Can Alternative Therapies For PTSD Help Improve Mental Health?

According to the United States Department of Veterans Affairs, post-traumatic stress disorder is a serious psychiatric disorder that affects an estimated 6% of the US population. While talk therapy is currently considered to be the gold standard of treatment for PTSD, some complementary and alternative medicine (CAM) approaches (including acupuncture and mindfulness) may be beneficial as well. When used as part of an integrative mental health approach, CAM therapies can be safe and potentially effective. 

What is Post-Traumatic Stress Disorder or PTSD?

Post-traumatic stress disorder (PTSD) is a psychiatric disorder triggered by traumatic experiences. When a person is directly or indirectly exposed to a distressing event—such as physical, sexual, or emotional abuse, an accident, war, terrorism, or a natural disaster—they may develop PTSD. Symptoms typically develop within months or years of experiencing trauma, and they tend to significantly interfere with daily life and functioning.    

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According to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), PTSD symptoms may include:

• Recurrent, intrusive memories of the traumatic event
• Episodes of feeling like the traumatic event is recurring (also known as “flashbacks”)
• Significant distress at reminders of the traumatic event, such as locations, people, or objects
• Negative changes in thoughts and mood in the aftermath of the traumatic event (such as guilt, shame, or an increase in negative beliefs about oneself or others)
• Irritability
• Hypervigilance
• Reckless behavior
• Feelings of detachment from others

Additionally, post-traumatic stress disorder can also cause a variety of physical symptoms, such as:

• Trouble sleeping
• An increased startle response
• Increased fatigue and/or tension
• Difficulty concentrating
• Self-destructive or risky behaviors
• Increased heart rate or blood pressure
• Overwhelming shame or guilt 
• Angry outbursts or irritability 

On average, one in every eleven people in the United States will be diagnosed with post-traumatic stress disorder at some point. Additionally, PTSD commonly co-occurs with other mental illnesses, with an estimated 80% of people having at least one additional diagnosis. 

What are alternative and complementary medicine (CAM) approaches in mental health? 

There are three common approaches often taken to address mental health challenges, from post-traumatic stress disorder to depression to virtually any other condition:

• Conventional or standard approaches. Standard approaches to treating post-traumatic stress disorder include psychiatric medications and psychotherapy (talk therapy). The benefits of conventional mental health care include rigorous testing, standardization, and significant research funding that tends to confirm treatment effectiveness. 
• Alternative therapies are any non-standard intervention used instead of conventional approaches. 
• Complementary therapies refer to alternative therapies when they are used in combination with conventional mental health care approaches. 

Integrative mental health care, which combines conventional and CAM approaches, can provide a middle ground for more individualized care. 

Are there effective alternative therapies for PTSD?

There are many alternative and complementary therapies that may be used to address post-traumatic stress disorder, including: 

• Acupuncture. A 2013 systematic review of four randomized controlled trials and two uncontrolled clinical trials determined that acupuncture seemed to effectively reduce PTSD symptom severity. A more recent study proposed that, when combined with conversation-based techniques for traumatic memory retrieval, acupuncture may be even more effective. 
• Massage therapy. Some studies suggest that massage therapy may reduce some symptoms of PTSD, such as anxiety, irritability, muscle tension, and depression. 
• Yoga. A 2018 meta-analysis found that yoga may reduce symptoms of posttraumatic stress. However, due to poor study quality, the authors caution that high-quality research is needed to determine the effectiveness of yoga as a complementary therapy.  
• Tai chi. While there is a lack of research evaluating the effectiveness of tai chi for PTSD, the Veterans Association suggests that movement-based therapies can improve mental and physical health for people with a variety of conditions. 
• Deep-breathing exercises. A 2013 randomized controlled clinical trial conducted on mindfulness-based breathing exercises found that they reduced PTSD symptoms in individuals with subclinical PTSD-like symptoms. A more recent study suggests that mind-body exercises, which include deep breathing, may help reduce depression and anxiety in people with PTSD.
• Mindfulness. A review evaluating mindfulness-based treatments for PTSD suggests that these approaches have low dropout rates and may effectively reduce PTSD symptoms. The authors indicate that, according to their findings, mindfulness-based treatments helped reduce the occurrence of avoidance, shame, and self-blame. 

Many studies have indicated that CAM therapies tend to pose minimal health risks and are typically well-tolerated, and that they can be effective complementary therapies to conventional treatment approaches. Overall, though, most review articles find the existing evidence of effectiveness to be of insufficient quality, so more research is needed.

The potential benefits of talk therapy for PTSD or Post-Traumatic Stress Disorder

In their Clinical Practice Guideline for the Treatment of Post-traumatic Stress Disorder, the American Psychological Association strongly recommends the following evidence-based interventions: 

• Cognitive behavioral therapy (CBT). This type of talk therapy emphasizes the interactions between thoughts, feelings, and behaviors. Cognitive behavioral therapists work with their clients to help them learn to reframe unhelpful thought patterns that exacerbate symptoms. 
• Cognitive processing therapy (CPT). CPT is a subset of CBT that focuses on challenging maladaptive or negative beliefs related to trauma. 
• Cognitive therapy. Cognitive therapy is also derived from CBT. During sessions, clients are encouraged to identify trauma memories and triggers and modify their evaluations of them, which may reduce threatening feelings and the recurrence of disturbing thought patterns. 
• Prolonged exposure. Prolonged exposure is a type of CBT that helps clients safely revisit traumatic memories to reduce avoidant behaviors. 

Cognitive behavioral therapy is frequently considered the most effective approach for post-traumatic stress disorder symptom reduction. It’s often used as part of an integrated mental health care approach that incorporates both conventional as well as complementary and alternative therapies. 

When should you consider online CBT or Cognitive Behavioral Therapy?

For people experiencing symptoms of PTSD that may make it difficult to leave the house, attending therapy from home may be more comfortable and convenient. With an online platform like BetterHelp, you can get matched and then meet with a licensed therapist from the comfort of your home via phone or video call. Plus, BetterHelp also offers in-app messaging so you can get in touch with your therapist outside of your regular sessions, and they will respond as soon as they can. 

A 2022 study of 196 participants with mild to moderate PTSD aimed to evaluate the effectiveness of online CBT. Half of the participants were assigned to in-person CBT while the other half were assigned to online CBT. After 16 weeks of therapy, the researchers’ findings suggested that in-person and online therapy were equally effective at reducing PTSD symptoms. They recommended either approach as a first-line treatment for PTSD.