Post-traumatic stress disorder (PTSD) is common in military veterans but can affect anyone who has suffered or witnessed an extreme physical or emotional event, and it is very hard to treat. More than two-thirds of people fail to respond to treatment with drugs and therapy. Novel treatments are urgently needed.
A recent study from Israel has been showing promise with an unusual treatment: hyperbaric oxygen therapy (HBOT). This involves breathing pure oxygen in a pressurised chamber. HBOT is conventionally used to treat various physical ailments, such as carbon monoxide poisoning and decompression sickness (also known as “the bends”).
The study, published in The Journal of Clinical Psychiatry, included 63 male veterans aged 25 to 60 who had suffered from PTSD for more than five years. Fifty-six subjects completed the study.
Participants in the study were randomly assigned (28 in each group) to either receive the active treatment with 60 sessions of hyperbaric oxygen at a pressure corresponding to diving 10 metres underwater, or a “sham treatment” (the control group), with air just above atmospheric pressure.
Treatments were 90 minutes a day, five days a week for 12 weeks and included air breaks, or simulated air breaks for people in the control group, every 20 minutes. The groups were similar (as expected in a randomised study) and could not correctly guess which treatment they received (this “blinding” helps remove bias from the study).
The group that received hyperbaric oxygen improved much more in self-reported symptoms related to PTSD and depression compared with the control group, immediately after the treatment and three months later.
Interestingly, changes could also be seen in certain areas of the brain associated with PTSD, with magnetic resonance imaging. The study reported some mild side-effects including resurfacing of traumatic memories, which in itself is very interesting and possibly part of the treatment effect.
Hyperbaric oxygen treatment has been used for more than half a century for its multiple effects on the immune system – in wound healing, infections and chronic inflammation. If we consider PTSD a wound with chronic inflammation, it is not difficult to imagine how it works, even if we do not fully understand the mechanisms involved.
In a wound, the damaged cells release molecules that trigger the immune system and attract stem cells involved in the healing process. This process uses lots of oxygen and the mitochondria that are the power plants of the cell need to work at full capacity.
If the healing is not completed, some cells close to the wound change their behaviour and close down power plants (mitochondria) to survive, instead of choosing to die and be replaced. This is a natural survival mechanism, important for regeneration after an injury.
The study suggests that hyperbaric oxygen therapy may be a promising new treatment for PTSD, with potential benefits including improved symptoms and changes in brain function. While more research is needed to fully understand the mechanisms involved, this novel approach offers hope for individuals struggling with this debilitating condition.
Q: What is hyperbaric oxygen therapy?
A: Hyperbaric oxygen therapy involves breathing pure oxygen in a pressurised chamber.
Q: How does it work?
A: Hyperbaric oxygen therapy has been used for its multiple effects on the immune system – in wound healing, infections and chronic inflammation.
Q: Is it a new treatment?
A: No, hyperbaric oxygen therapy has been used for more than half a century. However, its application in treating PTSD is a new and promising area of research.
Q: What are the potential benefits?
A: The study suggests that hyperbaric oxygen therapy may improve symptoms of PTSD and depression, and potentially change brain function.
Q: Are there any side-effects?
A: The study reported some mild side-effects, including resurfacing of traumatic memories, which may be part of the treatment effect.
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