A study conducted by researchers from Tel Aviv University and the Shamir Medical Center on 35 veterans from the Israel Defense Forces found that new HBOT protocols reduce symptoms in those that suffer from treatment-resistant PTSD, demonstrating significant improvement in all classes of symptoms.
The peer-reviewed study was published earlier this week in the prestigious scientific journal PlosOne.
While there have been studies on the effects of oxygen therapy on PTSD patients who also suffered from traumatic brain injury, this is the first time researchers have focused on using oxygen therapy to treat patients only suffering from psychological trauma, Dr. Keren Doenyas-Barak, one of the researchers that led the study, tells NoCamels.
Dr. Doenyas-Barak was part of the research team that led the study. The team also included Prof. Shai Efrati, Dr. Ilan Kutz, Dr. Merav Catalogna, Dr. Efrat Sasson, Dr. Amir Hadanny, Gabriela Levi, and Yarden Shechter from the Sagol School of Neuroscience and the Faculties of Medicine and Life Sciences at Tel Aviv University and the Shamir Medical Center.
PTSD is a disorder that develops in some people who have experienced a shocking, scary, or dangerous event. While it is natural to feel afraid during and after a traumatic situation, fear can also trigger many split-second changes in the body and brain to help defend against danger or to avoid it.
“I would sit with some of these patients and I would get such a strong reaction,” says Dr. Doenyas-Barak, “Like when you look at a dog, you can tell if he’s calm or very stressed or afraid. And for these patients, the disease is actually in their limbic system. So you can actually tell if they’re looking around or if they’re calm. There were certain days when you could feel that they were lost. There was a need [for these veterans] to look around for danger.”
Dealing with daily life was a struggle, she tells NoCamels. They would get scared hearing loud noises or when airplanes flew above their head. Some couldn’t stand in line to order food because they were worried about who was behind them.
Hyperbaric oxygen therapy has been used as a type of treatment to speed up healing of carbon monoxide poisoning, gangrene, stubborn wounds, diabetic skin wounds, and infections in which tissues are starved for oxygen, among others. During the treatment, a patient breathes in pure, high-pressure oxygen at various concentrations through a mask while seated in a hyperbaric (pressurized) chamber to stimulate the healing process.
Efrati’s team at Shamir Medical Center’s Sagol Center for Hyperbaric Medicine and Research has done extensive research on the use of HBOT to improve brain function in patients that suffer from stroke, fibromyalgia, and Alzheimer’s. In one contentious 2020 study, Efrati even claimed that HBOT has the potential to “reverse” aging at the cellular level.
“Today we understand that treatment-resistant PTSD is caused by a biological wound in brain tissues, which obstructs attempts at psychological and psychiatric treatments,” said Prof. Shai Efrati in a statement, “With the new HBOT protocols, we can activate mechanisms that repair the wounded brain tissue.
The treatment induces reactivation and proliferation of stem cells, as well as generation of new blood vessels and increased brain activity, ultimately restoring the functionality of the wounded tissues. Our study paves the way to a better understanding of the connection between mind and body.”
The study included 35 combat veterans with a mean age of 32 years old who had undergone treatment for PTSD but had been resistant to both psychiatric medications and psychotherapy. The veterans were divided into two groups where one served as a control group and one received HBOT. The group of 18 veterans that received HBOT went through a course of 60 daily sessions in the hyperbaric chamber for about three months.
PTSD symptoms reduced sharply, the researchers said, with specific improvement in hyper-arousal, avoidance, and depression. These were caused or related to specific improvements in biological factors, like changes in brain activity and heart rate, which have been identified as effects of PTSD.
“Oxygen is the basic source of energy production. We must have oxygen in order to generate energy. Generally, the brain doesn’t work 100 percent when it lacks oxygen. We have two main vessels bringing blood to the brain and only certain parts of the brain are active when we don’t have enough energy for the rest.
So these hypometabolized brain regions cannot heal if they don’t have enough energy,” says Dr. Doenyas-Barak, comparing it to someone putting a pillow against someone’s face so that they could not breathe, signaling a need for a healing response. “We could also demonstrate changes in the activity of certain brain regions such as the prefrontal cortex and the hippocampus, and improved connectivity. There was a very good correlation between the changes in the clinical score [of our patients] and the activity in certain brain regions.”
One of the things Dr. Doenyas-Barak said the soldiers complained about was hot flashes and sweat. When they were fearful, the sweat had a sour smell that was not pleasant. After the HBOT treatment, “one of the soldiers described to me how he had many undershirts in his car, which would be there because he had to change his shirt a few times a day because it got smelly. He had to get to his car, change the shirt, and get back to work. One day he realized that there were many shirts accumulating in his car. Suddenly he didn’t need to change them anymore, even when he was nervous.”
Other soldiers reported unique changes in their quality of life, Dr. Doenyas-Barak explains. One said the neighbor’s dog, which would always bark at him, suddenly stopped barking. Another said that for the first time, he could use a touch screen in a McDonald’s restaurant without paying attention to who was behind him.
Our results indicate that exposure to severe emotional trauma can cause organic damage to the brain,” says Prof. Efrati. “We also demonstrate for the first time that direct biological treatment of brain tissues can serve as a tool for helping PTSD patients. Moreover, our findings may be most significant for diagnosis.
To date, no effective diagnostic method has been developed and diagnosis of PTSD is still based on personal reports which are necessarily subjective – leading to many clashes between the suffering veterans and the authorities responsible for treating them,” said Efrati, “At present, we are conducting continuing research in order to identify the biological fingerprint of PTSD, which can ultimately enable the development of innovative objective diagnostic tools.”
“We believe that in most patients, improvements will be preserved for years after the completion of the treatment,” added Dr. Doenyas-Barak, “This study gives real hope to PTSD sufferers. For the first time in years the study’s participants, most of whom had suffered from severe PTSD, were able to leave the horrors behind and look forward to a better future.”
How HBOT Works for Post-Traumatic Stress Disorder (PTSD) Patients
Many PTSD cases among veterans often coexist with cases of TBI. As a result, many wonder if, in those cases, PTSD is in some way connected or the result of the damage to the brain. However, not all cases of PTSD are connected to brain injury. In cases where no trauma to the brain occurs, neuroimaging tests reveal that PTSD affects many areas of the brain. This damage includes hippocampal atrophy, altered activity in the insular cortex, and hypoactivity of the hypothalamic-pituitary-adrenal axis. These areas of the brain distinguish between safe and unsafe conditions. They control the brain’s interpretation of stimuli as well as fear conditioning and cognitive and emotional interactions. As a result, all of these areas are typically abnormal in cases of PTSD.
Hyperbaric oxygen therapy, orHBOT, treatments provide 100 percent oxygen delivered under increased pressure that helps treat post-traumatic stress disorder, or PTSD. This increased oxygen helps heal damaged brain tissue, improves blood flow, reduces inflammation, and promotes the growth of new tissue and blood vessels.
Study Show Effectiveness of HBOT on Post-Traumatic Stress Disorder (PTSD)
Over the last few years, many new studies have looked at the benefit of hyperbaric oxygen and HBOT treatments for those suffering from TBI and/or PTSD. One study conducted by Dr. Paul Harsh and published in Medical Gas Research looked at 29 active-duty or retired military personnel with mild TBIs. All participants suffered from post-concussion syndrome, with some suffering from PTSD. After completing 40 HBOT treatments, 52 percent of those that met the PTSD Checklist-Military diagnosis no longer met the diagnostic threshold. Improvements occurred in general anxiety, depression and PTSD symptoms. Out of 12 participants that expressed suicidal thoughts at the beginning of the study, 10 no longer felt suicidal. Dr. Harsh stated that “The PTSD symptom reduction is one of the greatest reductions in PTSD symptoms in a four-week period with any reported treatment.”
Symptoms of PTSD
With any traumatic event, nightmares or severe anxiety are common, and in most cases expected. But, with time, most people can process the trauma and move forward with their lives. However, with PTSD, those feelings don’t go away. In many cases will worsen to the point that they interfere with everyday activities. In some cases, symptoms do not begin immediately. However, an event can occur months after the initial traumatic event that triggers the PTSD.
Symptoms of PTSD break down into four main types:
- Memories – Memories include flashbacks of images from the event where a person goes back to reliving the event. Everyday images or events may bring back memories, resulting in severe emotional reactions or physical reactions.
- Avoidance – Someone with PTSD will try to avoid talking or thinking about the event. They may also avoid people, places and things that remind them of the event. They may become emotionally detached, withdraw from friends and family, and lose interest in everyday activities.
- Changes in Mood and Thinking – With someone suffering from PTSD, you may notice a negative change in mood or thinking. They may feel very negative about themselves and the future. Memory problems may surface. Family detachment and difficulty maintaining relationships become a problem. They feel emotionally numb, losing interest in favorite activities and have a hard time feeling positive about anything.
- Changes in Physical and Emotional Reactions – PTSD sufferers can be easily frightened and always on guard. Sleeping and concentrating become difficult. They may seem irritable, aggressive and may participate in self-destructive behavior, such as excessive drinking.
Traditional Treatments for Post-Traumatic Stress Disorder (PTSD)
The main two treatments for PTSD are psychotherapy and medications. The goal of treatment is to help the person learn skills to cope with the trauma, as well as treat problems associated with the PTSD. This includes depression, anxiety and the abuse of alcohol and drugs. Medications typically include antidepressants and anti-anxiety medications. No one treatment works for every patient, so it is a matter of trial and error to see what works.
Psychotherapists use different treatment options including:
- Cognitive Therapy – This therapy focuses directly on the trauma behind the PTSD. A therapist will work with patients to identify and understand the trauma while also changing the patient’s thinking and behavioral response to the trauma.
- Exposure Therapy – Exposure therapy helps people face their trauma by exposing them to it while in a safe environment. This therapy can use mental stimulation, writing, or even virtual reality to simulate the traumatic event. Over time, the person becomes less sensitive to the traumatic event.
- Eye Movement Desensitization and Reprocessing (EDMR) – EDMR involves the use of exposure therapy. At the same time, the patient focuses on a specific sound or eye movement while traumatic thoughts occur. This helps reprogram behavioral actions when traumatic memories are triggered.
- Stress Inoculation Training (SIT) – The goal of this therapy is to reduce anxiety levels by teaching coping skills. This form of therapy is often used together with other methods of dealing with the trauma. The purpose of this therapy is to change the way a person reacts to stress.
- Present Centered Therapy (PCT) – Present therapy works a little different in that it does not focus on the trauma. Instead, it teaches problem-solving skills in order to deal with the trauma.
HBOT, PTSD and the Department of Veterans Affairs
In 2017, the U.S. Department of Veterans Affairs (VA) announced that it would offer hyperbaric oxygen and HBOT treatments for veterans with post-traumatic stress disorder (PTSD) that had failed or seen little effects from traditional treatment methods. The Veteran’s Administration and Department of Defense have approved and will pay for HBOT treatment for TBIs and PTSD in seven states (AL, FL, GA, MD, NJ, TX and OK) currently. In addition, there are 19 US Congressional Legislators encouraging the VA and DOD to use HBOT for TBIs and PTSD as a treatment option.
Additionally, New York State American Legion Commander Kenneth Governor has been very vocal in his support of HBOT for veterans with TBI and PTSD. He states, “We’re losing 22 veterans a day who take their own lives, with another 44 attempts. We need to offer veterans with TBI/PTSD an alternative to a sliding slope of drug therapy. We need to do it now. Today.”