Post-traumatic stress disorder (PTSD) is no stranger to Israelis. The disorder, which develops in some people who have experienced a shocking, scary or dangerous event, affects over 10% of the population – three times the rate in the US – according to the non-profit Israel Center for the Treatment of Psychotrauma (ICTP), which is affiliated with Jerusalem’s Herzog Medical Center and diagnoses and treats many victims as best as it can.

It’s natural to feel afraid during and after a traumatic situation, and fear triggers many split-second changes in the body to help defend against danger. But Holocaust survivors with emotional and physical wounds from seven or eight decades ago still suffer from PTSD, as do veterans of Israel’s many wars and terror attacks, victims of crime and sexual abuse and other traumatic events. 

Now, for the first time in the world, Israel can really be a light unto the nations in treating victims of PTSD that has been resistant to drugs and talk therapies. Researchers from Tel Aviv University (TAU) and the Shamir (Assaf Harofeh) Medical Center in Tzrifin (southeast of Tel Aviv) have relieved the PTSD symptoms of Israel Defense Forces (IDF) veterans using new protocols of hyperbaric oxygen therapy (HBOT). The veterans, who suffered from severe PTSD, demonstrated significant improvement in all classes of symptoms following a controlled clinical trial.

The “breakthrough research” was led by Prof. Shai Efrati, Dr. Keren Doenyas-Barak, Dr. Ilan Kutz, Dr. Merav Catalogna, Dr Efrat Sasson, Dr. Amir Hadanny, Gabriela Levi and Yarden Shechter from TAU’s Sagol School of Neuroscience and the university’s Faculties of Medicine and Life Sciences and the Shamir Medical Center. 

The peer-reviewed study was published today in the prestigious scientific journal PlosOne under the title “Hyperbaric oxygen therapy improves symptoms, brain’s microstructure and functionality in veterans with treatment resistant post-traumatic stress disorder: a prospective, randomized, controlled trial.”

“The study included 35 combat veterans who suffered from PTSD that was resistant to both psychiatric medications and psychotherapy,” said Doenyas-Barak. “The veterans were divided into two groups. One received HBOT while the other served as a control group. Following a protocol of 60 treatments, improvement was demonstrated in all PTSD symptoms including hyper-arousal, avoidance and depression.” 

In addition, she said, “both functional and structural improvement was observed in the non-healing brain wounds that characterize PTSD. We believe that in most patients, improvements will be preserved for years after the completion of the treatment. This study gives real hope to PTSD sufferers. For the first time in years the study’s participants –

most of whom had suffered from severe PTSD – were able to leave the horrors behind and look forward to a better future.”

Hyperbaric medicine involves treatments in a pressurized chamber where atmospheric pressure is higher than sea-level pressure and the air is rich with oxygen. Considered a safe form of treatment, HBOT is already used for a range of medical conditions, including speeding up the healing of carbon monoxide poisoning, gangrene, stubborn wounds and infections in which tissues are starved for oxygen. 

Evidence gathered in recent years indicates that special hyperbaric protocols can improve the supply of oxygen to the brain, thereby enhancing the generation of new blood vessels and neurons. HBOT treatments always require the evaluation and supervision of qualified physicians, and for medical indications, it should be given using a certified chamber with appropriate quality assurance using the exact studied treatment protocols.  

According to the World Health Organization (WHO), almost four percent of the global population, and 30% of all combat soldiers, develop PTSD.  

“Today we understand that treatment-resistant PTSD is caused by a biological wound in brain tissues that obstructs attempts at psychological and psychiatric treatments,” said Efrati. “With the new HBOT protocols, we can activate mechanisms that repair the wounded brain tissue. The treatment induces reactivation and proliferation of stem cells, as well as generation of new blood vessels and increased brain activity, ultimately restoring the functionality of the wounded tissues. Our study paves the way to a better understanding of the connection between mind and body.” 

“Our results indicate that exposure to severe emotional trauma can cause organic damage to the brain,” added Efrati. “We also demonstrate for the first time that direct biological treatment of brain tissues can serve as a tool for helping PTSD patients. Moreover, our findings may be most significant for diagnosis. To date, no effective diagnostic method has been developed and diagnosis of PTSD is still based on personal reports that are necessarily subjective – leading to many clashes between the suffering veterans and the authorities responsible for treating them.”

Efrati concluded: “Think of a person who comes to the emergency room with chest pains. The pain might be caused by either a panic attack or a heart attack, and without objective electrocardiograms and blood tests, the doctors might miss a heart attack. At present, we are conducting continuing research in order to identify the biological fingerprint of PTSD that can ultimately enable the development of innovative objective diagnostic tools.”