Wednesday, December 17, 2014

Hydrotherapy and PTSD

Water is the basic unit of life that no human can deny; the purest form of life sustaining power composed of oxygen and hydrogen. It is a biological necessity that keeps each one of us alive. The miracle of water is that it is constantly recycled on a chemical level; a cheap universal resource that the majority of people have access to worldwide. Consider water for its healing properties-it obviously cleans physical wounds and reduces risks of infection in them, but the cryptic benefit of water is that it can help heal mental illness in Post-Traumatic Stress Disorder (PTSD) and help its victims cope with the struggles of everyday life. Hydrotherapy is the use of water in a solid (ice), liquid (water), or gas (steam) in a therapeutic manor. Many people who suffer from PTSD do not find relief in medication and even many forms of complementary/alternative therapies. However, some research supports the use of hydrotherapy in patients suffering from PTSD to combat chronic pain, promote circulation, induce meditation and relaxation, and prevent or interrupt bouts of dissociation.
Hydrotherapy is a suitable option for soldiers and survivors of abuse because this is a demographic of people that do not have a lot of resources or money. Fortunately, water is a resource that everyone has access to; it is a basic principle of human survival. More so, water is very cheap (if not free) and easy to manipulate to customize a therapy plan. Temperature preferences, aromatic oils and salts, and amount of water all have an impact on the effectiveness of treatment and vary from person to person.
Balneotherapy is a type of hydrotherapy where water therapy is used in conjunction with aromatherapy and bath salts. Bath salts are aromatic; producing pleasant scents to calm or stimulate the neurosensory pathways in the body. Bath salts containing lavender, jasmine, chamomile, and vanilla are commonly used in PTSD therapy for their relaxing qualities. Hydrostatic pressure from the water is successful at reducing pain and edema, while at the same time pores in the skin are open to diffuse minerals across the skin barrier into the body. Hot water is more effective at improving circulation and hemodilution while cold water helps to  suppress pain and improve muscle tone. (Kron)  A group of Hungarian researchers conducted a single-blind study concerning balneotherapy on a group of 60 patients with low back pain, half of which bathed in mineral water and half bathed in tap water. The 30 patients that bathed in mineral water found a significant improvement in their back pain for at least 3 months after the treatment ended. (Balogh, 2005). For this reason, balneotherapy (the use of minerals in water) is highly recommended to patients with chronic pain like those who suffer from PTSD.
Post-Traumatic Stress Disorder tends to sprout from traumatic events like military combat and abuse, though not everyone who experiences this gets the disorder. However, for those that do, life can be stressful to say the least. One major yet stressor of victims are flashbacks: events caused by a trigger that psychologically forces the victim to relive the traumatic situation. In the event of a flashback, a person may feel numb, disoriented, delirious, and struggle to stay in present time. The use of hydrotherapy is useful for producing sensory nervous responses that allows the person to focus on the physical qualities of the water to stay in touch with reality rather than succumb to the ensnarling thoughts of the mind.
Another ensnarling thought of the mind is anxiety; a main component of PTSD. Hydrotherapy can be combined with meditation and mental imagery to suppress and eliminate racing thoughts which potentially domino into panic attacks. Panic attacks are very real and have physical implications on the body from psychogenic pain to symptoms of a heart attack. Though medications can often rid people of anxiety and prevent panic attacks, they have side effects that often outweigh the benefits of use. For example, extreme dizziness, weight change, drug interactions with other medications, and fatigue are common side effects associated with the use of anti-depressants and anti-anxiety medication. To no surprise, water has no side effects of use and therefore can be complemented by any medication, so there is no fear of a bad reaction. On a similar note, there is no magic pill that can cure or treat PTSD, so there is no large benefit of using psychological drugs that have a small probability of fixing the problem.
(OIF Abigail, 2013) “Anger and aggression are associated with post-combat problems among military veterans…anger is an emotional manifestation marked by hostile impulses and the perception of blocked goal, which includes particular cognitive, physiological, motivational, and behavioral components”. Anger is a large component of PTSD for anyone who has the disorder and has been in a traumatic physical confrontation. Hydrotherapy is a prime way to channel out the anger and “cool off” or relax. Water has physical properties that cushion a blunt force and make it easy to safely punch it without causing damage to the victim or others. Other properties of this fluid that make it a suitable outlet for hostile aggression include: the absence of feelings, inanimate properties, unable to communicate with the victim. Just as the victim may have felt at one point, the water will not act out against the aggressor (victim) or talk back to it as the victim may have done in a previous time. This remarkable idea has the potential to influence the complete destruction of the cycle of abuse in some cases. Water can also be manipulated, as the aggressor once was, to help the person regain a sense of control and relaxation- aromas, bubbles, colors, and light refraction, and temperature of the water.
Just like how these qualities of water are able to treat psychogenic pain (Ricciardi, 2013), they can also successfully treat chronic physical pain as well. (Sanchez, 2012) In 2011, a study was conducted at the University of Almeria on a group of patients with pain associated with multiple sclerosis resulted in the following: “50-75% of patients with MS used CAM because it reduces the severity of painful symptoms and offers functional improvement…with no adverse effects”. Even though pain is still subjective and can never truly be accurately measured for research, it is fascinating that such a large amount of people saw improvement in this 20-week program. After 40 sessions, this “aquatic exercise program improves pain, spasms, disability, fatigue, and depression, and autonomy”. Hydrotherapy was used in this study by combining joint/muscle-friendly exercise with deep, synchronized, breathing techniques to gain control of the body and self to conquer pain. Water cushions bodily joints to aid movement while the water relaxes muscles to promote easy movement geared towards pain control. The controlled breathing relaxes the nervous system to improve neuromuscular functioning. PTSD patients are able to benefit from this because of the similar complaints of symptoms prior to the study such as pain, fatigue, depression, and muscular spasms which can diminish autonomy and self-image.
Water therapies are an innovative and unique complementary/alternative treatment; however, it is not right for everyone. Some patients who are burdened by the disorder are a high suicide risk and should not be left unattended submerging in large quantities of water in the event of asphyxiation by drowning. Nevertheless, this is an easy problem to fix if the person is supervised. If the patient does not feel comfortable being watched, this is a normal behavior and shut the door to then room and make sure to constantly listen that the water is still moving. In addition, continue to check on the patient. Also, patients with peripheral vascular issues such as diabetes or cardiovascular disease should not participate in hydrotherapy because it may worsen the condition. In water, these people may also lack the sensory capability to feel the onset of diabetic shock, heart attack, hypotension, hypertension, hypothermia, hyperthermia, and diabetic shock. With this exception, water therapies have the potential to help a large number of people suffering from PTSD.

Post-Traumatic Stress Disorder is an ailment that often results in a challenging life with few close relationships and a lot of pain with little relief. Fortunately, hydrotherapy has been shown to suppress both psychogenic and physical pain while promoting relaxation techniques and channeling anger. The popularity of use is increasing with further research and education because there are no direct negative side effects of use and no adverse reactions. Therapeutic treatments are as cheap as the patient wants them to be, depending on the quality and location of the treatment. Lastly, it helps to provide a foundation for rebirth and growth to start a new and happy life with each breath submerging from the water. 

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