Editor's note: Norman Rosenthal, M.D.'s pilot study on PTSD will appear in the June 1 issue of "Military Medicine." He is the renowned psychiatrist and 20+ years NIH researcher who identified seasonal affective disorder (SAD) and developed the light therapy for treating it.
As Memorial Day approaches, it is fitting that we remember the debt owed, in the words of Winston Churchill, by so many to so few -- those men and women who have fought and, in some cases, paid the ultimate price, so that the rest of us can live in freedom and safety.
Here in Washington, D.C., there will be formal ceremonies at Arlington Cemetery and informal ceremonies at the monuments that mark the wars that claimed too many. Likewise, throughout our great country, people will be remembering, grieving, reflecting.
Allow me to share with you the stories of five veterans, who are very much on my mind this Memorial Day. These five young men participated in a study under my direction to determine whether meditation could help assuage the painful and disabling aftermath of their service in Iraq, Afghanistan or both. While serving, all were exposed to the horrors of war in one form or another. They saw their fellow soldiers and the enemy killed at close quarters, directly experienced the blasts of powerful bombs or improvised explosive devices, and drove along country roads, never knowing when they would drive into the next ambush.
After returning to the U.S., these young men were among the huge number of soldiers and Marines (1.6 million and counting) who have suffered the devastating effects of post-traumatic stress disorder (PTSD). Symptoms of this condition vary, but typically involve hypervigilance (jumpiness, irritability), detachment, avoidance of situations that trigger memories of the traumatic events, flashbacks and nightmares – as memories spring unbidden into consciousness, accompanied by drenching sweat, a pounding heart and other signs of system overload. Needless to say, living with these symptoms can feel like torture. To escape, some resorted to drugs, alcohol or even suicide.
Surveys show that only half of those affected by PTSD seek help. According to one of the five men in our study (I’ll call him Joe), “My biggest fear was being unemployed and unmarketable in the work force. I believe that if, as a retired solder, I were to whisper any of my symptoms, it would mean certain unemployment and immediate loss of security clearance.”
That’s why Joe chose a research study instead of receiving care through conventional channels. The only current treatment for combat-related PTSD approved as effective is aversive deconditioning – which involves exposing patients to simulated battlefield conditions by means of specialized computer equipment operated by specially trained personnel.
As you can imagine, this is far from universally available, and studies show that half of those suffering from combat-related PTSD receive inadequate care. To make matters worse, a recent Pentagon study found that after almost a decade at war, the U.S. military is showing “a significant decline in individual morale” and a significant increase in self-reported “acute stress” as compared with data from just two years ago.
Clearly new approaches to treating traumatized veterans are sorely needed. The approach we took in our small pilot study was to teach the young men Transcendental Meditation (TM). Once properly taught, this simple technique can be easily carried out twice a day – which is exactly what these young men did. While the specific results of the study are currently in press in the refereed journal Military Medicine, it is fair to say that they were highly encouraging.
Transcendental Meditation is known to be able to reduce responses to stress, as evidenced, for example, by its capacity to lower blood pressure in numerous controlled studies. TM appears to quiet the fight-or-flight response system, which is on overdrive in people with PTSD.
It is now over a year since the study ended and three out of the five veterans I was able to reach are still meditating daily, and still enjoying it. Here’s how Joe describes the effects of his daily routine. “I now feel, after practicing T.M. daily: that I can relax before the day and unwind completely at day’s end; I can be more orderly and think more clearly before acting; I project a positive vibe at work; the thoughts of events that were disturbing or causing problems for me are less detailed; I am thankful for what I have and where I am in my life.”
One final reflection this Memorial Day: Shouldn’t we consider teaching T.M. to some of our other traumatized soldiers and Marines? It is relatively cheap and easy to do, requires no special equipment, and causes few if any side-effects. If even a small percentage of people with PTSD were to obtain the kind of benefits Joe reports, then teaching our wounded warriors to meditate promises an abundant return on our investment.
Norman E. Rosenthal, M.D. is Clinical Professor of Psychiatry at Georgetown University and the author of "Transcendence: Healing and Transformation Through Transcendental Meditation." (Tarcher Penguin, 2011).