Acupuncture for PTSD and Trauma
Learn about how acupuncture can help with Post Traumatic Stress Disorder (PTSD) and trauma.
Living through a traumatic event can leave lasting effects on our mental and physical well-being. That’s because experiencing traumatic events affects our nervous system and our perception of the world. This can lead to predictable physical symptoms along with residual feelings of anxiety, anger, fear, and depression. Acupuncture has been shown to relieve the physical symptoms of stress as well as calm down an overactive nervous system to reduce feelings of anxiety and depression.
The nervous system and trauma
According to the Polyvagal Theory by Stephen Porges, our nervous system has evolved to help us deal with stressful and traumatic situations. There is a predictable way that our nervous system responds to signals from our external environment as well as internal bodily processes.
Our nervous system has developed to alert us of potential threats, prepare our body to respond, and process experiences to affect how we view future threats.
Porges highlights 3 branches of the nervous system that have evolved over time:
Dorsal Vagal (Parasympathetic)
The first branch that evolved is part of the parasympathetic nervous system which provides immobilization strategies like freezing or playing dead when faced with a potential threat.
Sympathetic
Next came the sympathetic nervous system, which adds the well-known fight or flight response.
Ventral Vagal (Parasympathetic)
The most recent development to the nervous system is also part of the parasympathetic nervous system.
The ventral vagal system promotes social engagement and connection to provide a sense of safety.
What happens when we experience a traumatic event?
According to research, our perceived threats activate parts of the brain related to the stress response and memory including the amygdala, hippocampus, and prefrontal cortex. These areas of the brain are responsible for processing emotions and fear (amygdala), learning and memory (hippocampus), and decision making and social engagement (prefrontal cortex).
Our memory of a traumatic events affects the way our brain and body will react to future potential threats by being quicker to release neurochemicals like cortisol and norepinepherine that are released when our stress response is activated. There can be lasting changes to these areas of the brain as a result of traumatic events.
What is PTSD?
Post Traumatic Stress Disorder (PTSD) is a collection of symptoms one experiences after being exposed to an acute or repeated traumatic event. Things like car accidents, natural disasters, physical or sexual violence, or exposure to war can trigger PTSD. Symptoms usually occur within 3 months of the event, but can come on even years afterwards in some cases. They need to last for at least one month to be considered PTSD. Diagnosing PTSD is outside of the scope of an acupuncturist, and can be determined by a psychologist or psychiatrist.
Key Points: DSM-5 Criteria for PTSD Simplified
Exposure to Trauma: Experiencing, witnessing, learning about violence or death affecting close ones, or repeated exposure to traumatic details (e.g., first responders).
Intrusion Symptoms: Unwanted, distressing memories, dreams, flashbacks, or intense reactions to reminders of the trauma.
Avoidance: Steer clear of thoughts, feelings, or external reminders of the traumatic event.
Negative Changes in Thoughts and Mood: Examples include forgetting key details of the trauma, negative beliefs about oneself or the world, persistent negativity, loss of interest in activities, feeling detached from others, and inability to feel positive emotions.
Changes in Reactivity and Arousal: This could manifest as irritability, risky behavior, hypervigilance, being easily startled, concentration issues, and sleep disturbances.
Duration and Impact: Symptoms last more than a month and significantly impair one’s life.
Not Due to Other Factors: Symptoms are not caused by medication, substance use, or other illnesses.
Subtypes:
With Dissociative Symptoms: Presence of depersonalization or derealization.
With Delayed Expression: Full criteria are not met until at least six months after the traumatic event.
Physical Symptoms of PTSD
While the diagnosis of PTSD requires specific conditions to be met, experiencing any trauma can effect our nervous system and our perception of the world which can result in a change in our nervous system response. Physical symptoms associated with PTSD and an overactive nervous system include:
Increased heart rate and heart palpitations
Insomnia or difficulty sleeping
Shallow, rapid breathing
Muscle tightness and tension that can lead to chronic pain
Fatigue and lethargy
Feelings of anxiety, fear, depression, anger, or sadness
Nightmares or flashbacks of the traumatic event(s)
Social avoidance, feeling isolated, or feeling frozen or numb
Acupuncture for PTSD
Experiencing traumatic events affects our nervous system and the way our brain perceives safety. It changes the way our alert system responds to potential threats after the initial traumatic event. The brain also sends signals to the body to mobilize a response to the threat which results in predictable physical symptoms.
These physical symptoms can be explained by the body’s nervous system response to acute or chronic stressors. When placed in a stressful situation, our nervous system responds via the fight or flight, or freeze responses. The brain responds by putting us in a heightened state of vigilance, and by shutting down secondary processes that are not critical to survival. These changes correspond with many of the symptoms listed above, either while we are in the heightened survival state, or afterwards when our resources have been depleted and we are having trouble returning to a state of balance and calm.
Acupuncture has been shown to:
Release neurotransmitters and endorphins to relieve pain
Regulate the sympathetic and parasympathetic nervous system
Reduce anxiety
Promote more restful sleep
Relieve muscle tension
Improve digestion and circulation
In simple terms, it does so by activating parts of the brain that regulate physiological processes and also by relieving local myofascial constriction and tension.
For more information please see our related blog posts about how acupuncture can help regulate the nervous system:
Acupuncture has been used to treat PTSD following natural disasters and other traumatic events for a long time. Acupuncturists Without Borders is a great organization that was formed in 2005 after hurricanes Rita and Katrina to provide free acupuncture to areas of the world impacted by natural disasters and other traumatic events.
A 2024 study demonstrated that acupuncture significantly reduced PTSD symptoms and improved fear extinction in combat veterans, outperforming sham acupuncture with notable clinical efficacy and low withdrawal rates.
How can acupuncture help PTSD symptoms?
There are numerous studies that show acupuncture can improve feelings of stress and anxiety, and physical symptoms related to traumatic events. A 2019 study on survivors of a large earthquake in Italy showed acupuncture improved mental and physical symptoms associated with this traumatic event. The study found that 54% of patients had marked improvements in the psychological symptoms (anxiety, depression, insomnia, etc.) and 60% had marked improvements in pain symptoms.
Another 2019 study found that transcutaneous electrical acupoint stimulation in addition to sertraline or cognitive behavioral therapy (CBT) enhanced treatment of PTSD symptoms. The groups that used electrical acupoint stimulation as part of their treatment plan had marked improvements in PTSD symptoms versus the groups that did not use it.
An older 2011 study of earthquake survivors in China showed that acupuncture with cognitive behavioral therapy (CBT) was more effective than just CBT alone in relieving PTSD symptoms.
Consider Acupuncture for Trauma and PTSD Treatment
Acupuncture has emerged as an effective treatment option for PTSD, offering a holistic approach to managing both the mental and physical repercussions of traumatic events. Its ability to regulate the nervous system and alleviate symptoms such as anxiety, depression, and chronic pain positions it as an invaluable first-line treatment for PTSD.
Beyond merely addressing symptoms, acupuncture fosters a deeper sense of well-being and balance, allowing individuals to reclaim a sense of normalcy and peace in their lives. This ancient practice, backed by contemporary research, underscores the potential for acupuncture to transform the therapeutic landscape for PTSD, providing hope and healing for those navigating the aftermath of trauma.
For individuals suffering from PTSD or related symptoms, incorporating acupuncture into their care regimen with other types of treatment could mean a significant step towards recovery and a return to a life defined not by trauma, but by resilience and wellness.
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Sources:
Porges S. W. (2009). The polyvagal theory: new insights into adaptive reactions of the autonomic nervous system. Cleveland Clinic journal of medicine, 76 Suppl 2(Suppl 2), S86–S90. https://doi.org/10.3949/ccjm.76.s2.17
Payne, P., Levine, P. A., & Crane-Godreau, M. A. (2015). Somatic experiencing: using interoception and proprioception as core elements of trauma therapy. Frontiers in psychology, 6, 93. https://doi.org/10.3389/fpsyg.2015.00093
Center for Substance Abuse Treatment (US). Trauma-Informed Care in Behavioral Health Services. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2014. (Treatment Improvement Protocol (TIP) Series, No. 57.) Exhibit 1.3-4, DSM-5 Diagnostic Criteria for PTSD. Available from: https://www.ncbi.nlm.nih.gov/books/NBK207191/box/part1_ch3.box16/
Hollifield, M., Hsiao, A. F., Smith, T., Calloway, T., Jovanovic, T., Smith, B., Carrick, K., Norrholm, S. D., Munoz, A., Alpert, R., Caicedo, B., Frousakis, N., & Cocozza, K. (2024). Acupuncture for Combat-Related Posttraumatic Stress Disorder: A Randomized Clinical Trial. JAMA psychiatry, e235651. Advance online publication. https://doi.org/10.1001/jamapsychiatry.2023.5651
Moiraghi, C., Poli, P., & Piscitelli, A. (2019). An Observational Study on Acupuncture for Earthquake-Related Post-Traumatic Stress Disorder: The Experience of the Lombard Association of Medical Acupuncturists/Acupuncture in the World, in Amatrice, Central Italy. Medical Acupuncture. Apr 2019.116-122.http://doi.org/10.1089/acu.2018.1329
Feng, B., Zhang, Y., Luo, L. Y., Wu, J. Y., Yang, S. J., Zhang, N., Tan, Q. R., Wang, H. N., Ge, N., Ning, F., Zheng, Z. L., Zhu, R. M., Qian, M. C., Chen, Z. Y., & Zhang, Z. J. (2019). Transcutaneous electrical acupoint stimulation for post-traumatic stress disorder: Assessor-blinded, randomized controlled study. Psychiatry and clinical neurosciences, 73(4), 179–186. https://doi.org/10.1111/pcn.12810
Zhang, Y., Feng, B., Xie, J. P., Xu, F. Z., & Chen, J. (2011). Clinical study on treatment of the earthquake-caused post-traumatic stress disorder by cognitive-behavior therapy and acupoint stimulation. Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan, 31(1), 60–63. https://doi.org/10.1016/s0254-6272(11)60014-9
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