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PTSD and Poor Physical Health Behaviors


Updated March 26, 2012

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Study after study has found that post-traumatic stress disorder (PTSD) is connected with a wide range of mental health problems (for example, major depression, anxiety disorders and substance use disorders). However, there is also a good amount of evidence that PTSD increases the risk for a wide range of physical health problems, in particular heart disease.

There are a number of theories why PTSD may be associated with high risk for heart disease. Chronic PTSD results in the release of stress hormones, which may contribute to inflammation and eventual damage to a person's cardiovascular system. This would increase a person's risk for heart disease and premature death. It is also thought that the avoidance symptoms of PTSD may lead to a number of unhealthy behaviors (for example, smoking, isolation and inactivity) that could put people with PTSD at risk for poor physical health.

To better understand what might contribute to heart disease among people with PTSD, a group of researchers at the University of California, Los Angeles (UCLA) and the San Francisco VA Medical Center decided to examine specific physical health behaviors associated with PTSD among a large group of people with cardiovascular disease. They refer to this project as the Heart and Soul Study.

Poor Physical Health Behaviors Connected to PTSD

In this study, researchers surveyed and interviewed 1,022 patients with cardiovascular disease. They asked them questions about their PTSD symptoms, their level of physical exercise, how often they took their medication according to their doctors' orders and how often they smoked. Of this larger group, 95 were identified as having a PTSD diagnosis.

They found that people with PTSD and cardiovascular disease were much less likely than those without PTSD to exercise. They also tended to view themselves as less active than people without PTSD. People with PTSD were also much more likely not to adhere to their recommended medication regimen, and were also more likely to skip taking medications. Finally, people with PTSD were more likely to be current or former smokers than those without PTSD. Importantly, the researchers also took into account depression, and they determined that the poor physical health behaviors were likely due to the experience of PTSD and could not be attributed to higher rates of depression among those with the disorder.

Understanding Poor Physical Health Behaviors in PTSD

This study shows that people with PTSD engage in a number of poor physical health behaviors, as compared to people without PTSD. The fact that the people in the study already had cardiovascular problems is even more alarming. This group of people has likely already been advised about the dangers of smoking, inactivity and poor medication adherence. However, it seems as though PTSD still contributes to these unhealthy behaviors even in the context of an existing medical problem.

More research is needed to understand why these unhealthy behaviors develop and how they can be prevented. One symptom of PTSD is that people believe that their future may be cut short. This sense of foreshortened future might cause low motivation or a low desire to make positive life changes. Coping skills focused on this PTSD symptom might be helpful in increasing motivation to live a healthier life. To the extent that smoking or lack of exercise stems from a desire to avoid emotional or physical distress, learning ways to reduce avoidance behaviors may also be of benefit.

There are also a number of effective treatments available for PTSD. By addressing your PTSD symptoms, you may be able to lift some of the obstacles that are preventing you from making positive life changes. If you are looking for a PTSD therapist, there are helpful websites that can connect you with a therapist in your area.


Zen, A.L., Zhao, S., Whooley, M.A., & Cohen, B.E. (2012). Post-traumatic stress disorder is associated with poor health behaviors: Findings from the Heart and Soul Study. Health Psychology, 31, 194-201.

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