PTSD

Post-Traumatic Stress Disorder (PTSD) is a mental disorder characterized by recurring re-experiencing of traumatic events, such as actual or threatened death, serious injury, or sexual assault, following exposure to such traumatic incidents. Symptoms include nightmares, feelings of numbness or detachment, indifference toward others, lack of interest in the environment, anhedonia, helplessness, and associations related to the trauma.PTSD was classified under anxiety disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR); however, it has been reclassified as a Trauma and Stressor Related Disorder in the Fifth Edition (DSM-5). Although the cause of PTSD is clear, the manifestations of the disorder can vary based on the nature of the traumatic event, the time elapsed since the event, and individual factors such as vulnerability and resilience. Additionally, if the experiences of trauma survivors are not addressed sensitively, there is a risk of re-traumatization, making diagnosis and treatment challenging.Traditional Korean Medicine understands PTSD through a holistic lens, viewing it as a condition that arises from imbalances within the body’s systems, particularly in relation to Qi (vital energy), blood, and organ health. TKM emphasizes the role of specific organ systems, particularly the heart, liver, spleen, and kidneys. The heart is associated with emotions and mental clarity, the liver with the smooth flow of Qi and emotions, the spleen with nourishment and blood production, and the kidneys with resilience and vitality. PTSD is often seen as a result of stagnant or deficient Qi and blood. Emotional trauma can lead to stagnation of liver Qi and deficiency of heart blood, resulting in symptoms like anxiety, irritability, insomnia, and emotional numbness. TCM also considers the balance of Yin and Yang. A deficiency in Yin can lead to excess Yang, causing heat in the body, which may manifest as anxiety or agitation.After a practitioner has understood how PTSD has come to affect you, they will employ a number of modalities in order to restore your body and mind’s balance.Herbal Medicine: Customized herbal formulas are used to nourish the heart, calm the mind, and promote the flow of Qi. Herbs may include:Suan Zao Ren (Sour Jujube Seed): Nourishes heart blood and calms the spirit.Bai Zi Ren (Biota Seed): Nourishes the heart and calms the mind.He Huan Pi (Mimosa Bark): Relieves emotional distress and promotes relaxation.Acupuncture: Specific acupuncture points are targeted to help regulate the flow of Qi, calm the mind, and alleviate symptoms. Research indicates the acupuncture may modulate and regulate the body’s overactive sympathetic nervous system (“fight-or-flight response”).Qi Gong and Mind-Body Techniques: Practices such as Qi Gong, Tai Chi, and meditation are emphasized to help regulate the body’s energy, reduce stress, and promote relaxation.Lifestyle and Dietary Recommendations: TCM practitioners may suggest lifestyle changes that support emotional well-being, including stress management techniques, dietary adjustments to nourish blood and Qi, and practices that enhance overall health.Therapeutic Massage (Tui Na): This can be used to promote circulation, relieve tension, and enhance relaxation, addressing both physical and emotional symptoms.In summary, TKM approaches PTSD by focusing on restoring balance within the body, nourishing the mind, and supporting the emotional and physical health of the individual. The treatments are tailored to each person’s unique constitution and symptoms, aiming to provide a comprehensive and holistic way to heal from trauma.Treatment Case: 47-year-old womanThis 40-year-old woman began experiencing these symptoms after a traumatic experience during an earthquake, when her building shook significantly. She was at home relaxing after dinner when she felt extreme fear as the building trembled. The symptoms persisted and eventually led her to seek treatment at the clinic.She is a mother of two in her early 40s. According to her husband, she is usually positive and cheerful. Since the earthquake, she has suffered from severe anxiety, insomnia, and heart palpitations. These physical symptoms intensified, and she has been on sick leave from work. Despite resting at home, her symptoms have not improved, and she has been emotionally unstable. She has difficulty falling asleep, experiences nightmares, and frequently wakes up, leading to severe insomnia. She feels constant anxiety, is easily startled by small noises, and has become irritable, often snapping at her husband and children. She avoids old or high-rise buildings due to anxiety. When she must enter such buildings, she feels extremely uneasy and cannot stay long, which significantly disrupts her daily life.Her heart rate was between 110–120 beats per minute. Other vital signs were within the normal range. Her tongue was red at the tip, with little coating. She reported a dry mouth, reduced appetite, but normal digestion. Her hands and feet were cold, though she felt heat in her chest. Her menstrual cycle was usually irregular.Due to the severe trauma, she developed disrupted circulation of Qi and blood, along with issues affecting the heart. Her diagnosis included Qi Stagnation with Blood Stasis (기울혈어어) and Heart Yin Deficiency (심음휴허). Based on this diagnosis and PTSD from a previous mental health practitioner, her treatment plan included herbal medicine, acupuncture, moxibustion, and meditation as part of oriental psychotherapy. The herbal medicine Initially focused on clearing stagnant blood to improve Qi and blood circulation. Later, prescriptions were adjusted to nourish the heart Yin and blood. Acupuncture focused on points that aid in clearing blood stasis and reducing tension, using electroacupuncture, heat therapy, moxibustion, and aromatherapy. She came in 1–2 times per week for treatment.After two weeks, she reported reduced dryness in her mouth and chest tightness. She still experienced insomnia and heart palpitations, but physical symptoms were gradually improving. After week 4, she no longer felt chest tightness or heat, and heart palpitations had decreased by over half in both frequency and intensity. Her husband observed that her irritability and hypersensitivity were also lessening. After week 7, although her physical symptoms continued to improve, she still had difficulty entering old or tall buildings and felt discomfort at dusk. After week 9, physical symptoms only appeared when she thought about the earthquake, though they were less intense. She reported waking from nightmares about once every 2–3 days. After week 12, she rarely thought about the earthquake during the day, and physical symptoms were minimal. Though she still experienced flashbacks at dusk, they didn’t last as long. After week 16, she still occasionally had nightmares but was able to sleep through them. She began entering buildings she previously avoided and felt increasingly comfortable.After week 20, earthquake-related dreams almost disappeared. She still experienced slight anxiety at dusk, but it quickly faded as she distracted herself with other activities. She said she felt almost the same as she had before the earthquake.In this case, the patient’s physical symptoms, combined with re-experiencing and avoidance behaviors, worsened her anxiety and overall symptoms. Initially, treatment focused on reducing blood stasis and stabilizing physical symptoms. Once her physical symptoms had improved and re-experiencing of the traumatic event subsided, she was gradually exposed to similar environments while practicing oriental psychotherapy and visualization techniques to control her anxiety and physical responses. After 6 months, she achieved near-complete recovery and continues to come in for monthly follow-up sessions.