PTSD, post traumatic stress disorder

On The Path Forwards After 20 Years with PTSD

If you’ve been reading our blogs for a while, you should be no stranger to what post traumatic stress disorder (PTSD) is and how it affects those living with it. If you do need a refresher, check out our blog, PTSD – What Is It And Why Exercise??, to get up to scratch. 

At Specialised Health we work with many PTSD sufferers. Most often, we see those who have recently been diagnosed, in an effort to help them manage the array of symptoms they are experiencing and help them return to “life as normal” as much as possible. For many people however, the symptoms of PTSD can go on for years and years before they find any relief. That was exactly the case for a client who met our EP Georgia earlier this year. 

Meet Jason* 

Jason was a firefighter, who in the 90’s, experienced a sequence of events that heavily dictated the next 20 years of his life. For those 20 years, Jason experienced the debilitating symptoms of PTSD, triggered by the many day to day reminders of his painful experiences. 

The symptoms of PTSD can vary drastically for those who suffer; for Jason it manifested as recurring dreams and nightmares, disturbed sleep, low mood, low motivation, episodes of panic and not surprisingly, severe cognitive and physical fatigue. As a result of his declining mental health, Jason found himself unable to work and moreover, disconnected from friends, family and his community as a whole. Jason’s diagnosis soon progressed to include major depressive disorder alongside his initial diagnosis of PTSD. In recent years, he has spent up to a month at a time in facilities for his mental health, alongside regular visits to psychiatrists. 

Earlier this year, Jason was offered a role and he made the pivotal decision to return to work part time in forestry; an exciting, yet difficult challenge after all that he has been through. To help him in this journey, he was referred to us by his occupational therapist, and our EP Georgia came into the picture. 

The EP approach

Georgia set out to first build rapport with Jason, an important step for all clients but particularly for those experiencing mental health challenges. From there, Georgia’s goal was to identify Jason’s main barriers in relation to life and work. She asked the question, “what are the most significant factors getting in the way of the life Jason would like to be able to live?”

Together, they identified fatigue as the main limiting factor; fatigue which was greatly exacerbated by poor sleep and pain (from numerous chronic injuries). Alongside fatigue, Jason’s mental health diagnosis presented as low mood and motivation, adding to the wall between him and the life he wanted to lead. 

Building resilience to fatigue became the cornerstone feature of Jason’s program, with supplementary components which addressed many of Jason’s coinciding barriers. Georgia set him up with an activity diary and a heart rate variability (HRV) monitor. This initially allowed Georgia to look at how his nervous system was responding to various activities (at home and work), and then adjust those activities accordingly. Furthermore, Georgia guided Jason through specific activities, such as breath work and stretching, to tactically up or down regulate his nervous system in response to stress, pain and mood fluctuations. 

On the path forward!

It’s only 5 weeks into the 8 week program and Jason is making significant headway! He is successfully working 15-hours per week and with each weekly EP session, is learning how to manage his fatigue to reduce the all too familiar ups and downs in his energy levels. 

Jason’s sleep score (on his Garmin watch) is already up from 15 to 75, and his pain has reduced significantly as a result of regular stretching. Jason has expressed that having the HRV data each day not only gives him guidance in planning his days, but also greatly validates his personal experience, giving him “permission to rest”. Beyond the progress itself, each of these small successes are acting as the building blocks in self-confidence and self-efficacy. 

We can’t wait to see what his results are at the end of the 8 week program – but his story was so good, we couldn’t help but share it sooner! Jason is a great example that no matter how long you have felt stuck, there is still a path forward. As EP’s, we absolutely love walking that path with our clients. 

*Name changed for privacy 

Author: Tessa Nielsen
Editor: Yolanda van Vugt
Clinical Exercise Physiologist and Content Creator at Specialised Health

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