Meditation and mindfulness exercises proved more successful than standard group therapy in treating symptoms of post-traumatic stress disorder (PTSD) in veterans at the Minneapolis VA Medical Center — a finding that could reshape the nation’s approach to treating the psychological scars of war.
Two months after a 9-week course on stress reduction using mindfulness techniques, veterans showed more rapid decline in the severity of their PTSD symptoms than a comparison group, the researchers reported Tuesday. Nearly half receiving the mindfulness training showed clinically significant reductions in their disorders, compared with 28 percent of the comparison group who received standard group therapy, according to results published in the Journal of the American Medical Association (JAMA).
The training gives veterans take-home strategies to confront the nightmarish memories from war or other traumas — memories they otherwise try to avoid, said Melissa Polusny, a VA psychologist who co-authored the study.
“Avoidance … seems like it helps to manage those symptoms, but in the long run it makes them worse,” she said. “This treatment gives people a different way of looking at their symptoms.”
PTSD is a condition of reliving traumatic experiences that causes people to feel anxiety and fear, often driving them to abuse drugs and alcohol or to contemplate self-harm. An estimated 23 percent of troops returning from Iraq and Afghanistan are affected by the disorder.
For Jeff Hellesvig, who was diagnosed with PTSD years after fighting for the Army’s 1st Calvary in the Cambodia campaign of the Vietnam War, war footage on TV or loud noises can trigger stress or depression. Hellesvig, 65, lost his wife, lost contact with friends and family, struggled with alcohol abuse, and retreated to hermit-like solitude in Lakewood, Minn., where he worked odd jobs and fixed up old cars.
“I screwed up anything I ever really touched,” he said, “not knowing what the hell was wrong with me and never dealing with it or having the ability to know how to deal with it.”
Hellesvig was skeptical but seeking more help two years ago, when he signed up for the PTSD study and mindfulness training.
Eventually, he discovered that breathing and calming exercises helped him focus on the present and not so much on old memories and the disappointments of how his life turned out.
“There were times during these sessions when I really didn’t want to leave,” he said, “because I really felt comfortable. I never really felt that before in my life.”
Mindfulness training reflects a growing wave of alternative therapies in mainstream medicine, and is offered by Allina Health and other Twin Cities providers.
How the VA will use it, given the research findings, is unclear. While the study of 116 veterans was the largest of its kind, Polusny said follow-up research is needed. A JAMA editorial by VA doctors in Seattle noted that the study looked at PTSD symptoms just two months after the therapy program, so long-term benefits remain unproven.
The mindfulness therapy also wasn’t tested directly against tried-and-true forms of PTSD treatment such as exposure therapy — a method of having veterans repeatedly confront their traumatic memories that is successful but also has a high dropout rate. Mindfulness training could work as an alternative or complement to such standard treatments.
VA psychiatrists have nonetheless been ordering the training for patients such as John Hargens, 68, of Rosemount, who suffered PTSD after being overwhelmed with life-or-death decisions as a teenage Marine lieutenant in Vietnam. Even now, he feels on high alert — as if a grenade might roll into his cubicle at work, or he might be ambushed driving his car in a valley. Nine months after mindfulness training at the University of Minnesota’s Center for Spirituality & Healing last fall, co-workers and relatives notice a difference.
“I have more peace than I have ever had in the 40-some years since I came back from Vietnam,” Hargens said.
Given the practical value of mindfulness training, there could be value in teaching them to all soldiers returning from deployment, regardless of PTSD symptoms, Polusny said. She and a colleague flew to Washington, D.C., Tuesday to brief VA leaders on the study results and how they might be applied to future research or clinical care.
Hellesvig now starts each day in bed with calming breaths followed by “quiet time,” an opportunity to map out the day ahead. Meditation has helped him to “tone it down” when something triggers his stress, and avoid the depressions that compelled him for weeks to cover his windows and stop answering the phone.
Beyond restoring a 1955 Chevrolet, Hellesvig now wants to work with younger veterans to help them cope.
“That’s what I’m trying to make out of the rest of the time I have,” he said, “that and to maybe breathe a little easier.”