The Positive Effects of Water Immersion for Symptoms of PTSD in Veterans: A Mixed Methods Study

Introduction Posttraumatic stress disorder (PTSD) is prevalent among military veterans around the world, with many remaining symptomatic despite standard therapies. We hypothesized that warm water immersion might have a positive therapeutic effect on veteran’s mood, anxiety, and pain. Methods This clinical trial used a mixed methods approach: a quantitative single case design with repeated measures followed by a qualitative descriptive semistructured interview of participant perceptions and experiences to examine the effects of warm water immersion on improving mood, anxiety, and pain. Veterans with PTSD symptoms and comorbid depression, anxiety, and pain were immersed to the chest in 33°C water for 45 min. Repeated measures of the Multidimensional Mood State Questionnaire and the visual analog scales for anxiety and pain were taken at dry baseline and at 15 and 45 min of immersion, followed by a semistructured interview. Results A mixed regression model (Holm–Bonferroni adjusted p values), controlling for veteran participants’ ( N = 13; mean age = 31 years; male = 9, female = 4) PTSD symptoms, depression status, and combat score, revealed significant improvements compared to baseline. At 15 min, scores improved for good mood ( B = 3.85, SE = 1.21, t = 3.18, p = 0.016), calmness ( B = 8.15, SE = 1.57, t = 5.19, p < 0.001), and anxiety ( B = −10.92, SE = 4.53, t = −2.41, p = 0.048). At 45 min, improvements were observed in good mood ( B = 6.38, SE = 1.21, t = 5.27, p < 0.001), calmness ( B = 11.38, SE = 1.57, t = 7.25, p < 0.001), and anxiety ( B = −23.69, SE = 4.53, t = −5.23, p < 0.001). Pain scores also improved significantly at 45 min ( B = −17.69, SE = 4.42, t = −4.00, p = 0.003). Veterans described the experience as relaxing, calming, pain‐relieving, and promoting mental rest as they actively engaged with the properties of the water. Conclusion Warm water immersion provides an effective, fast‐acting, low‐risk, nonstigmatizing, accessible adjunct therapy for veterans experiencing PTSD symptoms and comorbid depression, anxiety, and pain. A comparison of the same participants’ responses on the psychosocial instruments with qualitative themes yields similar results, providing additional credence for immersion effectiveness. Trial Registration ClinicalTrials.gov identifier: NCT0530903