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The Relationship between PTSD and Medication Adherence

Understanding the Poor Physical Health Outcomes Observed among People with PTSD

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Updated July 27, 2012

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Few studies have looked at post-traumatic stress disorder (PTSD) and medication adherence. However, doing so may provide some insight into why people with PTSD often experience a number of physical health problems. For example, people with PTSD are more likely than those without PTSD to experience cardiovascular problems, obesity, chronic pain, diabetes, and a wide range of other physical ailments. Taking medication as it is prescribed for a medical condition (for example, high blood pressure, diabetes, high cholesterol) is a very important health behavior that can reduce the risk for physical health problems or complications associated with certain medical conditions.

The Mind Your Heart Study

A group of researchers looked at the ways in which PTSD may negatively impact medication adherence. This research was done as part of the Mind Your Heart Study, a large-scale study in military veterans looking at the connection between PTSD and health over the course of a number of years.

The researchers found that people with PTSD were almost twice as likely to not take their medications as prescribed compared to those without PTSD. In addition, people with PTSD were also more likely than those without PTSD to forget taking their medications or to skip taking their medications.

The Importance of Managing Symptoms of PTSD

The findings from this study are similar to other studies showing that PTSD negatively influences adherence to HIV medication or medication for coronary heart disease. So, what is it about PTSD that interferes with taking prescription medications?

The jury is still out when it comes to this question; however, there are some possible reasons. First, one of the symptoms of PTSD is difficulty concentrating. Some medication regimens can be difficult to follow even in the absence of PTSD symptoms. People with difficulty concentrating may easily forget to take their medication or have trouble following a regular medication schedule. Related to this, some people with PTSD also have problems remembering things, especially everyday activities. This may also influence a person's ability to regularly take their medications.

Another symptom of PTSD is a sense of a foreshortened future. People who experience this symptom feel as though their life will somehow be cut short without any real explanation why. They may also feel as though they won't be able to reach milestones in their life, such as a career, marriage or children. As a result, people with this symptom may feel as though there is no point to taking medications as prescribed, as their life is going to be cut short anyway.

Given that PTSD symptoms can interfere with medication adherence, it is important to learn healthy and effective ways of managing these symptoms. Doing so may result in an improvement in medication adherence, which can then ultimately translate into some positive health benefits. There are a number of strategies that you can use to improve your memory and concentration. In addition, there are ways of reducing a sense of a foreshortened future.

Finally, if you feel as though your PTSD symptoms are greatly interfering with your life, it may be helpful to seek out treatment for your PTSD. There are a number of effective treatments for PTSD. In addressing your PTSD through treatment, you may notice that other areas of your life (such as your physical health) are more easily managed. There are a number of search engines on the internet that can help you find a PTSD treatment provider in your area.

Sources:

Boarts, J.M., Sledjeski, E.M., BOgart, L.M., & Delahanty, D.L. (2006). The differential impact of PTSD and depression on HIV disease mearkers and adherence to HAART in people living with HIV. AIDS and Behavior, 10, 253-261.

Kronish, I.M., Edmondson, D., Li, Y., & Cohen, B.E. (in press). Post-traumatic stress disorder and medication adherence: Results from the mind your heart study. Journal of Psychiatric Research.

Shemesh, E., Yehuda, R., Milo, O., Dinur, I., Rudnick, A., Vered, Z., et al. (2004). Posttraumatic stress, nonadherence, and adverse outcome in survivors of a myocardial infarction. Psychosomatic Medicine, 66, 521-526.

Zen, A.L., Whooely, M.A., Zhao, S., & Cohen, B.E. (2011). Post-traumatic stress disorder is associated with poor health behaviors: Findings from the mind your heart study. Health Psychology.

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