Treatment for complex post-traumatic stress disorder (C-PTSD) happens on many levels. In order to heal emotionally and mentally, we need to support the physical body as well.
Research has found extensive comorbidity for C-PTSD and major depressive disorder (MDD) (95% lifetime, 50% current), as well as anxiety disorders. ((Bleich, A., Koslowsky, M., Dolev, A., & Lerer, B. (1997). Post-traumatic stress disorder and depression: An analysis of comorbidity. The British Journal of Psychiatry, 170(5), 479-482.)) In addition to the higher prevalence of depression and anxiety, depressed patients with posttraumatic stress disorder (PTSD) tend to experience more severe symptoms. ((Campbell, D. G., Felker, B. L., Liu, C. F., Yano, E. M., Kirchner, J. E., Chan, D., … & Chaney, E. F. (2007). Prevalence of depression-PTSD comorbidity: Implications for clinical practice guidelines and primary care-based interventions. Journal of general internal medicine, 22(6), 711-718.))
Addressing Anxiety and Depression as Part of Treatment for C-PTSD
We now know that our physical bodies are interconnected with the functioning of our mental and emotional experience. ((Physical health and mental health [n.d.] Mental Health Foundation.Retrieved from https://www.mentalhealth.org.uk/a-to-z/p/physical-health-and-mental-health)) The nervous system and brain do not operate separately from the physical body. When we are hurt emotionally and mentally, leveraging the power of lifestyle change should be an important part of the treatment process and effective recovery.
Lifestyle changes that reduce depression and anxiety should be considered, and encouraged, as part of the whole treatment program for C-PTSD.
Exercise has profound effects on the functioning of the brain and nervous system. A large population-based study found lower anxiety and depression in people who exercised regularly. ((De Moor, M. H. M., Beem, A. L., Stubbe, J. H., Boomsma, D. I., & De Geus, E. J. C. (2006). Regular exercise, anxiety, depression and personality: a population-based study. Preventive medicine, 42(4), 273-279.)) Exercise as a treatment for depression was found to be effective on its own and effective in addition to medication. ((Schuch, F. B., Vancampfort, D., Richards, J., Rosenbaum, S., Ward, P. B., & Stubbs, B. (2016). Exercise as a treatment for depression: a meta-analysis adjusting for publication bias. Journal of psychiatric research, 77, 42-51.)) The study found that aerobic exercise had large effects ameliorating major depression at moderate and vigorous intensities, supervised and unsupervised. These results show strong treatment benefits for depression.
If aerobic exercise is not for you, you may want to consider yoga. Yoga has also been shown to have beneficial effects for both anxiety and depression. ((Harvard Mental Health Letter. (April 2009). Harvard Health Publishing. Harvard Medical School. Retrieved from https://www.health.harvard.edu/mind-and-mood/yoga-for-anxiety-and-depression)) Yoga includes not only the movement of the body but (in some classes) meditation and relaxation as well. Additionally, the group environment of a yoga class may provide additional benefits and support, including motivation purposes, peer encouragement, and just plain enjoyment from participation in an instructor-led group atmosphere.
For reasons not well understood, exercise also has beneficial effects on sleeping patterns and the circadian clock (an internal timing mechanism that coordinates biochemical, physiological, and behavioral processes over a 24 hour period). Poor sleep is thought to be a significant factor contributing to depression and anxiety. ((Morgan, J. A., Corrigan, F., & Baune, B. T. (2015). Effects of physical exercise on central nervous system functions: a review of brain region specific adaptations. Journal of molecular psychiatry, 3(1), 3.)) Difficulty sleeping can be a symptom of C-PTSD in addition to being both a contributor to and result of high stress and anxiety. ((Leonard, J. (2018). What to know about complex PTSD. Medical News Today. Retrieved from https://www.medicalnewstoday.com/articles/322886.php))
Our diet contributes significantly to our overall mental health and wellbeing. Recently, what we eat has gained the attention of mental and neurological health researchers as our eating habits seem to be related to a variety of conditions. ((Dash, S.R. (2016). Nutritional Psychiatry: Investigating the Link Between Food and Mood. Retrieved from http://foodandmoodcentre.com.au/nutritional-psychiatry-investigating-the-link-between-food-and-mood/)) Nutrition affects the structure and function of the brain and nervous system. The Mediterranean Diet (high in fresh seasonal and local foods, generally high in fresh fruit, vegetables, nuts, and fish and low in meat and dairy) has been found to have a beneficial impact on mood. ((The Mediterranean Diet. (2018). Retrieved fromhttps://www.eufic.org/en/healthy-living/article/the-mediterranean-diet)) In addition, research has demonstrated that eating unhealthy foods high in sugar and processed carbs can increase the risk of depression. ((Large-scale study finds that the Mediterranean diet is best for your mental health. (2018). Retrieved from https://medicalxpress.com/news/2018-10-large-scale-mediterranean-diet-mental-health.html))
The Overall Impact of a Healthy Lifestyle as a Treatment Strategy
Complex posttraumatic stress disorder is a serious condition that leads to many negative mental, emotional and physical health issues. Although C-PTSD is treatable with therapy and sometimes medication, it is crucial to include diet and exercise as part of the treatment plan. The body and the mind support each other and affect each other profoundly. In addition to seeking help with therapy for C-PTSD, consider consulting your doctor or other professional that can help you develop and implement a program to improve your overall physical health.