Mental stress affects the lives of many, and in some cases can lead to suicidal ideations. In a recent issue of The Journal of Nervous and Mental Disease, Dr. Simon Rosenbaum and colleagues examined the association between the time spent walking and symptoms of post traumatic stress disorder (PTSD) among hospitalized patients. PTSD occurs after an individual has experienced a disturbing or traumatic event in their life. Some professionals such as police officers, war veterans, and fire-fighters are exposed to violence and crimes daily, which can make them prone to PTSD. Symptoms of PTSD can manifest in different ways, including depressive symptoms such as, low mood, low energy, and lack of appetite, or anxiety symptoms such as sleep disturbances, mood swings, and poor appetite. Previous studies have shown that PTSD is related to increased rates of diabetes (a condition which raises blood sugar levels leading to heart problems, nerve damage and even blindness) and weight gain, leading to heart attacks. These medical conditions may be related to the daily stress that those who have experienced a traumatic event go through. There is also indication that people with PTSD have a greater tendency to smoke, are less physically active, and eat more. All these factors can contribute to being overweight. Previous studies, such as the “Obesity and Heart Disease” study conducted by Eckel and colleagues, suggest a relationship between obesity (being very overweight) and increased rates of heart attacks in the general population. Thus, as a PTSD patient becomes more overweight, they are at a greater risk for a heart attack. An additional supporting study, “The interactive role of exercise and sleep on veteran recovery from symptoms of PTSD” by Babson and colleagues, involving United States veterans, showed that increasing exercise in these patients improved their sleep quality. The improvement in sleep quality was especially apparent in relation to the number of hours the participants walked during the day. As they walked more, their sleep deprivation (extended periods of time without sleep) decreased. The improvement in sleep quality was especially apparent in relation to the number of hours the participants walked during the day. In the study performed by Rosenbaum and colleagues, 76 participants were assessed for symptoms of PTSD. The participants chosen were in the age range of 18 to 65 years old, and 83% of them were males. In this study, the researchers created a structured 12-week exercise program for the participants. The “structured program” was specific in details of how many times certain movements were done and how many minutes for each movement. The program included aerobic exercise and resistance-based exercises. Aerobic exercise aims to improve the body’s use of oxygen (for example, jogging). Resistance-based exercise involves complex movements that cause muscles to contract in opposition to an external force such as a band, rope, or dumb-bells. The study, performed by Rosenbaum and colleagues, used “walking” as a primary physical activity. This method was chosen instead of “jogging” or “running” primarily because it is a safe and manageable means of exercise for people who suffer from PTSD. Additionally, like running, walking has been shown to have health benefits such as “reducing cardiometabolic risk and improved mental outcomes.” Although past studies have established that depression symptoms improve with physical activity such as walking, PTSD has not been studied to the same extent. The effects of exercise on mental health were evaluated by participant responses to five questionnaires, which assessed PTSD severity and validated improvements in anxiety and depression symptoms on a monthly basis. The results of this study failed to show any significant improvement of PTSD symptoms with moderate to vigorous physical activity (exercises such as resistance training). Due to the set schedule for patients, each one received similar strength training regiments and rest time. Only “time spent walking” measured by statistical analysis and a step counter, was directly correlated with improvement in symptoms. Only “time spent walking” measured by statistical analysis and a step counter, was directly correlated with improvement in symptoms. The study found that total symptoms of PTSD, including depression, anxiety, sleep disturbances, and stress were reduced with “time spent walking,” as opposed to strength training. The relationship between reduction of symptoms and time spent walking was directly correlated, meaning that symptoms of PTSD decreased as time spent walking increased. These results should be considered when making treatment plans for individuals with PTSD, and could be utilized to structure exercise programs to aid those suffering. With previous studies showing improved symptoms of depression when people walked in familiar settings (such as their homes or neighborhoods), it is possible that PTSD could be treated by using “walking programs” created to fit people in their homes or nearby areas. The health benefits of increased time walking can only help overall functioning. It is also important to overcome challenges such as lack of motivation to participate, lack of support from family and friends, and lack of space to walk when hospitalized. When implementing such plans it will be important to provide support systems to encourage individuals with PTSD to participate in these walking programs. After all, walking is a cheap and cost-effective treatment for many health problems. REFERENCES Rosenbaum, S., D. Vancampfort, A. Tiedemann, B. Stubbs, Z. Steel, PB. Ward, D. Berle, and C. Sherrington. (2016). Among Inpatients, Posttraumatic Stress Disorder Symptom Severity Is Negatively Associated With Time Spent Walking. The Journal of Nervous and Mental Disease, 204(1), 15-19. Other Information Gathered From Babson, K. A., Heinz, A., Ramirez, G., Puckett, M., Irons, J. G., & Bonn-Miller, M. (2015). The interactive role of exercise and sleep on veteran recovery from symptoms of PTSD. Mental Health and Physical Activity, 8, 15-20. Eckel, Robert H. (1997). Obesity and Heart Disease: A Statement for Healthcare Professionals from the Nutrition Committee, American Heart Association. American Heart Association, 96(9).