I'm married to a full-time soldier, so few things get my attention like a headline about post-traumatic stress disorder. I've been riveted by the recent surge in PTSD research spurred not just by the wars in Iraq and Afghanistan but also by terrorism and natural disasters. Government institutions, military hospitals and universities have all stepped up efforts to understand this anxiety disorder, teasing out what makes some people vulnerable and others resilient, as well as how the brain can heal. What they're discovering about PTSD is yielding important insights into how the rest of us can manage the moderate stress we deal with every day.
"The mind needs support — we call it 'mental armor' — just as much as the body does," says Amishi Jha, PhD, an associate professor of psychology at the University of Pennsylvania, who studies stress-fighting techniques such as mindfulness to help military personnel. "Research shows it's possible to cushion yourself against stress, and the tactics we're using with soldiers also apply to real folks and more common types of anxiety." Key to the recent breakthroughs is a much clearer picture of how destructive stress can be. Persistent anxiety can kill neurons in brain structures concerned with memory and decision-making, and such damage is even visible on brain scans.
Although women are less likely to experience traumatic events than men are (about half of women in the United States will encounter a trauma in their lifetime, most commonly sexual assault, followed by car crash), we're twice as likely to develop PTSD when we do, says the U.S. Department of Veterans Affairs. Women are also more vulnerable to everyday stress — mothers, for example, are 5 times as likely as fathers to rate their stress at the highest level, says the American Psychological Association.
Fortunately, experts are learning that all along the continuum — from severe anxiety disorders to garden-variety worry — coping and even prevention tactics are highly effective. Here's what new PTSD science can teach all of us about outsmarting stress. If these solutions work for soldiers in Iraq and Afghanistan, they can certainly help the rest of us on the home front.
For stress survivors:
Build mental armor with meditation
Mindfulness meditation works wonders to boost stress resilience, say experts from the University of Pennsylvania who are using the practice with military personnel. "We teach them to focus on the present moment instead of catastrophizing about the future," says Jha. After 8 weeks of meditation training, Marines became less reactive to stressors — plus they were more alert and exhibited better memory.
For the rest of us:
Take short mindfulness breaks
"Even I get too busy to meditate," says Jha. "Then I remember the Marines in the study calling my colleague while they were deployed to ask for mindfulness pointers, and I think, If they can do it in a war zone, I can do it in my office!"
Try this technique Marines use anywhere: Sit upright, focus on your breath and pay attention to a physical sensation, such as the feel of air in your nostrils. When your mind wanders, notice the disruption, then return your attention to that simple sensation. Jha herself now meditates 5 to 10 minutes at a time, several times a day.
For stress survivors:
Remember the tough stuff
Cognitive behavioral therapy (CBT) — which helps you recognize and change knee-jerk reactions to stress triggers — is one of the most effective methods of managing PTSD. In the military, such training can include a technique called "exposure therapy," in which soldiers relive disturbing past experiences in small doses with a therapist until the memories become less overwhelming. Along the same lines, doctors have achieved promising results by asking patients who developed PTSD following an illness to imagine a relapse.
Such intense visualizations should be undertaken only with a licensed professional, but "practicing" feeling stressed can help anyone cope day to day, says Elizabeth Carll, PhD, a trauma specialist on Long Island, N.Y. "If you learn to recognize how your body feels when anxiety starts, it's easier to intervene and calm yourself."
For the rest of us:
Imagine a moment of tension
Fortify yourself against anxiety by trying an at-home exercise, says Susan Fletcher, PhD, a psychologist in private practice in Plano, TX. Picture yourself in a stressful place, such as your commute and imagine the tension you feel. Write out the realities of the situation: If I don't leave by 7:30, I'll be late. On the other hand, I'll be in traffic about 60 minutes, so I can listen to a book on disc. This lets you feel the stress and know it's not debilitating, and helps you devise solutions. If you want to try formal CBT, which encompasses a range of methods, you can find a certified practitioner through the National Association of Cognitive-Behavioral Therapists (nacbt.org).
For stress survivors:
Bike for long-term resilience
Researchers are learning that exercise doesn't just soothe stress, it also fortifies brain cells so they're less vulnerable to anxiety in the future. Neuroscientists at Princeton University recently discovered that neurons created in the brains of rats that run regularly are less stress-sensitive than those in rats that don't exercise.
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While all exercise adds to your resilience, PTSD experts find that outdoor activities are particularly beneficial — especially cycling, says Melissa Puckett, a recreation therapist at the VA Palo Alto Healthcare System in California. "It's so effective because of the fresh air and the fact that it can be a group activity," she says. "We've seen people who were once afraid to leave the house make tremendous strides."
For the rest of us:
Sweat outside for 5 minutes
Break from the gym and try something outdoorsy, like hiking or a simple walk. Even 5 minutes outside — especially if spent near water, like a fountain or stream — is enough for a mental boost, found a 2010 study from the University of Essex in England.
For stress survivors:
Pets can reduce your use of meds
New research shows that owning an animal is an even more powerful way to cultivate calm than previously thought. An astonishing 82% of PTSD patients paired with a service dog reported a significant reduction in symptoms, and 40% were able to decrease their medications, in an ongoing study at the Walter Reed Army Medical Center.
The specially trained pooches can sense before their owners do when a panic attack is coming, and then give them a nudge to start some preemptive deep breathing. "While we don't yet understand why, we know the dogs' presence affects serotonin levels and the immune system," says lead study researcher Craig Love, PhD. "The animals are so helpful, one soldier named her dog Paxil."
For the rest of us:
Bond with Fido
Pet owners can reduce stress by building extra playtime into the day, says Carll. If you don't own a pet, offer to take a neighbor's dog for an after-dinner walk or cat-sit for a friend — even short outings provide enough "pet exposure" to lessen anxiety.
For stress survivors:
Sleep to rebalance sneaky stress hormones
Sleep suppresses stress hormones, such as cortisol, and spurs the release of others, like DHEA, which plays a key role in resilience and protecting the body from stress. Yale University researchers tracked the hormone levels of a group of elite Special Forces soldiers who operate in treacherous underwater conditions and confirmed that higher DHEA levels predicted which divers were most stress hardy. Among women with PTSD, those with higher levels of DHEA have fewer negative moods, other Yale researchers found.
For the rest of us:
Do a nightly stress scan
To boost DHEA naturally, get more sleep. Before you set your alarm, take stock of your stress status, says Fletcher. The more demanding your days, the more sleep you need to handle them. If the recommended 7 to 8 hours isn't possible, at least plan for an early night or two during a rough week or, if nothing else, a weekend nap. "And get anything that reminds you of work — laundry, your laptop — out of your bedroom," Fletcher adds. "It's psychologically noisy."
These coping skills don't just make it easier to manage stress, they help you thrive in general. "People who beat chronic stress often develop positive shifts in their outlook," says Elissa Epel, PhD, a stress researcher at the University of California, San Francisco. Cliched as it sounds, surviving a stressful event can open a new philosophical window on life. "People don't just cope, they grow," says Carll. "And the experience makes them stronger overall."