May 22, 2013
Breathing exercises help veterans find peace after war, Stanford scholar says
Research by Stanford scholar Emma Seppala at the Center for Compassion and Altruism Research and Education found that post-traumatic stress disorder decreased in veterans who participated in a weeklong breathing, yoga and meditation workshop, and remained lower a year later.
By Brooke Donald
Adam Burn, a veteran of the U.S. Air Force, practices yogic breathing techniques to help combat stress. A Stanford scholar has found that the techniques dramatically reduce PTSD in veterans. (Photo: Linda A. Cicero / Stanford News Service)
Post-traumatic stress disorder affects about one in five veterans, and traditional treatments that can include medication and therapy only relieve symptoms in about half of those who seek it, experts say.
But new research by Stanford scholar Emma Seppala, associate director of the Center for Compassion and Altruism Research and Education, reveals an alternative way to help bring peace to those returning from military service.
Seppala found that breathing exercises dramatically decreased PTSD in veterans, and the effects of a weeklong workshop practicing the techniques remained a year later, suggesting lasting impact from this type of treatment.
"That's the mind-blowing part of this data," Seppala said. "You send people to a workshop for a week and you figure they're going to feel better. But to see something one year after is pretty amazing."
The study, which is being prepared for publication, started in 2010, when Seppala was a post-doctoral fellow at the University of Wisconsin at Madison.
Twenty-one male veterans of the Iraq and Afghanistan wars participated. Half took part in the intervention, a seven-day workshop that emphasized a set of breathing techniques from the Sudarshan Kriya Yoga practice. The rhythmic breathing patterns exercised during this practice are meant to relax participants physically and mentally, and reduce symptoms of anxiety, depression and stress.
"Some people think of it as yoga, but it's really more breathing – an active breathing intervention," Seppala explained.
Before and after the workshop, which lasted three hours a day, the veterans completed questionnaires about how they were feeling. They also underwent cognitive and physiological tests to measure how they responded to loud noises and other startling stimuli.
The questionnaires were given and the tests were taken again a month after the workshop, then a year after.
Seppala called the results "extraordinary."
"Somehow the workshop is having an acute impact that is then leading to a shift," she said.
Seppala said the breathing exercises may be effective because they are accessible, relaxing and require active participation.
"Certain exercises are not always accessible to people injured in war. Therapies that require sitting still are difficult, too, for someone with high anxiety. Imagine sitting, doing nothing, under those circumstances," she said. "However, the breathing is active so it gives them something to do and it relaxes them."
No relief, no comfort
PTSD is defined by three characteristics: startle response, emotional numbness and recurring intrusive thoughts.
Those diagnosed with PTSD can be hyper-vigilant, feel constantly alert, and may over-react to small noises. They sometimes feel they can't connect with others, even family, and they may experience debilitating flashbacks.
"There's no relief from it," said Adam Burn, an Air Force veteran who served in Saudi Arabia and now works at Stanford. "There's no such thing as comfort. Your emotional spectrum shrinks."
Burn, who was not part of the study, sought the breathing treatment after nearly a decade of living with symptoms of PTSD.
He took a weeklong workshop in Palo Alto, and said he immediately felt better.
It was a similar experience for Hannah McBride, a veteran of the U.S. Marine Corps.
"I thought I was fine. But I couldn't sleep well. I was tired. I was irritable," McBride said. After the workshop, "I felt release."
McBride, who was not involved in the study, took the workshop from Seppala in Palo Alto. Seppala learned to instruct the workshops after the results of her study suggested the breathing practice could have long-term effects.
"The research is great but I didn't want the opportunity to help to stop there," Seppala said.
Programs emphasizing yogic-breathing techniques have long been available for veterans, including through Project Welcome Home Troops, which ran the study workshop. But Seppala's research provides data to back up the anecdotal evidence that it is an effective treatment for PTSD symptoms.
Data give the promise of affecting policy and policymakers, Seppala said, "which is the goal."
A screening of the new documentary, Free the Mind, which showcases Seppala's research, recently played at Stanford. In the audience were veterans, Veterans Affairs officials and others.
"I'm hoping having the data will help move this kind of treatment forward in a more substantial way – funding-wise," Seppala said.
Traditional treatment includes medication and therapy that recalls the trauma. But Seppala said many veterans drop out of those options, then self-medicate with alcohol or cannabis. Only half of those who go through a full course of traditional treatment are helped by it, she said.
"It's leaving a huge gap where there's no knowledge of how to help these people and there are several suicides a day," she said.
The breathing practice is more economical and has fewer side effects, she added.
"Veterans don't want to depend on a drug or therapist or some survivors group," Seppala said. "Practices that give them the tools to help themselves, that are healthy, that don't have side effects are a fantastic fit for them."