Health and Disease, Lifestyle, Uncategorized

Aerobic Exercise Helps Control PTSD

Aerobic Exercise Helps Control PTSD

 

After losing 29 Marine brothers in Iraq, infantryman Mike Ergo returned home to California with a severe case of post-traumatic stress disorder (PTSD).

Featured in NBC’s coverage of the 2017 Ironman competition in Kona, Hawaii, Mike shared how he successfully deals with his stress disorder: “When I started running again, I felt good,” he said. “I think endurance sports [are] almost the perfect prescription for PTSD.”

If you have access to a pool, moving your workouts into the water is a great way to burn belly fat. Not only are swimming and water aerobics great cardio exercises, every move you make in the pool challenges your muscles since the water creates constant resistance.

We’re getting closer all the time to finding out why that is. A lab study from Texas A&M University examined how neurons in the brain that cause feelings of fear to get stirred up again (that’s called a fear relapse) are activated by everyday stress — and how such stress also dampens down brain areas that usually reduce fear.

It’s a dastardly duo, but one that finally provides a clearer explanation of how and why stress-relieving aerobic exercise helps control PTSD.

Although we’ve known for a long time that the prefrontal cortex regulates behavior, thought, and emotion, this enhanced understanding can lead to new treatments for PTSD — not just for soldiers, but for victims of various traumatic events, from car accidents to cancer diagnoses.

A man riding an exercise bike in the bedroom.

In the meantime, anyone contending with PTSD (more than 13 million Americans have the condition at any given time) should develop an aerobics regimen and use other emotion-soothing techniques such as meditation, acupuncture, massage therapy, or even just breathing deeply to change their response to stressors.

These methods work by causing your body to produce soothing endorphins. They’re also a good complement to cortisol-dispelling aerobic exercise.

 

-People Start to Heal The Moment They Are Heard-

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Lifestyle, Uncategorized

Intimate Partner Violence : BWS Battered Woman’s Syndrome

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Intimate Partner Violence

Battered Woman’s Syndrome

 

Women who are victims of intimate-partner violence have been identified by the mental health field for more than 30 years now.  It is understood that domestic violence is part of gender violence, and that many more women than men are the victims of physical, sexual, and psychological abuse.

 

Even when women strike back or engage in mutual violence, it is usually the woman who is most likely to be hurt—both physically and emotionally. Women who strike back in self-defense are often arrested along with the batterer.

 

It is further understood that gender violence is fostered by the socialization of men to be more powerful than women. In some men, this process creates the need to abuse power and to control women. While the term “victim” is not always considered politically correct, in fact, until battered women take back some control over their lives, they may not truly be considered survivors.

 

Psychological symptoms, called battered woman syndrome (BWS), develop in some women and make it difficult for them to regain control. Mental health professionals have been able to assist these battered women with empowerment techniques and with accurate diagnosis and proper treatment, as described here.

 

If you are a woman who has suffered from gender abuse by your partner and you’ve lived through at least two cycles of being battered, physically or emotionally,  you might have what’s known as battered woman syndrome. It may not seem like it now, but you can get help and break the cycle.

 

Phases of Gender Abuse

 

In the first phase, tension builds between the two people.

 

The second phase is an explosion or encounter when the woman is the victim of emotional or physical battering and could be seriously injured physically and psychologically.

The third is when her abuser strikes back!   Does something to take control of the other person.  This can be in a physical method, even taking something away, or destroying a cell phone, or keeping the other person isolated.  The abuser will not usually leave the other person alone.

 

Some experts see the battering cycle as a circle.

“I draw it as a graph because it repeats itself and keeps getting worse and worse.”

 

( BWS) battered woman syndrome is a subcategory of post-traumatic stress disorder (PTSD), a psychological disorder that is the result of facing or witnessing a terrifying event.  The battered woman is so traumatized by her partner’s abuse that she may believe she is in danger even when she’s safe.  It also shows itself as the one being abused can not tell that anything is wrong, and they keep it to themselves.

 

Why Women Take It

 

Many battered women stay in abusive relationships. There are a number of reasons why they don’t leave, says Deb Hirschhorn, PhD, a marriage and family therapist in Woodmere, New York, and author of The Healing Is Mutual. They include:

 

She worries she would have no way to support herself or her children if she left.

She may come from a background of abuse and “is conditioned to look for the good in her partner just as she had to see the good in her parents,” Hirschhorn says.

She truly believes her spouse or partner wants to help and protect her. “It’s a ‘rescue syndrome,’” Hirschhorn says. The battered woman remembers why she fell in love with her partner and believes they can get back to where they began, Walker says.

She’s likely to have low self-esteem. She believes she’s only getting what she deserves.

She also might fear that if her partner learns she wants to leave, it will only heighten the abuse, says Rena Pollak, LMFT, a licensed marriage and family therapist in Encino, California.

 

Getting Out of the Abuse Cycle

Talk with your doctor. Discussing your battered woman syndrome symptoms with your doctor is a good idea because your doctor or nurse can give you resources if you don’t know where else to turn, Pollak says.

 

Seek shelter.  Realize that you are not alone and that there are people who can help you, Pollak says. She recommends starting with the National Domestic Violence Hotline, which has advocates who can speak on the phone or online.

 

Have a safety plan. Most women can sense danger and when their partner is likely to hurt them. The National Domestic Violence Hotline says that whether you are living in an abusive relationship or planning to leave one, you should have a plan that identifies safe areas of your home where you can go if you need to. If you can’t avoid violence, make yourself small – curl up in a ball and protect your face with your arms.

 

Work with a counselor. When you are being emotionally abused, a  marriage counselor or therapist can help you see your strengths and help you realize it’s not your fault – despite what you’ve heard over and over again from your abuser.

 

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Lifestyle, Uncategorized

PTSD: Post Traumatic Stress Disorder: The Symptoms

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Post-Traumatic Stress Disorder: The Symptoms

 

Post-Traumatic Stress Disorder (PTSD) is a complex anxiety disorder that may develop after exposure to an extremely stressful or life-threatening event — involving death, the threat of death or serious injury — with resulting intense fear, helplessness or horror. If you experience these symptoms for a duration of more than a month, you could be suffering from PTSD.

 

Persistently Re-Experiencing the Event Having recurring dreams about the event or having persistent and distressing recollections of the event. Feeling and acting as if the trauma was reoccurring — hallucinations or flashbacks — and experiencing distress when exposed to cues. For example, Dr. Phil’s guest, Shelia, was attacked at gunpoint in her house, so when she is at home, she often replays the event in her mind.

 

Avoiding Stimuli Associated with the Trauma Making efforts to avoid thoughts, conversations, people, places and activities associated with the trauma, and avoiding activities, places or people that arouse recollections of the trauma. Shelia makes every effort to avoid being inside her house. She often spends long periods of time at the mall and sits in her car outside her home so she doesn’t have to go inside.

 

Numbing of General Responsiveness Pulling back and having a diminished interest in activities that are significant, and suffering low energy. Feeling detached or estranged from others. Displaying a restricted range of affect — unable to have loving feelings, or don’t want to become excited and happy or let scared emotions out.

 

Increased Arousal Symptoms Not Present before the Trauma Being easily startled, having difficulty sleeping or concentrating. Developing a heightened irritability and/or having angry outbursts. Becoming hypervigilant — behaviors you did not experience before the event.

 

Disturbance Impairs Other Areas of Functioning Experiencing significant impairment in social or occupational activities or any other important areas of functioning. Shelia has a difficult time working, because loud noises easily startle her.

 

If you have any questions or concerns about this or any area of healthcare please call us.

 

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Health and Disease, Lifestyle, Uncategorized

Breakthroughs Help Vets Fight the PTSD War

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Breakthroughs Help Vets Win the PTSD Battle

Thanks to medical miracles, veterans of today’s wars survive battlefield injuries that almost certainly would have been fatal just a generation ago.

 

But when those wounded warriors return home, they face another monumental challenge: How to mend their broken minds and bodies to resume successful, rewarding lives after they leave the military.

 

Fortunately, doctors and therapists are studying a number of innovative methods that could help get wounded veterans back on their feet.

 

Among the promising techniques for veterans currently being explored:

 

Electric Patch Treatment

 

Post-traumatic stress syndrome, or PTSD, plagues many soldiers returning home from war. Researchers at the University of California in Los Angeles report trigeminal nerve stimulation, or TNS, has shown promise in treating chronic PTSD.

 

“This could be a breakthrough for patients who have not been helped adequately by existing treatments,” Dr. Andrew Leuchter said.

 

A second study is now under way.

 

Transcendental Meditation

 

Seventy-four soldiers seeking treatment for PTSD at the Army Medical Center’s Traumatic Brain Injury Clinic at Fort Gordon, Ga., recently participated in a study on transcendental medication. Within one month, nearly 84 percent of the meditating soldiers had stabilized, reduced, or eliminated their use of the psychotropic drugs that were helping them to cope with their condition.

 

Meditating twice a day helped veterans remain calm and avoid the “fight or flight” response associated with PTSD.

 

 

Hyperbaric Oxygen Therapy

Subjecting patients to oxygen at a higher-than-atmospheric pressure infuses the cells of their bodies with oxygen. This has proven especially effective in fighting infections and warding off the effects of concussion, a common injury sustained by soldiers.

 

But doctors report the Veteran’s Administration and the Pentagon have been slow to fully adopt the use of hyperbaric oxygen by veterans.

 

Equine Therapy

 

President Ronald Reagan famously remarked there is nothing as good for the inside of a man than the outside of a horse. Therapists say as soon as vets get around horses they tend to relax, and their anxieties begin to fade away.

 

OperationWeAreHere.com offers contact information for over a dozen equine-therapy organizations that work with veterans.

Cognitive Behavioral Therapy

 

Sensitizing patients to their fears, and the stimuli that tend to trigger panic and anxiety, can help veterans learn to control their reactions. Researchers say those who return from war zones often suffer from “hypervigilance,” an exaggerated readiness to respond to perceived threats in the environment.

 

Cognitive behavioral therapy helps patients learn to respond productively to stressful situations.

 

Virtual Reality Therapy

 

Using computer-generated simulations, veterans under expert medical supervision can get in touch with traumatic events, to better process and understand their own reactions. One small trial suggested it might reduce the effects of PTSD, but more studies are needed.

 

Accelerated Resolution Therapy

Using a technique called eye movement desensitization and reprocessing, PTSD patients learn to process the traumas they experienced thereby reducing anxiety. A patient brings to mind the disturbing images they cannot escape, while practicing deep breathing and focusing on the rapid movements of a therapist’s hand.

 

A technique just beginning to gain widespread acceptance, it appears to work by mimicking the rapid eye movements people experience during REM sleep.

 

Magnetic Resonance Therapy

 

Colloquially known as “brain zapping,” magnetic resonance therapy uses magnetic coils to stimulate the cortex. The FDA approved the procedure in 2008 to combat major bouts of depression.

 

Published studies suggest it could also help patients suffering from PTSD. The Washington Post reported the procedure is offered as a treatment for depression by the Johns Hopkins Hospital in Baltimore.

 

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Is it ADHD or Trauma (PTSD)

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Is it really ADHD or is it Trauma (PTSD)

 

Dr. Nicole Brown’s quest to understand her misbehaving pediatric patients began with a hunch.

Brown was completing her residency at Johns Hopkins Hospital in Baltimore, when she realized that many of her low-income patients had been diagnosed with attention deficit/hyperactivity disorder (ADHD).

These children lived in households and neighborhoods where violence and relentless stress prevailed. Their parents found them hard to manage and teachers described them as disruptive or inattentive. Brown knew these behaviors as classic symptoms of ADHD, a brain disorder characterized by impulsivity, hyperactivity, and an inability to focus.

When Brown looked closely, though, she saw something else: trauma. Hyper-vigilance and dissociation, for example, could be mistaken for inattention. Impulsivity might be brought on by a stress response in overdrive.

“Despite our best efforts in referring them to behavioral therapy and starting them on stimulants, it was hard to get the symptoms under control,” she said of treating her patients according to guidelines for ADHD. “I began hypothesizing that perhaps a lot of what we were seeing was more externalizing behavior as a result of family dysfunction or other traumatic experience.”

Inattentive, hyperactive, and impulsive behavior may mirror the effects of adversity, and many doctors don’t know how—or don’t have time—to tell the difference.

Considered a heritable brain disorder, one in nine U.S. children—or 6.4 million youth—currently have a diagnosis of ADHD. In recent years, parents and experts have questioned whether the growing prevalence of ADHD has to do with hasty medical evaluations, a flood of advertising for ADHD drugs, and increased pressure on teachers to cultivate high-performing students. Now Brown and other researchers are drawing attention to a compelling possibility: Inattentive, hyperactive, and impulsive behavior may in fact mirror the effects of adversity, and many pediatricians, psychiatrists, and psychologists don’t know how—or don’t have the time—to tell the difference.

Though ADHD has been aggressively studied, few researchers have explored the overlap between its symptoms and the effects of chronic stress or experiencing trauma like maltreatment, abuse and violence. To test her hypothesis beyond Baltimore, Brown analyzed the results of a national survey about the health and well-being of more than 65,000 children.

Brown’s findings, which she presented in May at an annual meeting of the Pediatric Academic Societies, revealed that children diagnosed with ADHD also experienced markedly higher levels of poverty, divorce, violence, and family substance abuse. Those who endured four or more adverse childhood events were three times more likely to use ADHD medication.

Interpreting these results is tricky. All of the children may have been correctly diagnosed with ADHD, though that is unlikely. Some researchers argue that the difficulty of parenting a child with behavioral issues might lead to economic hardship, divorce, and even physical abuse. This is particularly true for parents who themselves have ADHD, similar impulsive behavior or their own history of childhood maltreatment. There is also no convincing evidence that trauma or chronic stress lead to the development of ADHD.

For Brown, who is now a pediatrician at Montefiore Medical Center in the Bronx, the data are cautionary. It’s not evident how trauma influences ADHD diagnosis and management, but it’s clear that some misbehaving children might be experiencing harm that no stimulant can fix. These children may also legitimately have ADHD, but unless prior or ongoing emotional damage is treated, it may be difficult to see dramatic improvement in the child’s behavior.

“We need to think more carefully about screening for trauma and designing a more trauma-informed treatment plan,” Brown says.

Dr. Kate Szymanski came to the same conclusion a few years ago. An associate professor at Adelphi University’s Derner Institute and an expert in trauma, Szymanski analyzed data from a children’s psychiatric hospital in New York. A majority of the 63 patients in her sample had been physically abused and lived in foster homes. On average, they reported three traumas in their short lives. Yet, only eight percent of the children had received a diagnosis of post-traumatic stress disorder while a third had ADHD.

“I was struck by the confusion or over-eagerness–or both–to take one diagnosis over another,” Szymanski says. “To get a picture of trauma from a child is much harder than looking at behavior like impulsivity, hyperactivity. And if they cluster in a certain way, then it’s easy to go to a conclusion that it’s ADHD.”

A previous edition of the Diagnostic and Statistical Manual of Mental Disorders urged clinicians to distinguish between ADHD symptoms and difficulty with goal-directed behavior in children from “inadequate, disorganized or chaotic environments,” but that caveat does not appear in the latest version. Unearthing details about a child’s home life can also be challenging, Szymanski says.

It’s not clear how many children are misdiagnosed with ADHD annually, but the number could be nearly 1 million.

A child may withhold abuse or neglect to protect his family or, having normalized that experience, never mention it all. Clinicians may also underestimate the prevalence of adversity. The Adverse Childhood Experiences Study, a years-long survey of more than 17,000 adults, found that two-thirds of participants reported at least one of 10 types of abuse, neglect, or household dysfunction. Twelve percent reported four or more. That list isn’t exhaustive, either. The study didn’t include homelessness and foster care placement, for example, and the DSM doesn’t easily classify those events as “traumatic.”

It’s not clear how many children are misdiagnosed with ADHD annually, but a study published in 2010 estimated the number could be nearly 1 million. That research compared the diagnosis rate amongst 12,000 of the youngest and oldest children in a kindergarten sample and found that the less mature students were 60 percent more likely to receive an ADHD diagnosis.

Though ADHD is thought to be a genetic condition, or perhaps associated with lead or prenatal alcohol and cigarette exposure, there is no brain scan or DNA test that can give a definitive diagnosis. Instead, clinicians are supposed to follow exhaustive guidelines set forth by professional organizations, using personal and reported observations of a child’s behavior to make a diagnosis. Yet, under financial pressure to keep appointments brief and billable, pediatricians and therapists aren’t always thorough.

“In our 15-minute visits—maybe 30 minutes at the most—we don’t really have the time to go deeper,” Brown says. If she suspects ADHD or a psychological condition, Brown will refer her patient to a mental health professional for a comprehensive evaluation. “You may have had this social history that you took in the beginning, but unless the parent opens up and shares more about what’s going on in the home, we often don’t have the opportunity or think to connect the two.”

 

Caelan Kuban, a psychologist and director of the Michigan-based National Institute for Trauma and Loss in Children, knows the perils of this gap well. Four years ago she began offering a course designed to teach educators, social service workers and other professionals how to distinguish the signs of trauma from those of ADHD.

 

“It’s very overwhelming, very frustrating,” she says. “When I train, the first thing I tell people is you may walk away being more confused than you are right now.”

In the daylong seminar, Kuban describes how traumatized children often find it difficult to control their behavior and rapidly shift from one mood to the next. They might drift into a dissociative state while reliving a horrifying memory or lose focus while anticipating the next violation of their safety. To a well-meaning teacher or clinician, this distracted and sometimes disruptive behavior can look a lot like ADHD.

Kuban urges students in her course to abandon the persona of the “all-knowing clinician” and instead adopt the perspective of the “really curious practitioner.”

Rather than ask what is wrong with a child, Kuban suggests inquiring about what happened in his or her life, probing for life-altering events.

Jean West, a social worker employed by the school district in Joseph, Missouri, took Kuban’s course a few years ago. She noticed that pregnant teen mothers and homeless students participating in district programs were frequently diagnosed with ADHD. This isn’t entirely unexpected: Studies have shown that ADHD can be more prevalent among low-income youth, and that children and adolescents with the disorder are more prone to high-risk behavior. Yet, West felt the students’ experiences might also explain conduct easily mistaken for ADHD.

Kuban’s course convinced West to first consider the role of trauma in a student’s life. “What has been the impact? What kind of family and societal support have they had?” West asks. “If we can work on that level and truly know their story, there’s so much power in that.”

As a school official, West sometimes refers troubled students to a pediatrician or psychiatrist for diagnosis, and meets with parents to describe how and why adversity might shape their child’s behavior. In her private practice, West regularly assesses patients for post-traumatic stress disorder instead of, or in addition to, ADHD.

 

Though stimulant medications help ADHD patients by increasing levels of neurotransmitters in the brain associated with pleasure, movement, and attention, some clinicians worry about how they affect a child with PTSD, or a similar anxiety disorder, who already feels hyper-vigilant or agitated. The available behavioral therapies for ADHD focus on time management and organizational skills, and aren’t designed to treat emotional and psychological turmoil.

Instead, West teaches a traumatized child how to cope with and defuse fear and anxiety. She also recommends training and therapy for parents who may be contributing to or compounding their child’s unhealthy behavior. Such programs can help parents reduce their use of harsh or abusive discipline while improving trust and communication, and have been shown to decrease disruptive child behavior.

Szymanski uses a similar approach with patients and their parents. “I think any traumatized child needs individual therapy but also family therapy,” she says. “Trauma is a family experience; it never occurs in a vacuum.”

Yet finding a provider who is familiar with such therapy can be difficult for pediatricians and psychiatrists, Szymanski says. Though some hospitals have centers for childhood trauma, there isn’t a well-defined referral network. Even then, insurance companies, including the federal Medicaid program, may not always pay for the group sessions commonly used in parent training programs.

Faced with such complicated choices, Szymanski says it’s no surprise when clinicians overlook the role of trauma in a child’s behavior and focus on ADHD instead.

Inattentive and hyperactive behavior can be traced back to any number of conditions—just like chest pains don’t have the same origin in every patient.

While there are few recommendations now for clinicians, that will likely change in the coming years. The American Academy of Pediatrics is currently developing new guidance on ADHD that will include a section on assessing trauma in patients, though it won’t be completed until 2016.

Dr. Heather Forkey, a pediatrician at University of Massachusetts Memorial Medical Center, who specializes in treating foster children, is assisting the AAP. Her goal is to remind doctors that inattentive and hyperactive behavior can be traced back to any number of conditions—just like chest pains don’t have the same origin in every patient. Ideally, the AAP will offer pediatricians recommendations for screening tools that efficiently gauge adversity in a child’s life. That practice, she says, should come before any diagnosis of ADHD.

When speaking to traumatized children inappropriately diagnosed with ADHD, she offers them a reassuring explanation of their behavior. The body’s stress system, she says, developed long ago in response to life-or-death threats like a predatory tiger. The part of the brain that controls impulses, for example, shuts off so that survival instincts can prevail.

 

“What does that look like when you put that kid in a classroom?” Forkey asks.

“When people don’t understand there’s been a tiger in your life, it looks a lot like ADHD to them.”

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PTSD

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PTSD

 

If you’re like most people, when you hear the term “post-traumatic stress disorder” you think of war veterans and survivors of a traumatic event. When your life is in imminent danger, your fear triggers a fight-or-flight response that floods your body with adrenaline, so that you can respond to the threat. Once the threat has passed you may experience emotional aftershocks. This is the classic form of PTSD recognized by therapists and psychiatrists.

 

However, there’s an epidemic of hidden PTSD in our culture. In its true definition, PTSD involves lingering negative feelings that can result from any adverse experience—getting fired, the end of a relationship, chronic illness, or even just a time when you feel like you failed at something—and that limit a person in any way. These feelings can include fear, doubt, panic, avoidance, anger, hypervigilance, irritability, sadness, shame, vulnerability, distrust, and more.

 

There are no limitations to what can cause PTSD, yet even in today’s modern times of self-help, therapy, and emotional understanding, health professionals mostly reserve the term PTSD for life-or-death experiences. This ignores the numerous incidents that alter (for the worse) the way someone experiences life. Regardless of its cause or scope, PTSD negatively influences the choices we make and changes the fabric of who we are.

What is happening

 

On a physiological level, PTSD causes a chemical imbalance in the brain that occurs when someone experiences trauma. Glucose is a protective biochemical that provides a veil of protection for sensitive brain and neurological tissue. If there isn’t enough glucose stored in the brain to feed the central nervous system and to protect the brain from the corrosive effects of adrenaline and cortisol released during stress, emotional upheaval can create lasting effects. If someone’s glucose storage is low, she or he could get PTSD just from a flat tire, while someone with sufficient glucose storage could witness an armed robbery and tell the story to a friend over dinner that same day, unruffled.

 

Our culture also has a history of burying emotions with food (especially sugar), alcohol, drugs, and adrenaline-fueled activities. The problem with these approaches is that what goes up must come down. A sugar high from cupcakes means a crash later. And while an adrenaline high from running over fiery coals may feel healing and empowering in the moment, the surge won’t last.

 

Solutions for dealing with PTSD

 

One of the most powerful ways to heal PTSD is to create new experiences to serve as positive reference points in your life. These experiences don’t have to be big, or risky (nor should they be). It’s all about how you perceive each new adventure, however tame.

 

Keep a list of every new experience, taking notes on how you felt. For example, when you took a walk, did you see any birds? What was the weather like? What effect did it have on your state of mind? It’s all part of being in the moment. When you create new, constructive touch points for yourself—and pay attention to their positive effects—you train your brain to develop a healing response that is always available to you.

 

Try putting together a puzzle, painting, sketching, or drawing. These are powerful exercises that orient us in the present moment and help us pay attention to beautiful details in the world around us that otherwise go unnoticed.

 

Call up a friend you haven’t seen in years and ask her or him to lunch.

 

Adopt a pet—every day will be new and filled with love.

 

Start a new hobby. Choose a skill area you wouldn’t have expected yourself to venture

into, or one you always wanted to explore.

 

Learn a new language.

 

Take a vacation.

 

Start your own garden.

 

Journal about it all. It will help you become aware of the goodness life brings your way when you’re not even looking for it, and helps clear out negative experiences from your consciousness.

 

You can also literally nourish yourself with healing foods, including wild blueberries, melons, beets, bananas, persimmons, papayas, sweet potatoes, figs, oranges, mangoes, tangerines, apples, raw honey, and dates. These foods can create a glucose “storage bin” that helps prevent life disruptions from turning into PTSD.

 

You don’t have to live in a tortured state of mind anymore. By providing your body and soul with proper nutritional, emotional, and soul-healing support, you can reclaim your vitality and go back to fully living your life.

 

Many of you have been dealing with PTSD for many years, but maybe we brought up a new point for you, or you can call us and find out more about what can be done to diminish triggers.

 

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