08 Jul Post-Traumatic Stress Disorder and Exercise: A Case Study

Post-Traumatic Stress Disorder (PTSD) affects about 12% of Australians, and can have a really negative impact on your health. So, how can getting active help and what are the best types of exercise for PTSD?

Post-Traumatic Stress Disorder (PTSD) is a group of stress reactions that can develop after we witness a traumatic event, such as death, serious injury or violence to ourselves or others. It’s common that after exposure to a trauma, humans will experience a myriad of emotions such as fear, sadness, anger and grief. This is a natural human process. Sometimes these emotions will fade, but for some people they can stay for an extended period of time and have a negative impact on their life.

For some individuals, PTSD can develop after being exposed to one traumatic event, and for others it can take multiple traumas. About 25% of people who are exposed to traumatic events develop PTSD. This means that 12% of individuals living in Australia will experience this condition in their lifetime.

Physical, Psychological and Social Health Factors of PTSD

Although PTSD is a psychological health diagnosis, it can actually have a profound impact on physical health and social health factors as well. Every individual that is diagnosed with PTSD will have a different story, however it is common that there are also signs of reduced physical health, social inclusion and of course, psychological health. Some of many symptoms include:

Physically

• Weight fluctuations (weight gain or loss)
• Increased blood pressure
• Increased sedentary behaviours
• Higher risk of diabetes

Socially

• Increased time spent at home
• Avoid catching up with family and friends
• Avoidance of busy or noise stimulating areas
• Increased time spent away from work

Psychologically

• Increased anxiety
• Depressed mood
• Poor sleep hygiene due to night terrors
• Increased fear/avoidance associated with certain triggers

How can exercise be administered: A Case Study

There are numerous ways in which physical activity can be helpful for someone who is dealing with a diagnosis of PTSD. Let’s go through a case study to touch on a few ways in which exercise can help not only for psychological health, but also physical and social health as well.

Nell has been a paramedic for the past 20 years and seen many traumatic incidences whilst treating patients at work. She started noticing increased anxiety surrounding going to workand found herself avoiding watching TV shows that included violence. She also had poor sleep hygiene (often waking throughout the night due to night terrors), was getting irritable quickly and often felt depressed.

Getting help

Nell decided to chat to her GP and her manager and they recommended she take some time off work to focus on her health. Nell started seeking help from a local psychologist and psychiatrist who placed her on some medication.

After being off work for some time, Nell started becoming highly sedentary. She was no longer leaving the home to take the dog for a walk or attend her local gym like she used to. Consequently, she gained weight and was diagnosed with pre-diabetes. Being a paramedic, Nell knew that her sedentary behaviour was having a poor impact on her physical health so she started walking her dog again. Unfortunately, Nell fell out of this routine after 3 days as she felt increased anxiety when leaving the home and also felt negatively about her body image and poor cardiorespiratory health.

Luckily, she got some assistance from a friend who was an Accredited Exercise Physiologist. With this support, she decided to try exercise once again. This time, she recognised the need to set some goals to ensure she was able to stay on track and benefit her physical, psychological and social health outcomes.

Setting Goals

Setting goals and sticking to them can be a hard task to accomplish, especially when you are working with added variables of poor psychological health such as PTSD. Nell decided the best way for her to set some goals was to recognise what she wants to achieve and apply it to a plan, using the SMART goal setting process.

SPECIFIC, MEASURABLE, ACHIEVABLE, REALISTIC, TIME-ORIENTED

Nell’s goals were:

1. To jog the full length of Park Run (5km) within an 8 week time-frame.

2. To attend her local yoga class 1x per week in a habitual manner, over the next 12 weeks.

2. To take her dog for a walk/jog for 20-30 minutes , 3x per week, demonstrating habitual engagement in aerobic-based exercise.

4. To attend the gym 3x per week, focusing on resistance-based exercises, for a period of 12 weeks.

With these goals in mind, her exercise physiologist helped to tailor a weekly exercise regime to ensure she was working towards her goals.

What exercise and how much to do?

Best Types of Exercise for PTSD

Research suggests that numerous types of exercise can be beneficial for those living with PTSD and that the best type of exercise is something that you enjoy. Exercising for enjoyment will further increase your changes of staying motivated and engaged with exercise. Strength/resistance based exercise, aerobic exercise and mindful-based exercise practice such as yoga can all help. So realistically, all exercise is beneficial!  It comes down to what you enjoy and ultimately, what you want to achieve. That’s why the goal setting process is so important. In Nell’s case, she enjoys having a variety of exercise and subsequently set goals to ensure she could achieve this.

How Much Exercise

The amount of exercise you should be engaging in really depends on your exercise history and what your goals are. The World Health Organisation has set a recommended amount of physical activity for all individuals which is a great place to begin.

Adults aged 18-64 Years should:

• Accumulate at least 150 minutes of moderate-intensity physical activity throughout the week, or do at least 75 minutes of vigorous-intensity physical activity throughout the week.
• Do muscle-strengthening activities sinvolving major muscle groups on 2 or more days per week.

To learn more about the exercise guidelines for your stage of life, click here. 

Take Home Notes

• Exercise in a form that will provide YOU with the most enjoyment. Whether it’s strength training in the gym, running, walking, bike riding, team sports, even yoga or tai-chi, they all provide benefit for your mental health inclusive of PTSD. There’s no “best type” of exercise for PTSD.
• Follow the World Health Organisation (WHO) recommendations as a guide. Start slow and gradually increase exercise levels to meet these guidelines.
• Exercising with a friend or family member can help to keep you on track and motivated to exercise. This is especially true when starting out, as you may find it harder to remain consistent with your plan.
• Don’t forget to look back and see how far you have come! It’s healthy to check in with your exercise goals and see how you are tracking to achieve them. If they seem slightly unrealistic for you at this time, don’t hesitate to make some changes. Remember any exercise is better than none!

Where to find help

If you or someone you know is living with PTSD and wants some help to start exercising, contact your local Accredited Exercise Physiologist. They will help with goal setting and will prescribe exercises that are safe and tailored to your individual needs.

To find an exercise physiologist near you, click here. 

Amy-Lee is an Accredited Exercise Physiologist at Guardian Exercise Rehabilitation. She is passionate about injury recovery and musculoskeletal rehabilitation and understands how valuable patient education is in the recovery process.