This article is for informational purposes only. None of the information here should be taken as medical advice. If you suspect you may have PTSD, seek medical help. You may try the complementary approaches listed below if you and your doctor determine that they could be appropriate for you. Discuss the strategies listed here with your doctor.
- Cognitive-behavioral therapy can improve different anxiety disorders, including PTSD, especially if combined with medication [1, 2].
- Different forms of behavioral therapy, such as cognitive processing therapy and narrative exposure therapy, are a part of standard care for PTSD— consult with a healthcare professional about your options .
- Multiple studies found that mindfulness can help improve PTSD, both alone and as an add-on to conventional therapies [4, 5].
- A study on discharged ICU patients with PTSD found a mindfulness program self-directed by a mobile app as effective as a therapist-led program .
- People who exercise regularly experience lower levels of neuroticism, anxiety, and depression, while lack of regular physical activity has been associated with an increased risk of anxiety [7, 8].
- Physical exercise interventions based on aerobic exercise, resistance training, or both improved PTSD in multiple trials. While aerobic exercise was more effective at improving anxiety and overall psychological distress, resistance training also helped with specific PTSD symptoms, distress tolerance, and sleep quality [9, 10, 11, 12, 13, 14, 15].
- Strenuous exercise increases the blood levels of neuropeptide Y (NPY), a messenger molecule that helps prevent PTSD caused by rises in stress hormones [16, 17].
Yoga and Meditation
- Yoga and other forms of meditation have a natural stress-relieving effect, which could help mitigate the hyperarousal symptoms of PTSD [18, 19, 20].
- A yoga program called trauma-sensitive yoga has been associated with reduced symptoms of PTSD, depression, and anxiety in people with PTSD [21, 22, 23, 24].
- A meta-analysis concluded that the evidence to support yoga for PTSD is encouraging but preliminary due to the low quality of most studies .
- Several studies on war veterans show that horse-assisted therapy can improve PTSD symptoms [26, 27, 28, 29, 30].
- Similarly, dog-assisted therapy has been reported to improve PTSD in children [31, 32].
Heart Rate Variability Biofeedback Training
- A lower heart rate variability from a normal “baseline” heart rate indicates a dominance of the “fight-or-flight” (sympathetic) nervous system, which is associated with increased stress and many forms of anxiety [33, 34].
- Heart rate biofeedback training improved symptoms in two studies on soldiers. Those in their late 30s benefited more from this technique than younger soldiers [35, 36].
- Applied relaxation techniques can reduce general anxiety, excessive worry, and tension. The improvements may be maintained for up to one year after initial treatment [37, 38, 39].
- Preliminary clinical research shows that applied relaxation can reduce feelings of anger and guilt in people with PTSD. However, cognitive behavioral therapy is generally more effective at managing this condition [40, 41, 42].
- People with PTSD and other anxiety issues tend to preferentially pay attention to threatening information (this is called attention bias) [43, 44, 45].
- Attention bias modification is the practice of “re-training” this type of bias. Attention bias modification programs improved PTSD symptoms in several studies [46, 47, 48].
- Preliminary clinical research found Tai Chi effective at improving PTSD symptoms such as fear, intrusive thoughts, memory impairment, and concentration difficulties, [49, 50, 51].
- Preliminary clinical research suggests that acupuncture can improve self-perceived symptoms of PTSD. However, a meta-analysis found the quality of the existing evidence insufficient [52, 53, 54].
- Acupuncture helped with sleep disturbances caused by PTSD in two small-scale clinical trials [55, 56].
- Several studies have associated PTSD and early-life traumatic experiences with poor diet quality, as well as with fewer healthy dietary changes over time [57, 58, 59].
- In animal studies, consumption of a Western-like, high-fat diet during adolescence increased susceptibility to traumatic stress by altering brain development [60, 61, 62, 63].
- A fermented soy product normalized steroidal hormones in war veterans with treatment-resistant PTSD, leading to improved mental and physical wellness .
- In rats with PTSD, the soy isoflavone genistein reduced anxiety and prevented chronic stress-induced memory impairment [65, 66].
- In a study in rats with PTSD, including blueberries in the diet reduced anxiety and restored normal neurotransmitter levels. The anti-inflammatory and antioxidant properties of blueberries may have been responsible for these effects .
- Supplementation with serine reduced anxiety and depression symptoms in a small clinical trial on people with chronic PTSD .
- Low blood serine levels have been associated with increased PTSD severity and worse response to treatment with ketamine .
Fish Oil/Omega-3 Fatty Acids
- A study associated PTSD with low blood levels of the omega-3 fatty acid docosahexaenoic acid (DHA) .
- Conversely, high blood levels of eicosapentaenoic acid (EPA) from taking omega-3 supplements have been associated with a reduced severity of PTSD after a traumatic injury .
- Supplementation with omega-3 fatty acids prevented pounding heart rate in accident survivors with PTSD and memory impairment in chronically stressed rats [72, 73].
- Fatty fish (such as mackerel, salmon, sardines, and herrings) are especially rich in omega-3 fatty acids .
- In a small study on war veterans with PTSD and a history of substance abuse, supplementation with N-acetylcysteine enhanced the effectiveness of cognitive behavioral therapy on both PTSD symptoms and substance cravings .
- A study to evaluate the effectiveness of N-acetylcysteine for treatment-resistant PTSD is underway .
- Anecdotal evidence reports that CBD reduced anxiety in 3 adults and 1 child with PTSD [78, 79].
- Repeated administration of CBD prevented long-term anxiety effects in rats with PTSD caused by interactions with a predator .
- Note that CBD oil is derived from cannabis, which is a controlled substance in many countries and states. Therefore, make sure to verify the legality of CBD and similar products where you live before seeking them out.
Melatonin/Blocking Blue Light at Night
- Melatonin is an important hormone that controls the sleep-wake cycle. Light at night, especially blue light, suppresses melatonin production [81, 82].
- A study on soldiers with PTSD found they produced lower melatonin levels at night .
- Another human study found lower melatonin production following a traumatic injury, possibly increasing the risk of developing PTSD .
- Research in animals shows that melatonin reduces fear conditioning, possibly helping with PTSD .
- A study associated PTSD with vitamin D deficiency. In line with this, a variant of the gene encoding the protein that stores and transports vitamin D (GC) was associated with both higher blood vitamin D levels and reduced risk of PTSD .
- Another study suggested that vitamin D deficiency may increase the risk of PTSD in war veterans by altering testosterone levels .
- In addition to taking supplements, you can increase your blood vitamin D levels through a healthy exposure to sunlight and eating food sources of this vitamin such as fatty fish, liver, egg yolks, and dairy .
- A study found that people with PTSD had lower levels of anti-inflammatory and immunoregulatory bacteria (Actinobacteria, Lentisphaerae, and Verrucomicrobia) in the gut .
- In animal studies, PTSD reduced the levels of some bacteria (Lactobacillus, Oscillospira, Streptococcus) while increasing others (Akkermansia, Helicobacter, Campylobacter) in the gut [90, 91].
- A study on war veterans associated low L-arginine availability with increased incidence and severity of PTSD, as well as with a trend to experience negative emotions and some inflammatory markers .
- Most protein-rich foods contain arginine, which is especially abundant in fish and nuts .
- L-theanine is an amino acid found in white, black, and green tea, and has been widely touted for its calming effects .
- In animal studies, supplementation with L-theanine alleviated behavioral symptoms of PTSD [95, 96].
- In rats with PTSD, treatment with the main active compound of licorice (glycyrrhizin) reduced anxiety and fear memories while restoring a normal circadian rhythm [97, 98].
- Note that chronic or excessive consumption of regular licorice can cause unwanted complications and health problems. Since these side effects mostly come from glycyrrhizic acid, using deglycyrrhizinated licorice can help avoid them .
- In rats with PTSD, ginseng reduced anxiety and prevented stress-induced depression [100, 101].
- Ginseng may increase resistance to stress by raising blood corticotropin and corticosteroid levels .
- In a study in rats, vitamin C supplementation reduced PTSD symptoms and oxidative stress .
- Food sources of vitamin C include fruits and vegetables such as citrus fruits, peppers, berries, and broccoli .