Exercise as an RX for Veterans Recovery from Post-Traumatic Stress

WarriorWOD “Exercise is the RX” treats veterans for invisible wounds. When left untreated, often result in veterans finding ways to numb their pain through increasingly stronger substance abuse, self-harm behaviors or suicidal ideations. Our program helps veterans recover from their invisible wounds and, through that, reduces or even eliminates their dependency on anti-depressants, alcohol, and illegal drugs. Further, we see reduction of Post-Traumatic Stress symptoms and a decrease in acts or thoughts of suicide. The program prioritizes exercise, physical fitness, nutrition, and accountability with a “battle buddy” as a leading prescription in veterans' recovery from post-traumatic, preventing substance abuse, and suicide.

The prevalence of "invisible wounds" among the veteran population is growing, and the lack of a scar doesn't make mental health concerns any less critical or real. One in five veterans who served in Iraq or Afghanistan experiences Post-Traumatic Stress or major depression, but only half of those who need treatment seek medical help. One in 15 of all veterans has documented substance abuse disorder, while many more suffer in silence. Severe mental health challenges connected to military service – challenges such as depression, PTS, and anxiety - are directly related to substance abuse and suicide, impacting the individual veterans and their families.

All these factors contribute to the staggering number of veterans taking their own lives. Veterans are at a 57.3% higher risk of suicide than their peers who have not served. 22 veterans die each day by suicide, and an additional 20 die each day from overuse of drugs and alcohol.

According to the Department of Veterans Affairs, there are 19 million veterans in the United States. Since 9/11, four times as many U.S. service members and veterans have died by suicide than have been killed in combat. The unadjusted suicide rate for Veterans was 23.3 per 100,000 in 2001 and 31.7 per 100,000 in 2020. In 2020, Veterans aged 18-34 had an unadjusted suicide rate of 46.1 per 100,000. Every year since 2001, we lose an average of 6,100 veterans to suicide and an equal number to substance abuse. Additionally, according to the National Veteran Suicide Prevention Annual Report for 2022, from 2001 to 2020, mental health or substance abuse diagnoses rose from 27.9% to 41.9%.

America’s Warrior Partnership (AWP) recently released a striking report concluding that the veteran suicide rate is 2.4 times greater than the Department of Veteran Affairs (VA) estimates. According to AWP’s findings, 22-24 veterans ages 18-64 commit suicide each day, and 18-20 veterans in the same age group die per day by self-injury. Combined, this points to at least 40-44 veterans taking their lives every day.

Our program directly helps veterans achieve the following outcomes: improvement of quality of life, reduction of PTS symptoms, improved social and occupational functioning, improved self-worth, improved motivation, and reduction of substance abuse.

To date, WarriorWOD has demonstrated success and impact in decreasing veteran PTS symptoms. Comparing the symptoms before and after being involved in the WarriorWOD program, there is an overall 18% decrease in PTS symptom intensity. Through this improvement, WarriorWOD positively impacts both the suicide and substance abuse issues above.

Further, when analyzing the subcategories of the PCL-5, WarriorWOD's program demonstrated significant improvements in Avoidance (15.2%), Reactions (22.5%), Thinking & Mood (19.6%), and Intrusive Memories (10.8%). Funding would allow WarriorWOD to increase the number of veterans impacted directly through our “Exercise as an RX” Program.

As by-products of our programs, we reduce PTS symptoms and suicide among our veterans. Further, our program reduces dependency on VA-prescribed antidepressants, self-prescribed alcohol, and illegal drugs.

WarriorWOD provides the following direct services to veterans in need of PTS support:
● 6-month access to the fitness program of their choice
● Bi-weekly support and consultation with a certified nutritionist
● Bi-weekly camaraderie, accountability, and mentorship from another veteran (“Battle Buddy”) who has experienced similar things during their military time and afterward.

Every veteran in the WarriorWOD program will be provided with a fitness program and resources to exercise designed o meet the veteran where they are physically and encourage them to exercise regardless of modality. They will be required to work out no less than twice per week, however, are encouraged to exercise as much as their capacity will allow while including time to recover and rest.

Along with the exercise component, we provide the Veteran with nutrition coaching. The Veteran meets virtually with a nutrition coach every week or twice monthly, depending on the coach’s assessment. They discuss eating habits, macro intake, goals, weight gain/loss, body image, and healthy eating. In addition, Veterans have access to a local In-Body machine to determine Lean Muscle Mass and Body Fat Percentages.

Ultimately, our Mentorship component is the lynchpin that brings everything together. Veterans are aligned with other Veterans who likely have a similar mindset, base of experiences, and can easily relate, sympathize, and empathize with them. This mentorship with a Battle Buddy fosters accountability, motivation, and ownership that leads to results, ultimately benefiting the participating veterans in their PTS recovery and minimizing substance abuse. The belief in health as a Mission is nourished in these relationships.

The benefits of exercise and nutrition as therapy for PTS, substance abuse, and reducing veteran suicide rates are well studied and documented. These benefits include:
● Improvement of physical and cognitive abilities.
● Increase in confidence and self-esteem.
● Fostering a greater involvement in the community.
● Advances in social tendencies.
● Improvement in interpersonal skills and relationships.
● Better coping and adaptation skills.
● Enhanced well-being.
● A greater sense of accomplishment.
● Reduction of antidepressants, alcohol, and illegal drugs.

Using exercise and nutrition as therapy tools has profound and research-proven impacts on everyone, as there are no barriers to any individual’s participation at some level. Unfortunately, although there is excellent documentation of their benefits, these therapeutic tools have yet to be incorporated as part of treatment plans by the Department of Veterans Affairs. Currently, the Department of Veterans Affairs protocol is to prescribe anti-depressants, which leads veterans with substance abuse issues further into numbing their mental wounds.

Broad population-based correlation studies show evidence that the benefits of physical activity extend beyond the actual exertion and help alleviate long-term depression and treat mild to moderate depression as effectively as antidepressant medication—but without the side effects. In addition, there are tested and proven correlations between exercise and alcohol recovery. Research shows that exercise releases endorphins into the body, creating a natural high. These are the same type of endorphins people release when they are abusing substances. By exercising during recovery, it helps a person reintroduce healthy endorphins into their body.

Studies also suggest that regular exercise can increase the abstinence rate for substance use by 95 percent. These studies also found that exercise can help manage stress, depression, and anxiety, which can all contribute to substance use. Experts indicate that regular physical activity is a healthy stand-in for addictive substances. That's because exercise and drugs of misuse work on similar parts of your brain. They both activate your reward pathway, which triggers the release of feel-good chemicals like serotonin and dopamine.

Exercise is a natural and effective way to help veterans decrease depression and anxiety. Research indicates that exercise can reduce psychological distress by 47%. Exercise releases endorphins which trigger a positive feeling in the body. Exercise also helps to improve cognitive functioning, including decision-making, learning, and mental focus. It also contributes to many positive physical health outcomes, such as improved cardiovascular health, weight loss, and greater flexibility and mobility. Studies on PTS found that physical activity significantly reduced depressive and PTS symptoms.

Nutrition plays a vital role in the reduction of PTS symptoms. For example, a regular diet of refined or processed foods and saturated fats increases the likelihood of depression by 41%. Conversely, there is a 25% reduction in the risk for major depression and anxiety disorders among adults who consume a diet of vegetables, fruits, whole grains, meat, and fish. Proper nutrition and hydration are key to the substance abuse healing process because they help restore physical and mental health and improve the chance of recovery. Eating a balanced diet and increasing your nutrition levels can help enhance the brain's neuroplasticity.