A diet rich in vegetables, fruits, and fish may help reduce or prevent symptoms of post-traumatic stress disorder (PTSD), reports NBC News. 

The study, conducted by researchers at Brigham and Women's Hospital and the Harvard TH Chan School of Public Health and published in Nature Mental Health, found that women who followed a Mediterranean diet experienced fewer PTSD symptoms compared to those who didn't adhere to the dietary pattern.

Releasing tomorrow - Advances in the Understanding of PTSD. This is a long one! It has to be

To truly grasp PTSD, we must return to first principles and understand the fundamental stress response. The challenge lies in avoiding diagnostic overshadowing by viewing PTSD too… pic.twitter.com/y5tnsoeYoC

— Dr Sanil Rege FRANZCP | MRCPsych (@sanilrege) October 30, 2024

 "When you put that in the context of PTSD, what's going to happen, I think, is that in response to overt stresses, if you're consuming a Mediterranean diet, you won't have these horrific stress responses that can be very damaging," said Carol Shively, a pathology professor at Wake Forest University School of Medicine, who was not involved in the research.

The peer-reviewed findings drew from two earlier studies conducted in 2008 and 2013, analyzing data from tens of thousands of female participants. For their analysis, researchers selected 191 women: 44 with PTSD symptoms, 119 who had experienced trauma but no PTSD symptoms, and 28 who had experienced neither.

The research team found that plant-based foods showed a negative correlation with PTSD symptoms, while red and processed meats were positively associated with such symptoms. The study's findings could help inform dietary recommendations for people at higher risk of PTSD, such as military service members, according to researchers.

Around 4% of the global population has experienced PTSD in their lifetime, according to the study. The condition develops in certain individuals who have experienced or witnessed traumatic events such as severe injuries, violence, or deaths.

"Many people get exposed to trauma, but only a small percentage go on to develop PTSD. It's always been a bit of a mystery," said Christopher Lowry, an associate professor of integrative physiology at the University of Colorado, Boulder, who was not involved in the research.

Yang-Yu Liu, the study's author and associate professor at Harvard Medical School, identified a specific species of gut bacteria that appeared to be linked to both the Mediterranean diet and protection against PTSD symptoms. "Maybe those enriched components of a Mediterranean diet help this particular bug thrive in the gut environment," said Liu, who is also an associate scientist at Brigham and Women's Hospital.

Lowry, however, expressed caution about attributing benefits to specific gut bacteria until additional studies replicate the results. He suggested that the Mediterranean diet's anti-inflammatory effects might be the key factor in alleviating or preventing PTSD symptoms. "The Mediterranean diet predominantly has an anti-inflammatory effect, and we have known for decades now that inflammation is a risk factor for depression," Lowry said. "Now it's become clear that it's also a risk factor for PTSD."

Several studies have suggested that elevated levels of inflammation may play a role in the development of PTSD. Research indicates that processed foods can increase gut permeability, allowing bacteria to enter the bloodstream and potentially affecting brain function through inflammation that travels from the blood to the central nervous system.

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IDF veteran Itzik Saidyan, who set himself on fire outside a Defense Ministry office in 2021 after his repeated requests for additional rehabilitation assistance were reportedly denied, was released Thursday from his rehabilitation center and returned home after two years of care.

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Saidyan self-immolated in protest over his treatment for PTSD outside the Petah Tikva offices of the Rehabilitation Department for disabled soldiers.
The IDF veteran fought in the 2014 Gaza war and was diagnosed with post-traumatic stress disorder following the conflict.

Video: Moshe Ben Simhon

The attempted self-immolation has left him with severe burns all over his body. He was being treated at the Sheba Medical Center in Ramat Gan.

In a press conference after his release, Saidyan warned that after a temporary improvement, the situation for veterans seeking assistance had started to deteriorate again.

"It is important for me to say that the reform has stalled. It is difficult for me that this has happened but I hear from friends that the committees have returned to making it as difficult as it was before," he said. "I ask the government not to forget us. There are thousands like me. I was trapped at home for six years, and every day was a war that cannot be explained in words. Loneliness can kill."

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Researchers at Ben-Gurion University of the Negev have developed the first methodology to assess symptoms associated with continuous exposure to traumatic stress from rocket attacks and other security threats not currently measured by diagnostic criteria.

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Published in the journal PLOS ONE, the study identified three distinct factors: exhaustion/detachment, rage/betrayal and fear/helplessness.

"Exposure to ongoing life risk exists wherever people experience continuous terror, rampant crime and civil war," says lead researcher Dr. Aviva Goral, a graduate of the BGU School of Public Health, Faculty of Health Sciences, and a researcher at the PREPARED Center for Emergency Response Research (PREPARED).

"Current scales assess the more commonly known effects of exposure to traumatic stress, mainly post-traumatic stress disorder (PTSD). This limits patient assessment and may lead to misdiagnoses and ineffective treatment," says Goral.

"The research was conducted to address this gap by developing a validated, comprehensive assessment tool, the Continuous Traumatic Stress Response (CTSR) Scale."

In the study, researchers sampled 313 adults who were and were not exposed to ongoing security threats between December 2016 and February 2017. Respondents lived in southern Israel communities bordering the Gaza Strip, where frequent rocket fire requires them to find shelter in 30 seconds or less. Researchers compared the concurrent validity of CTSR relative to the Post-traumatic Diagnostic Scale (PDS).

The findings indicated that the CTSR measures a construct related to, but distinct from PTSD; responses to ongoing exposure to threat are wider and more intensive than those associated with single traumatic exposure and may include cognitive, behavioral and emotional effects that are not part of traditional PTSD criteria.

Among CTSR criteria, a reduced sense of safety, distrust and mental exhaustion emerged with ongoing exposure to stressors. Other symptoms include social withdrawal, feelings of emptiness, hopelessness, estrangement and feelings of constantly being threatened.

"These findings imply that it is not exposure to ongoing threats per se, but rather the level of perceived threat (i.e., likelihood of injury or harm) that accounts for the difference in the prevalence and severity of CTSR stress symptoms," says Goral.

"Compared with distant communities, border-adjacent communities are much more vulnerable to rockets and tunnel infiltration, creating an atmosphere of tension and fear."

Professor Limor Aharonson-Daniel, head of PREPARED and Goral's Ph.D. supervisor, notes that "further studies are being conducted with larger samples and in broader populations around the Gaza Envelope. Future research will include international implementation in various languages and with other populations exposed to ongoing conflict or persistent civil war (e.g., Syria). This cross-cultural research will help identify the similarities and differences between conflict zones and cultures and facilitate the generalization of the CTSR scale."

"This study, and the diagnostic tool it yields, could benefit Israel and people around the world who suffer from continuous trauma and related symptoms," says Doug Seserman, chief executive officer of Americans for Ben-Gurion University.

"We look forward to seeing new research and development from BGU that continues to build off of this work," Seserman adds.

Reprinted with permission from JNS.org

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The condition of Itzik Saidyan took a turn for the worse Wednesday and his life is now in immediate danger.

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Saidyan set himself on fire in protest over his treatment for PTSD in front of the Defense Ministry's rehabilitation department offices in Petach Tikva, in central Israel.

The IDF veteran fought in the 2014 Gaza war and was diagnosed with post-traumatic stress disorder following the conflict.

The attempted self-immolation has left him with severe burns all over his body. He is being treated at the Sheba Medical Center in Ramat Gan. He is still anesthetized and ventilated.

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Israel Hayom learned Sunday that as part of authorities' efforts to help their officers, both the NYPD and the FBI have contacted Israel's largest crisis center for assistance in how to help their law enforcement officials psychologically deal with the highly volatile situation.

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Natal – the Israel Trauma and Resiliency Center is an NGO specializing in the fields of war and terrorism-related trauma, post-traumatic stress disorder, and resiliency-building among civil society.

The organization was established in 1998 by the late Dr. Yossi Hadar and Judith Yovel Recanati, who serves as its chairperson. Defense Minister Benny Gantz currently heads Natal's public advisory board.

In 2013, Natal was honored with the International Society for Traumatic Stress Studies Public Advocacy Award for outstanding and fundamental contributions to advancing social understanding of trauma.

Since its foundation, the organization has helped hundreds of thousands of Israelis of all ages deal with the country's complex security reality.

The unprecedented scope of the events rattling the US over the past few weeks has taken its toll on police officers, who are also dealing with increased anxiety and stress. This has prompted the FBI and NYPD to seek Natal's help due to its unique experience in treating members of the security forces who suffer from these conditions.

The sessions between American police officers and Natal's team of psychologists take place via video conference and focus on the ongoing crisis in the US, the coronavirus pandemic, the economic situation, the violent riots, and the burnout and fatigue wearing down law enforcement in the US.

So far, over 120 sessions have been held.

Natal CEO Orly Gal said the collaboration attested to the organization's professional experience and international reputation.

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The desecrated grave was discovered by a bereaved mother who was visiting the cemetery. Police officers arrived on the scene found a note on Ben-Yigal's grave that read, "Your son has 72 hours to be resurrected."

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Investigators identified the suspect, a 41-year-old resident of Rishon Lezion, with the help of security camera footage taken from a construction site adjacent to the cemetery. One of the cameras shows a woman digging around Ben-Yigal's grave. Police identified the suspect and proceeded to locate her whereabouts.

Police also collected various pieces of evidence from the grave itself, including tools and the handwritten note, all of which have been sent for forensic analysis.

The suspect has been jailed while the investigation continues. A hearing was scheduled for Tuesday, and police were expected to ask the court to extend her remand.

From the time the incident was first reported, police believed that the case was a criminal one, and not a terrorist hate crime. Eighteen years ago, the suspect survived a terrorist attack in Jerusalem and has been diagnosed with PTSD (post-traumatic stress disorder).

The woman has not yet given investigators her version of the story and is slated to undergo a psychiatric evaluation to determine whether or not she is capable of standing trial. A year ago, she was a suspect in a similar incident involving the grave site of a relative. 

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The number includes 5,000 veterans who suffer from post-traumatic stress disorder (PTSD)-related to their service. According to the ministry, much focus has been placed in recent years on treating and reintegrating PTSD victims back into the workforce.

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According to the published data, 591 of those being treated by the ministry's rehabilitation department are considered "highly disabled" and 817 were wounded during Operation Protective Edge in 2014. Of those injured during Protective Edge, 516 have a disability rate of 20% or higher, making them eligible for individual, spousal, and/or family psychological therapy.

For each patient, the department provides specialists and a social worker "in order to provide him with a comprehensive medical, social, employment, and profit-related response."

According to Defense Ministry Deputy Director General Hezi Mishta, who is also head of the ministry's rehabilitation department, the Day of Appreciation was instituted four years ago to "pay tribute to those who paid a heavy price for state security."

"The rehabilitation division cherishes disabled IDF veterans every day and works to provide them with the best medical care, to give them the full rights granted by the law and to help reintegrate them to society, school, and the workforce. This is our mission," he said.

In addition to the Day of Appreciation for wounded IDF veterans, the ministry's rehabilitation department collaborates with academia to publish and promote research about therapeutic treatments for PTSD.

Reprinted with permission from JNS.org.

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"Nights are the scariest," Rahal tells Israel Hayom. "Sometimes I hold onto my wife Amira's shirt and ask her not to leave me. In the day, I suffer panic attacks. I feel like I'm inside a sack, and they're closing it, and I can't breathe. At moments like these, I drip sweat and feel the pulse in my neck. Don't even ask," he says.

For 10 years, Rahal served as a career army tracker with the IDF's 91^st Division, and spent most of his service in Lebanese posts. Today, he deals with post-traumatic stress disorder on a daily basis as a result of the difficult events he experienced, incidents in which soldiers were wounded and killed.

"Anyone who wasn't in Lebanon doesn't know the IDF," he says.

As a tracker, Rahal would walk at the head of a troop contingent to break paths for the soldiers. In 1995, while still in the army, he married and was given a week off. But his commanding officer called him back to replace one of the other trackers. When he arrived, Rahal joined the 12^th Golani Brigade on a mission on the Shamis al-Arqub ridge, which overlooks Ishaya, a Christian village a few dozen kilometers from Beirut. As they were breaking a path, the forces encountered the enemy, and when they tried to attack, they were targeted by a bomb.

"It was a serious clash. I was wounded by shrapnel in my arm and my leg, but I went on. I needed to walk a long way with 17 other soldiers. The IDF started bombing and we asked the air force for help," he recalls.

At first, Rahal – then a master sergeant – didn't even realize he'd been wounded.

"I felt something cold in my leg, like ants. Only after quite a while, I noticed blood. I told one of the soldiers I'd been hurt, but even then I didn't feel too much. Only later did I realize the shrapnel had penetrated to the bone."

After he was wounded, one of the soldiers with him in the field tied a tourniquet onto Rahal's leg and tried to stabilize him and get him to a helicopter. "When I was in the helicopter, I lost consciousness. I was unconscious in the hospital for three days. Even today, I ask myself how exactly they treated me at that point."

Rahal sustained a bad wound to his leg and his ankle was smashed. He underwent a few failed operations, and doctors were eventually forced to amputate his leg.

"I wanted to run away from the hospital all the time. At first, I didn't dare think about amputation, not until the pain forced me to and I begged the doctors to take it off. After that, my situation really improved. Suddenly, I didn't have to drag a heavy leg [behind me] and not function. I felt relief, but even now, when I have to go to the doctor, my heart rate speeds up," he says.

Today, Rahal lives in the Bedouin town of Zarzir with his wife, Amira, and his four children.

Nearly all of the family's neighbors also served in the IDF. Amira's uncle is the late Col. Hussein al-Haib, who was the first tracker commander in the IDF to reach such a high rank. Rahal's father was killed during his service with the military police, and another 35 members of his extended family also fell serving their country.

Despite the grief, Amira stresses how much she loves the country: "I support the young Bedouin who enlist in the IDF. We have lectures to encourage them to join. Even after the nation-state law, it's important to us to enlist. I send my children to serve the nation with my eyes closed."

In the atmosphere of contribution and willingness to enlist that prevails in Zarzir, Rahal sharing his story is not something to be taken for granted. He speaks for the soldiers who were wounded during their service and must grapple with those wounds, physical and emotional, daily.

Dr. Yael Caspi, who coordinates mental health treatment on behalf of the Defense Ministry at Rambam Health Care Campus; Dr. Ortal Slobidin, and Dr. Shai Sorer – former coordinator for PTSD patients at Haemek Medical Center in Afula on behalf of the Defense Ministry – have conducted a series of studies among hundreds of Bedouin soldiers from northern Israel. They found that the population has great difficulty sharing their problems, which thereby makes it much more difficult for them to cope.

"Most of the Bedouin soldiers come from disadvantaged socio-economic backgrounds and a patriarchal cultural background, in which it isn't acceptable for men to share their troubles and feelings with others," explains Sorer.

"In this community, there is a stigma about mental health problems in general, and especially when it exists in men, who are traditionally expected to demonstrate self-command, courage, and capability.

"When a Bedouin soldier develops mental health problems and PTSD, he had to deal with his injuries on various levels. He loses his job and his solid standing in his family and his community. That situation creates a double injury in which a former soldier is forced to deal with things that are unfamiliar, in unsupportive conditions, all because of the negative, critical stigma by various elements in the society to which he belongs."

Sorer adds that because medication does not do enough to treat PTSD, and therapy requires them to share their difficulty – which is something foreign to the Bedouin population – Bedouin veterans are at high risk for developing chronic PTSD, which worsens with time.

The group Bshvil has identified the problem of dealing with PTSD in IDF veterans as a whole and the Bedouin sector in particular. The group organizes multi-day "release marches" in Israel and other countries, hoping to give veterans the emotional tools with which to process, accept, and confront their war experiences. The group sees it as a moral obligation to help former soldiers be able to live their lives as fully as possible.

Recently, Bshvil organized a special such event for the Bedouin veteran population. Rahal and 12 other Bedouin veterans took part in the 12-day hike abroad, which Amira – who represents the Bedouin sector in the Zahal Disabled Veterans Organization – helped organize.

"On the first day, we sat in a circle, and everyone told his story. Two of the participants served with me. Everything came up and it was really hard. Slowly we get into the process. Everyone came to the hike with his own baggage, and the guys opened up and cried like children.

"I learned that it's possible to get it out, to talk. We learned to create a different kind of internal dialogue, more constructive. It's a feeling of relief to see that there are other people like me, in my situation, who are having a difficult time after being wounded. We cried, we ate, we laughed, always moving forward. For years, I was dragging this weight around with me, feeling like it could explode at any minute. Now, finally, the weight is starting to fall away," Rahal says.

"We became different people and came back with a will to live. Even if the difficulty is still there, after the trip I suddenly saw the sun come out. I would sit and do nothing all day, and all of a sudden I have tools and meaning."

Eyal Bichler, 50, a psychotherapist who co-facilitated the trip, says, "We set out with members of five different tribes, and throughout the trip they opened up and shared the stories of their tribes and stories of the heroism of relatives who fell in battle, people we all knew about, in events and places we all knew as soldiers.

"On the fifth day of the trip, after one of the participants shared something moving about his tough experiences as a senior tracker, we went to the beach and stood there in a line, looking at the horizon. One of the participants led us in a Muslim religious ceremony – all of us, Jews and Muslims – in Arabic and Hebrew. At the end of the prayer, we all went into the water together. Brothers," Bichler says.

Q: We know that it's harder for Bedouin society to talk about trauma. How do you get them to open up and share?

"It happens through the experience of detaching from Israel and their day to day life, being in nature and … of course through patience and open facilitating. The trip is for the facilitators, like it is for the participants, and the more we are willing to make ourselves vulnerable and show trust, the easier it is for them to surrender to the process."

Q: How does the trip contribute to the mental welfare of the participants?

"After we got back, we didn't stop getting responses about changes in their worldviews, about a personal initiative they are taking and the ability to once again become part of their home lives. The warm responses came and are still coming from their wives and families, too."

Amira Rahal has become the guiding spirit behind the close bond that has formed between the trip participants, who continue to meet back in Israel.

"We've become one big family. I don't know how to thank the group that saved Majid for me. That trip showed them that finally there are people who are taking care of them. In my work with the Disabled IDF Veterans group, I hope to heal the injuries inside, as the trips do. There are a lot of wounded, not only physically, but mentally – and this trip is so crucial to their recovery," she says.

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