Self-Care And PTSD

A 2018 review of 1,349 studies (29 met eligibility criteria) concluded that individuals with PTSD are 5% less likely to have healthy diets, 9% less likely to be physically active, 31% more likely to be obese, and 22% more likely to smoke.¹  Self-care strategies can complement treatments specifically aimed at PTSD symptoms.  For example the National Center for PTSD recommends that people with PTSD do the following, all of which tie into various self-care circles within the Circle of Health²:

·         Have more contact with other trauma survivors

·         Start exercising

·         Change neighborhoods if living in a high-crime area

·         Volunteer

·         Avoid alcohol and drugs

·         Invest more in personal relationships

Many of the psychotherapeutic approaches that are beneficial in treating PTSD draw in proactive strategies, such as goal setting, increasing problem-solving or coping skills, clarifying values, and broadening social support. 

Considerations specifically related to PTSD for each of the eight components of proactive self-care are listed below.  These are framed as specific steps a care team member can follow when advising self-care practices for someone with PTSD.  Of course, which steps are taken will vary according to each individual’s needs.

Mindful Awareness

A 2018 scoping review concluded that mindfulness-based approaches have medium to large effect sizes and low attrition rates.³  The review included a number of studies focused on different formal approaches for enhancing mindful awareness, including Mindfulness-Based Stress Reduction (MBSR), Mindfulness-Based Cognitive Therapy (MBCT) and metta Loving-Kindness approaches.  The same study noted that neuroimaging research indicates that mindful awareness training targets over- and under-modulation of emotions, which are critical features of PTSD.  A 2018 review noted that fear extinction, in particular, may be tied to the benefits of mindful awareness for PTSD.⁴  Another meta-analysis from 2017, which included 18 studies of mindfulness training, concluded that longer training periods had stronger effects.⁵  These effects were not affected by gender or age.  Another 2017 review of 10 meditation trials (n=643) found that meditation approaches appear to be effective for PTSD symptoms (and noted that more research is needed).⁶  Yet another 2017 review emphasized that mindfulness approaches should not be used as first-line treatments but nevertheless do have potential benefit.⁷