Hyperbaric oxygen therapy (HBOT) involves breathing in pure oxygen in a pressurized chamber, to increase the amount of oxygen circulating in the blood. It works in a similar way to the pressurized diving bells used by deep-sea divers to treat decompression sickness (the ‘bends’), which occurs when they resurface too quickly.

With a history dating back as far as the 19th century, HBOT is now used to help with symptoms of multiple sclerosis, skin grafts and burns, carbon monoxide poisoning, the side effects of radiotherapy, and several other conditions. One emerging area of interest is the use of HBOT as a potential treatment for the symptoms of PTSD. So, how does it work?

What is hyperbaric oxygen therapy?

During therapy, patients sit in a hyperbaric oxygen chamber that’s pressurised at up to 3 times normal air pressure. Normally, we breathe are that’s made up of around 21% oxygen. HBOT makes it possible to breathe in 100% oxygen, so more oxygen can enter the bloodstream. In doing so, HBOT helps improve blood supply to speed up the healing process, boost healthy blood vessels to carry nutrients around the body, kill bacteria and fight infection.

Could hyperbaric oxygen therapy help your PTSD?

Recent studies suggest that HBOT could be an effective treatment for PTSD, especially where other conventional treatments (such as medication or psychotherapy) haven’t worked so well. The research suggests that experiencing a traumatic event can cause physical changes in the brain. HBOT is thought to help increase neuroplasticity (the ability to form new connections) in the brain and help heal this physical damage.

One study of military personnel with PTSD found that regular HBOT treatment over a 4-week period led to a significant reduction in symptoms: after HBOT, 52% no longer met the threshold criteria for a PTSD diagnosis. Anxiety and depression improved, while many were able to reduce psychoactive medications. These improvements seemed to continue for months after the treatment.

However, other studies have had more mixed results, suggesting that while HBOT may not be a primary treatment for PTSD, it could be a helpful alternative or additional therapy to ease particularly stubborn symptoms.

What happens during HBOT?

HBOT can be delivered in individuals chambers or in a larger room that fits a few people at once. Treatment happens in three phases:

  • Compression phase: at the start of the session, you will lie on a table and breathe in oxygen through a mask, while the pressure in the chamber slowly increases.
  • Treatment phase: once the pressure is at the right level, you’ll be asked to put your mask on so you can breathe in the pure oxygen. You can read, watch TV or listen to music during this phase, which can last up to a couple of hours.
  • Decompression phase: once treatment is over, the pressure in the chamber will slowly start to drop back down to normal, and then you can leave.

HBOT must always take place under a doctor’s supervision. They will explain what to expect, how to take breaks, and how to pop your ears to ease pressure.

It’s usually carried out in a few sessions over a period of weeks.

Are there any risks to HBOT?

HBOT is generally very safe, but isn’t suitable for everyone. It’s not recommended for anyone who has lung problems, a cold or fever, or ear injuries, or who may feel claustrophobic or uncomfortable in a small space.

Some people may feel tired or lightheaded after HBOT. Severe side effects are uncommon, but might include lung damage, ear and sinus problems, vision issues, or oxygen poisoning. Your doctor will make sure the oxygen dose and length of treatment is tailored specifically to your needs, to minimize the likelihood of side effects.

Where to find Hyperbaric Oxygen Therapy

While HBOT is available through the NHS for some medical conditions, it’s not yet routinely commissioned for PTSD. If you’re curious about whether HBOT could help with your symptoms, speak to your doctor, who may be able to refer you to a private provider.

You can also find out more information about HBOT through the Hyperbaric Oxygen Treatment Trust and the British Hyperbaric Association.

When exploring your recovery options for PTSD or C-PTSD, it’s essential to find an approach that addresses both the symptoms you’re experiencing and the underlying trauma that caused them. The most effective treatments work not just to manage distress in the moment, but to help your brain process what happened and reduce long-term impact.

In the UK, the NICE guidelines (updated in 2018) recommend a number of trauma-focused psychological therapies for adults with PTSD and C-PTSD. These include Eye Movement Desensitisation and Reprocessing (EMDR), Trauma-focused Cognitive Behavioural Therapy (CBT), Narrative Exposure Therapy (NET) and Prolonged Exposure Therapy (PE). These therapies are backed by extensive research and are considered first-line treatments for PTSD and C-PTSD.

It’s important to remember that recovery isn’t one-size-fits-all. While these approaches have helped many people, everyone’s healing journey is unique. Some people may also find additional support through other therapies, self-help tools, or lifestyle changes.

Please note: nothing here is intended as a medical recommendation. Instead, it’s a guide to help you understand what’s available. Always work with a qualified professional to explore the best treatment options for you.

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