Alternative Therapies For PTSD: What You Need To Know

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 U.S. population. While talk therapy is currently the gold standard for PTSD, some complementary and alternative medicine (CAM) approaches (including acupuncture and mindfulness) may be beneficial. When used as part of an integrative mental health approach, CAM therapies are shown to be safe and potentially effective. 

What is 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 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 a traumatic event
• Episodes of feeling like the traumatic event is reoccurring (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, or reckless behavior
• Feelings of detachment from others

Additionally, PTSD can also cause a variety of physical symptoms, such as:

• Trouble sleeping
• An increased startle response
• Increased fatigue 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 PTSD at some point. Additionally, PTSD commonly co-occurs with other mental illnesses, with an estimated 80% 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:

• Conventional or 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 patient care. 

Are there effective alternative therapies for PTSD?

There are many alternative and complementary therapies used to address PTSD, 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, including anxiety, irritability, muscle tension, and depression. 
• Yoga: A 2018 meta-analysis found that yoga may reduce PTSD symptoms. 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 supports that movement-based therapies can improve mental and physical health for people with a variety of mental and physical health 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. 
• Mindfulness: A review evaluating mindfulness-based treatments for PTSD found that these approaches have low dropout rates and can effectively reduce PTSD symptoms. The authors found that mindfulness-based treatments reduced the occurrence of avoidance, shame, and self-blame. 

Many studies identified that CAM therapies tend to pose little health risk, and they can be effective complementary therapies to conventional treatment approaches. Overall, though, most review articles find insufficient quality evidence of effectiveness, so more research is needed.

The benefits of talk therapy for PTSD

In their Clinical Practice Guideline for the Treatment of Post-traumatic Stress Disorder, the American Psychological Association strongly recommends the following 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 reframe unhelpful thought patterns that exacerbate symptoms. 
• Cognitive processing therapy (CPT): CPT is a subset of CBT, focusing on challenging maladaptive or negative beliefs related to trauma. 
• Cognitive therapy: Cognitive therapy is derived from CBT. During sessions, clients are encouraged to identify trauma memories and triggers and modify their evaluations of them, which can 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 PTSD symptom reduction, and it’s often used as part of an integrated mental health care approach that incorporates both conventional and CAM therapies. 

When to consider online CBT?

For people experiencing symptoms of PTSD, attending therapy from home may be more comfortable and accessible. Additionally, online platforms, like BetterHelp, let you use in-app messaging to get in touch with your therapist whenever you want to talk, 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 found that in-person and online therapy were equally effective at reducing PTSD symptoms. They recommended either approach as a first-line treatment for PTSD.