Veterans with PTSD turn to the outdoors to improve mental health 495d6p

Nothing could stop Sandi Braunstein from carving her way down a ski run at Snowmass Resort in Colorado. She glided over the snow alongside her two coaches, Jeff and Erik, who were there to instruct and her as she made turns down the mountain. Braunstein uses a bi-sit ski, which consists of a molded seat mounted on a frame with two skis underneath. This adaptive equipment is designed for people who ski in a seated position and might have difficulty balancing on traditional skis. “When you go down the hill, it is both thrilling and terrifying,” Braunstein said. “I’m like, don’t fall, don’t fall, don’t fall.” Braunstein is a full-time mom, student and hobby farmer in Grand Rapids. She is also a military veteran who served for nearly a decade in the Minnesota Army National Guard. During a training exercise in the Guard, she broke her leg and three vertebrae in her back. After seven unsuccessful surgeries over the span of nine years, Braunstein elected to have her left leg amputated below the knee. Now she is an avid member of the group Disabled American Veterans. That is why she was downhill skiing in Colorado. “I love sports, and this is the winter sports clinic that they do every year. I skipped last year, so I am happy to be back on the slopes,” Braunstein said. Returning to civilian life after military service can be a welcome change, but the abrupt transition can also be stressful and overwhelming. The reintegration process can feel isolating, and especially difficult for veterans who come back from long or dangerous deployments, or who found a deep sense of community in the military. Reentry can provoke anxiety, depression and post-traumatic stress. Braunstein has been exposed to multiple traumas over the course of her life and lives with post-traumatic stress disorder, or PTSD, a mental health condition that can develop after experiencing or witnessing a traumatic event. She said nature has a positive influence on her mental health. “Even if you go to a park, just touch the grass,” Braunstein said. “I know it sounds mundane, but it helps. It has helped.” Spending time engaging in outdoor recreation is known to improve general health and well-being. And research shows that veterans, in particular, benefit from outdoor activities as part of a complementary approach to treating mental health. Studies indicate that outdoor recreation and multi-day wilderness trips can reduce symptoms of PTSD, anxiety and depression. Outdoor excursions also build on veterans’ strengths and can echo positive aspects of military service, like being physically challenged, having a defined purpose and building camaraderie. “To me it’s more healing and fulfilling than anything else I’ve experienced,” Braunstein said. “I’ve met so many incredible people, and I’ve done so many incredible things that I don’t think I would have had the spirit to do otherwise.” The U.S. Department of Veterans Affairs says about 13 percent of female veterans and six percent of male veterans have been diagnosed with PTSD. The percentage is higher for Iraq and Afghanistan war veterans. Symptoms like flashbacks, nightmares, difficulty sleeping, hypervigilance and detachment manifest differently from person to person. They can persist for an extended period of time and impact a person’s relationships, ability to work and daily activities. The Veterans istration’s health care system sets clinical practice guidelines to identify first line treatments for PTSD. Psychiatric medication may be included in the treatment plan, but psychotherapy is generally the first line of treatment. Engaging in beneficial activities, such as wilderness adventures, can complement both medication and therapy. Getting outside is something Matthew Kaler, a psychologist with the Veterans istration in Minneapolis, encourages wholeheartedly. He said it is a way for people to introduce rewards into their day-to-day life that may have been taken from them by their symptoms. “Getting to a place where you feel like you have meaning in your life again is critically important and so we want to encourage people to find those things that fit for them,” Kaler said. Some veterans have found that fit and are sharing it with others. GalleryFullscreen SlideshowPrevious Slide1 of 2Sean Gobin hiking the Appalachian Trail in 2012 after returning home from war. In 2013, Gobin founded Warrior Expeditions and now serves as the executive directorCourtesy photo2 of 2Sean Gobin deployed to Afghanistan with the United States Marine Corps in 2011.Courtesy photoNext SlideSean Gobin lives in southern Virginia and served three combat tours in Iraq and Afghanistan with the Marines. Gobin was a tank platoon commander in 2003 during the initial invasion of Iraq and fought in Fallujah in 2005. He then spent 2011 in Afghanistan training the Afghan national security forces. Gobin says this was his breaking point. “I did not realize it at the time, but I was obviously struggling with pretty severe post-traumatic stress symptoms. I was having a really hard time connecting with people and talking to people and being around people. It was a lot,” Gobin said. “I was like, I have to get out. I have to make a change or else everything is just going to implode.” On Gobin’s last day in uniform, he left his base in North Carolina and headed to Springer Mountain, Georgia, to begin a 2,200-mile hike on the Appalachian Trail. He trekked across rugged mountainous terrain all the way to Maine to “walk off the war.” “What started as a bucket list item of something I always wanted to do since I was a kid — and I just looked at as a personal physical challenge — ultimately ended up saving my life,” Gobin said. It took him four and a half months to hike through 14 states on the Appalachian Trail. “Towards the end of the trail, I was like, wow, this has been so beneficial to me,” Gobin said. “I wonder if it would be beneficial to others.” The experience inspired him to form a nonprofit called Warrior Expeditions, an outdoor therapy program that aims to help veterans transition from their wartime experiences and recover from PTSD. Vets process their traumas, reconnect socially and improve their physical health through long distance hiking, paddling and biking expeditions. The trips last three to six months. “There’s enough duration within the experience to actually rewire the brain,” Gobin said. Numerous studies show that spending time outside has a direct impact on the brain and body. Outdoor experiences can lower blood pressure, heart rate and cortisol and improve cognitive function. Gobin said being on extended outdoor trips allows for decompression and the ability to process emotions. Warrior Expeditions collaborates with two psychologists who are also veterans. They measure post-traumatic stress, anxiety and depression among participants before and after each journey. They say the results show a clear reduction in symptoms and an improvement in psychological well-being. Gobin said when you see somebody at the end of a trip, it is like a light switch was turned on. “Eyes are bright. They are super exuberant and enthusiastic while talking and telling you about everything, and they are laughing,” Gobin said. “It is a night and day difference in interacting with the person I met six months ago.” Veteran advocacy groups around the U.S. successfully backed federal legislation in 2020 that launched programs and policies to help veterans with reintegration, mental health and treatment. The legislation also requires a Veterans istration task force to research the benefits of outdoor recreation therapy. GalleryFullscreen SlideshowPrevious Slide1 of 2Trent Dilks sits with a dog at a checkpoint in Iraq in 2006.Courtesy photo2 of 2Trent Dilks recreating in the mountains and snow in Colorado.Courtesy photoNext SlideTrent Dilks is the Minnesota legislative director for the group Disabled American Veterans. He advocates for veterans at the state and federal levels and said the VA task force study is overdue. Dilks also served 10 years with the Minnesota National Guard and did two combat tours in Iraq. “Being in Iraq and seeing all of that, and then the culture shock of coming back to all of the excess and all of the things and all of the noise here, it was difficult,” Dilks said. “I was restless. I was not comfortable where I was. I was dealing with a lot of anxiety. Later, I would realize it was post-traumatic stress.” Dilks coped with his PTSD in destructive ways by partying and trying to numb his feelings. He tried therapy and medication but did not like how the drugs made him feel. Dilks recognized that he needed to find his own path to healing. A significant part of that journey involved spending time outdoors. With a burst of excitement, Dilks grabbed his phone and tapped open a video from a trip to Colorado. In the clip, he and his former roommate from Iraq are summiting a peak. Snow is blowing in every direction. “It was him and I hiking up there and the wind gusts were just absolutely crazy,” Dilks said. Watching the video, Dilks burst into laughter, and a smile spread across his face as he noticed the icicle hanging from his beard. He said that whenever life feels difficult, he returns to the outdoors, because nothing beats fresh air and the space to breathe. This story is part of Call to Mind, American Public Media and MPR's initiative to foster new conversations about mental health. u6m2e