HBOT & PTSD — What the Research Shows · Oceanside, CA
PTSD &
THE BRAIN
CAN CHANGE.
Researchers and military institutions are taking a closer look at what happens inside the brain during HBOT — and what that might mean for people living with PTSD whose symptoms haven't responded to conventional approaches. This page explores what the science currently shows.
This page is educational and informational. It does not claim that HBOT treats, cures, or prevents PTSD or any other condition. HBOT is not an FDA-approved treatment for PTSD. If you are experiencing mental health symptoms, please speak with a qualified healthcare provider.
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Understanding PTSD
PTSD IS A BRAIN CONDITION AS MUCH AS A PSYCHOLOGICAL ONE.
Post-traumatic stress disorder affects an estimated 8 million Americans at any given time — and the rates among military veterans are significantly higher, with some estimates suggesting up to 30% of combat veterans experience PTSD at some point after service.
For decades, PTSD was understood primarily as a psychological condition, treated with psychotherapy and medication. But advances in neuroimaging have revealed something more complex: PTSD involves measurable, structural changes in the brain — particularly in areas responsible for memory, emotional regulation, and the stress response.
These changes — including altered activity in the prefrontal cortex, amygdala, and hippocampus — help explain why PTSD symptoms can persist for years, and why many people don't fully respond to talk therapy or medication alone. For roughly two-thirds of veterans diagnosed with PTSD, conventional treatments provide limited long-term relief.
"The imaging findings and hyperbaric oxygen therapy effects indicate that PTSD can no longer be considered strictly a psychiatric disease."
— Andrews & Harch, Frontiers in Neurology, 2024 Systematic Review
The Limitations of Current Approaches
Current first-line treatments for PTSD — including cognitive processing therapy (CPT), prolonged exposure therapy, and SSRI medications — help many people, but leave a substantial portion with persistent symptoms. The gap between available treatments and patient need has driven significant interest in exploring neurologically-targeted approaches.
This is where researchers began asking a different question: if PTSD involves measurable changes in brain structure and connectivity, could a therapy that promotes neuroplasticity — the brain's ability to repair and reorganize itself — address those changes at the biological level?
Altered brain connectivity — disrupted communication between regions governing fear response and rational thought
Reduced hippocampal volume — a structure central to memory processing and contextualizing threat
Dysregulated stress hormones — an imbalanced cortisol-catecholamine ratio affecting how the nervous system responds to triggers
Neuroinflammation — chronic low-grade inflammation in brain tissue that may perpetuate symptoms
Mitochondrial dysfunction — impaired cellular energy production in neural tissue linked to trauma exposure
The Research Question
WHY ARE RESEARCHERS
LOOKING AT HBOT FOR PTSD?
LOOKING AT HBOT FOR PTSD?
HBOT has a well-established history of promoting neuroplasticity — the brain's ability to repair, reorganize, and form new connections. Researchers investigating PTSD have been drawn to HBOT because the biological mechanisms it activates in the brain appear to directly correspond to the neurological changes that PTSD produces. This is not a claim that HBOT treats PTSD — it's an explanation of why the scientific community finds the connection worth studying.
Neuroplasticity Activation
HBOT creates a "hyperoxic-hypoxic paradox" — alternating between high and normal oxygen levels — that has been shown in multiple studies to trigger stem cell activity, mitochondrial regeneration, and the formation of new neural connections. These are the same repair mechanisms researchers believe may be disrupted in PTSD-affected brain tissue.
Brain Connectivity
PTSD is characterized by disrupted connectivity between the prefrontal cortex, amygdala, and other regions that govern emotional regulation and threat assessment. Researchers have been studying whether HBOT's neuroplasticity-promoting effects can restore communication between these regions — changes now being measured using resting-state functional MRI.
Neuroinflammation
Chronic neuroinflammation has been identified as a potential contributor to persistent PTSD symptoms. HBOT has demonstrated anti-inflammatory effects in neural tissue in other contexts — which has led researchers to explore whether similar effects may be relevant to the neuroinflammatory component of trauma-related conditions.
Mitochondrial Function
Mitochondrial dysfunction — impaired cellular energy production — has been linked to trauma exposure and PTSD symptom severity. HBOT has been shown to stimulate mitochondrial proliferation and biogenesis, which researchers hypothesize may support recovery of neural tissue function in trauma-affected regions.
Cerebral Blood Flow
Studies have documented reduced blood flow to specific brain regions in individuals with PTSD. HBOT promotes angiogenesis — the growth of new blood vessels — and has been shown to improve cerebral perfusion in other neurological conditions. Researchers are investigating whether similar improvements may occur in PTSD-affected brain regions.
A Biological Approach
Perhaps most significantly, HBOT represents a fundamentally different type of intervention — one that targets the biological and structural aspects of the brain rather than behavioral patterns or neurotransmitter levels. For patients who haven't responded to conventional approaches, this difference in mechanism is the primary reason researchers and clinicians are paying attention.
Important Context
HBOT is not an FDA-approved treatment for PTSD, and the research in this area — while promising — is still developing. The studies published to date involve relatively small sample sizes, and larger trials are ongoing. This page exists to share what researchers are currently finding, not to suggest that any individual should pursue HBOT as a replacement for evidence-based mental health care. If you're curious about whether HBOT might be worth exploring as a complementary option, the right first step is a conversation with your mental health provider and a consultation with our team.
Published Research
WHAT THE STUDIES
ARE ACTUALLY SHOWING
ARE ACTUALLY SHOWING
A growing body of peer-reviewed research — including randomized controlled trials conducted at institutions like Shamir Medical Center, Tel Aviv University, and published in journals including the Journal of Clinical Psychiatry and Frontiers in Neurology — has been investigating HBOT's effects on PTSD symptoms in military veterans. Here's a summary of what has been found.
Randomized Controlled Trial · 2024
68% OF VETERANS SHOWED SIGNIFICANT SYMPTOM REDUCTION
A randomized, sham-controlled clinical trial published in the Journal of Clinical Psychiatry (2024) studied 56 male combat veterans with treatment-resistant PTSD — participants who had not responded to prior psychotherapy or medication. Veterans received 60 daily HBOT sessions over three months. The primary endpoint was a 30% or greater reduction in clinician-assessed PTSD symptoms.
Results: 68% of veterans in the HBOT group achieved the primary endpoint, compared to only 4% of those in the sham group. Additionally, 39% of HBOT participants achieved complete symptom remission. The HBOT group also showed measurable improvements in depression scores and functional brain connectivity on MRI — specifically in the frontoparietal and default mode networks associated with emotional regulation.
Source: Doenyas-Barak et al., Journal of Clinical Psychiatry, 2024. DOI: 10.4088/JCP.24m15464
Long-Term Follow-Up Study · Military Medicine 2023
RESULTS PERSISTED TWO YEARS AFTER TREATMENT ENDED
A follow-up study published in Military Medicine (2023) evaluated the same cohort of veterans approximately two years after completing their HBOT protocol. The question was whether improvements observed immediately post-treatment would hold over time — a critical consideration given that most PTSD treatments tend to produce diminishing effects after discontinuation.
The findings: clinical improvements were sustained at the two-year follow-up, with overall PTSD scores remaining significantly improved compared to pre-treatment baselines. Additional long-term benefits were observed in social functioning, occupational status, and reduced reliance on benzodiazepines and cannabis. Researchers noted that cognition and mood symptoms continued to improve further at follow-up compared to short-term post-HBOT evaluation.
Source: Doenyas-Barak et al., Military Medicine, Vol. 188, Issue 7-8, July/August 2023. DOI: 10.1093/milmed/usac360
Systematic Review · Frontiers in Neurology 2024
ACROSS 8 STUDIES AND 393 SUBJECTS, CONSISTENT IMPROVEMENTS FOUND
A systematic review published in Frontiers in Neurology (2024) analyzed all available clinical research on HBOT and PTSD — identifying 8 studies involving 393 subjects, including 7 randomized trials. Six of the eight studies focused on military subjects; one included both military and civilian participants; one focused on civilians.
The review concluded that across multiple randomized and controlled trials, HBOT demonstrated statistically significant symptomatic improvements in patients with PTSD across a wide range of treatment protocols. The authors noted that imaging findings alongside clinical results suggest PTSD can no longer be considered strictly a psychiatric disease — with measurable neurological changes both causing and potentially addressable at the biological level.
Source: Andrews & Harch, Frontiers in Neurology, 2024. DOI: 10.3389/fneur.2024.1360311
The Military & VA Context
The U.S. Department of Veterans Affairs has been actively tracking HBOT research for PTSD and TBI. The VA's 2023 Clinical Practice Guideline for PTSD acknowledged that available studies suggested a benefit for HBOT on PTSD outcomes — and called for further research with adequate control conditions. Pilot HBOT programs for veterans with treatment-resistant PTSD have been launched at multiple VA-affiliated medical centers, including at Oklahoma State Medical Center and David Grant Medical Center at Travis Air Force Base.
Oceanside and the broader North County San Diego region is home to one of the largest active-duty and veteran populations in the country — with Camp Pendleton just north of the city. For many veterans in this community who have not found adequate relief through conventional PTSD care, HBOT represents a different kind of option worth knowing about. We are not a mental health clinic and do not provide PTSD treatment — but we are glad to have a conversation about what HBOT is, how it works, and whether it might be worth exploring alongside your existing care team.
Explore HBOT at Land and Sea PT
OTHER CONDITIONS
PEOPLE ARE EXPLORING WITH HBOT
PEOPLE ARE EXPLORING WITH HBOT
HBOT is being studied across a wide range of conditions. Explore what the research shows for other areas at Land and Sea PT in Oceanside.
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Curious About HBOT?
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A CONVERSATION.
We work with a wide range of people who are exploring HBOT — athletes, veterans, people dealing with chronic conditions, and those who are simply curious. If you want to understand what HBOT actually involves and whether it makes sense for your situation, we're a straightforward conversation away.
HBOT is not a cure for PTSD or any other condition. This page is educational only. If you are experiencing mental health symptoms, please work with a qualified mental health provider. HBOT at Land and Sea PT is offered as a wellness service.
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