Healing PTSD: The importance of circadian rhythms

Healing PTSD is a difficult task due to the many mental and physical features of the condition. Short for Post-traumatic stress disorder, PTSD is a repeated stress reaction to a traumatic event that continues well after resolution. Events that trigger PTSD immediately or in a delayed manner include:

  • Rape
  • War
  • Kidnapping
  • Loss of a loved one
  • Assault
  • Childhood trauma

People with PTSD relive their trauma and this has negative effects on their quality of life. They regularly experience flashbacks, nightmares, jumpiness, emotional detachment, and sleep problems.

Many think of PTSD as strictly a mental illness. But there are actually physiological manifestations of the disease as well. Things like:

These symptoms make life worse and often reinforce the condition. And it’s important to point out that an integrated approach addressing both the mental and physical aspects of PTSD yields the best results.

In fact, total resolution is unlikely without correcting both the inflammatory and metabolic abnormalities.

Are sleep and stress the canary in the coal mine?

It’s clear that both sleep disruption and a dysfunctional stress response are important factors for PTSD. Interestingly, circadian rhythms regulate both sleep and our sensitivity to stress.

Circadian rhythms are variations in physiological processes that follow a 24 hour pattern. As a result, these processes clearly occur at the same time, or during the same period, every day.

For example, we sleep at night and are awake during the day. Our stress hormone cortisol is highest in the morning and lowest in the evening. And our immune system is generally on high alert during the daytime when we are exposed to viruses and bacteria.

But circadian rhythms don’t just happen. You can alter your circadian rhythms by changing your exposure to environmental signals called zeitgebers, or time-givers.

Light exposure is the most well-known zeitgeber. But physical activity, the feeding/fasting cycle, stress exposure, temperature, and social interaction are other cues that can alter our circadian rhythms.

Disrupting circadian rhythms leads to the same inflammatory and metabolic abnormalities found in PTSD. And poor sleep and an altered stress response are a clear indication of circadian disruption.

This is no secret, and researchers are using circadian principles to treat PTSD successfully. In fact, a recent review states:

“PTSD development is associated with chronodisruption findings. Evaluation and treatment of sleep and circadian disruption should be the first steps in PTSD management.”

Healing PTSD using circadian rhythms: Let there be light

A recent study examined the use of light therapy to treat PTSD. Researchers exposed people with PTSD to either blue light or amber light first thing in the morning for 6 weeks. They also exposed them to a fear conditioning/extinction protocol.

This type of protocol determines if a person who develops a fear response to a stimulus can “learn” to forget that response. Those exposed to blue light were better able to “learn” to lose the fear response to the stimuli. They also experienced better sleep while those in the amber group had less sleep and retained the fear response.

How does this work? Emotional processing is under circadian control. Emotional processing occurs during REM sleep, which happens in the early morning hours just before awakening. Circadian disruption impairs REM sleep and, thus, the ability to properly process emotional information.

By increasing total sleep, exposure to blue light in the morning acts as a circadian cue, partially correcting circadian disruption. As a result, REM sleep improves along with the participants’ ability to process emotional information.

Healing PTSD: A gut instinct

Improving REM sleep is a fantastic result. And while improving sleep will have minor effects on improving gut health, just addressing early morning light exposure won’t correct gut inflammation. Correcting inflammation in the gut is a critical step in properly addressing PTSD.

In an inflamed gut, bacterial components within it pass in to the blood and induce a chronic state of inflammation. One of these inflammatory components, lipopolysaccharide(LPS), also creates inflammation within the brain.

Healing PTSD
https://www.physiology.org/doi/abs/10.1152/ajpgi.00194.2019

This is commonly referred to as leaky gut, or more appropriately, intestinal permeability. This condition creates the same metabolic abnormalities found in people with PTSD. For help on leaky gut, check out my free course 3 Common Causes of Leaky Gut.

This inflammatory soup also promotes overactivation of the fight or flight response. This, in turn, increases inflammation creating a perpetual loop that needs to be broken.

Without correcting the inflammation and the metabolic abnormalities, complete resolution is unlikely. Addressing circadian rhythms is important because it regulates the stress response, immune system, metabolism, and gut health.

Early morning light exposure is step 1. But exercise, nutrition, meal timing/frequency, sleep hygiene, and regulating light exposure at night are also really important.

Conclusion

Living with PTSD presents with many challenges. The primary focus for treating the condition has centered around behavioral therapy. And it’s obviously a piece of the puzzle, it’s lacking in its thoroughness.

The physiological manifestations of PTSD play a role in inducing the psychological manifestation. Poor sleep, circadian disruption, and gut inflammation create the inflammatory and metabolic abnormalities that drive the heightened stress response.

Interestingly, disrupting circadian rhythms drives poor sleep and an altered stress response. Additionally, the gut is under heavy circadian regulation. As such, addressing circadian rhythms should be at the top of the priority list for those healing PTSD.

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