Thanks to my friends over at Breath Research for tweeting about this interesting, albeit very small, study on the use of breathing exercises to reduce the symptoms of PTSD.
Post-traumatic stress disorder (PTSD) is triggered by experiencing or witnessing a terrifying event, such as rape, combat, domestic violence, or acts of terrorism. Symptoms include flashbacks – some can be debilitating, nightmares, severe anxiety, and uncontrollable thoughts about the event. People with PTSD describe being hyper-vigilent, feel constantly alert, and overreacting to small noises – interesting all characteristics that could be protective in a time of danger. Depression, suicidal ideation and completed suicides are also part of the disorder. People suffering from PTSD also complain that they have a hard time connecting with family and friends. It is not uncommon for people with PTSD to try to diminish their symptoms by drinking alcohol or smoking marijuana.
Traditional treatment of the disorder includes medications (typically sertraline (Zoloft) or paroxetine (Paxil) and talk therapy. The National Institute of Mental Health PTSD website, in fact, only lists these two types of treatment. That’s why the tweet caught my eye. Could Yogic breathing, often touted as useful to relieve anxiety and stress, provide some relief to sufferers of PTSD? Preliminary data suggests it can.
Stanford University researcher, Emma Seppala, Associate Director of Stanford’s Center for Compassion and Altriusm Research and Education recently completed a small study of the impact of breathing exercises on PTSD symptoms. Twenty-one male veterans of the Iraq and Afghanistan wars participated About half of the vets were assigned to take a week long breathing exercise workshop, the others were not. The vets in the intervention group were taught breathing exercises based on breathing techniques from the Sudarshan Kriya Yoga (SKY) practice. According to an article by Zopes and Zopes in the International Journal of Yoga (indexed on PubMed) SKY’s four main breathing techniques are as follows:
- Ujjayi or “Victorious Breath”: This involves experiencing the conscious sensation of the breath touching the throat. This slow breath technique (2-4 breaths per minute) increases airway resistance during inspiration and expiration and controls airflow so that each phase of the breath cycle can be prolonged to an exact count. The subjective experience is physical and mental calmness with alertness.
- During Bhastrika or “Bellows Breath,” air is rapidly inhaled and forcefully exhaled at a rate of 30 breaths per minute. It causes excitation followed by calmness.
- “Om” is chanted three times with very prolonged expiration.
- Sudarshan Kriya which is a Sanskrit term meaning “proper vision by purifying action” is an advanced form of rhythmic, cyclical breathing with slow, medium, and fast cycles.
What was “mind-blowing” according to Seppala, as reported in the May 22, 2013 issue of Stanford News Service, was not only did the breathing exercises have an acute impact on PTSD symptoms, “the effects of a weeklong workshop practicing the techniques remained a year later, suggesting lasting impact from this type of treatment.”
The results of this study have not yet been published, although it is being prepared for publication, so we can’t cast a critical eye on the rigor of the study’s design. There is, however, a body of research that has been published on the physiologic benefits of SKY. A paper by Zopes and Zopes published in the International Journal of Yoga reviews what is known. Although IJY is not a traditional medical journal, the publications cited in this paper make me think that there is enough known about SKY to suggest that larger and more systematic reviews of its use in various human conditions related to anxiety and stress be further explored. Hopefully, Dr. Seppala and other researchers will pursue the rigorous investigation of the role of Yogic breathing in this arena.