. This fear triggers many split-second changes in the body to prepare to defend against the danger or to avoid it. This “fight-or-flight” response is a healthy reaction meant to protect a person from harm. But in PTSD, this reaction is changed or damaged. People who have PTSD may feel stressed or frightened even when they’re no longer in danger.

So people reading the newspapers everyday have PTSD?  I mean they feel stressed and frightened despite not being in immediate danger…  Seriously though, I’ve heard stories of people having recurring nightmares because of this.

Soldiers 300x199 Healing Wounds of the Psyche

Soldiers may go home with their bodies healed, but their psyches scarred.

So what exactly does Post Traumatic Stress Disorder mean clinically?

PTSD can cause many symptoms. These symptoms can be grouped into three categories:

1. Re-experiencing symptoms:

  • Flashbacks—reliving the trauma over and over, including physical symptoms like a racing heart or sweating
  • Bad dreams
  • Frightening thoughts.

Re-experiencing symptoms may cause problems in a person’s everyday routine. They can start from the person’s own thoughts and feelings. Words, objects, or situations that are reminders of the event can also trigger re-experiencing.

2. Avoidance symptoms:

  • Staying away from places, events, or objects that are reminders of the experience
  • Feeling emotionally numb
  • Feeling strong guilt, depression, or worry
  • Losing interest in activities that were enjoyable in the past
  • Having trouble remembering the dangerous event.

Things that remind a person of the traumatic event can trigger avoidance symptoms. These symptoms may cause a person to change his or her personal routine. For example, after a bad car accident, a person who usually drives may avoid driving or riding in a car.

3. Hyperarousal symptoms:

  • Being easily startled
  • Feeling tense or “on edge”
  • Having difficulty sleeping, and/or having angry outbursts.

Hyperarousal symptoms are usually constant, instead of being triggered by things that remind one of the traumatic event. They can make the person feel stressed and angry. These symptoms may make it hard to do daily tasks, such as sleeping, eating, or concentrating.

It’s natural to have some of these symptoms after a dangerous event. Sometimes people have very serious symptoms that go away after a few weeks. This is called acute stress disorder, or ASD. When the symptoms last more than a few weeks and become an ongoing problem, they might be PTSD. Some people with PTSD don’t show any symptoms for weeks or months.

In traditional Chinese medicine, there is such a notion as a vicious cycle caused by severe, sudden emotions.  These affect certain organs, which in turn increase our susceptibility to the aforementioned emotions.  For example, frustration upsets the Liver, causing Qi stagnation, which leads to a greater tendency to feel anger or frustration – a vicious cycle.  Sometimes, the person is able to correct this on their own – as evidenced by healing after a time.  Sometimes, it gets stuck.  Chinese medicine works by breaking that cycle.

Let’s look at the study: (from http://nccam.nih.gov/research/results/spotlight/092107.htm)

Acupuncture May Help Symptoms of Post Traumatic Stress Disorder

A pilot study shows that acupuncture may help people with posttraumatic stress disorder. Posttraumatic stress disorder (PTSD) is an anxiety disorder that can develop after exposure to a terrifying event or ordeal in which grave physical harm occurred or was threatened. Traumatic events that may trigger PTSD include violent personal assaults, natural or human-caused disasters, accidents, or military combat.

Can it treat my stress secondary to watching Knicks games?  That’s very terrifying these days, and will be more so if we don’t get any free agents this summer…

Anyway here’s the gist:

Michael Hollifield, M.D., and colleagues conducted a clinical trial examining the effect of acupuncture on the symptoms of PTSD. The researchers analyzed depression, anxiety, and impairment in 73 people with a diagnosis of PTSD. The participants were assigned to receive either acupuncture or group cognitive-behavioral therapy over 12 weeks, or were assigned to a wait-list as part of the control group. The people in the control group were offered treatment or referral for treatment at the end of their participation.

And the results?

The researchers found that acupuncture provided treatment effects similar to group cognitive-behavioral therapy; both interventions were superior to the control group. Additionally, treatment effects of both the acupuncture and the group therapy were maintained for 3 months after the end of treatment.

The limitations of the study are consistent with preliminary research. For example, this study had a small group of participants that lacked diversity, and the results do not account for outside factors that may have affected the treatments’ results.

The abstract may be found here: (http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=17568299)

The purpose of the study was to evaluate the potential efficacy and acceptability of accupuncture for posttraumatic stress disorder (PTSD). People diagnosed with PTSD were randomized to either an empirically developed accupuncture treatment (ACU), a group cognitive-behavioral therapy (CBT), or a wait-list control (WLC). The primary outcome measure was self-reported PTSD symptoms at baseline, end treatment, and 3-month follow-up. Repeated measures MANOVA was used to detect predicted Group X Time effects in both intent-to-treat (ITT) and treatment completion models. Compared with the WLC condition in the ITT model, accupuncture provided large treatment effects for PTSD (F [1, 46] = 12.60; p < 0.01; Cohen’s d = 1.29), similar in magnitude to group CBT (F [1, 47] = 12.45; p < 0.01; d = 1.42) (ACU vs. CBT, d = 0.29). Symptom reductions at end treatment were maintained at 3-month follow-up for both interventions. Accupuncture may be an efficacious and acceptable nonexposure treatment option for PTSD. Larger trials with additional controls and methods are warranted to replicate and extend these findings.

Right, I’ll re-read the layman version.

Here’s the reference:

Michael Hollifield, Nityamo Sinclair-Lian, Teddy D. Warner, and Richard Hammerschlag, “Acupuncture for Posttraumatic Stress Disorder: A Randomized Controlled Pilot Trial.” The Journal of Nervous and Mental Disease, June 2007.

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