Complementary and alternative medicine for mental fitness

By: Sarah Steward, MS*

HPRC staff get many Ask the Expert questions from Military Service Members, and the answers often include vital information to help you stay mission-ready, so you can perform well.

Asked & Answered

I’m curious about the use of alternative medicine for mental health issues. Is massage therapy an effective way to treat stress, manage depression, and even reduce thoughts of suicide in Warfighters?

Massage is one of many therapeutic methods available to reduce stress and address stress-related issues. The use of complementary and alternative medicine (CAM)—treatments outside of the conventional biomedical model of care—is becoming more and more common to treat a variety of conditions, including chronic pain, sleep problems, stress, and anxiety. CAM categories include alternative medicine (things such as acupuncture and homeopathic treatments), biological-based practices (such as herbal products and dietary supplements), energy therapies (such as tai chi and Reiki), mind-body medicine (including meditation, hypnosis, and yoga), and manipulative and body-based methods (which include things such as chiropractic and massage therapy).

CAM is growing in popularity in both civilian and military populations. In fact, some estimates suggest that Military Service Members use CAM at a much higher rate than their civilian counterparts—especially for stress management. The vast majority of military treatment facilities (MTFs) also offer CAM, although only about 20% specifically provide massage therapy. Of those that offer massage therapy, it’s more commonly used for pain and physical conditions, with less than 5% using massage to treat stress, anxiety, or depression. In addition, TRICARE doesn’t generally cover massage therapy, although it sometimes covers other types of CAM treatment.

The reason for this might be that the research on the effectiveness of massage therapy to treat stress, depression, anxiety, and post-traumatic stress shows mixed results. For example, it isn’t clear whether massage therapy will consistently show long-term effects on some of the physiological markers of stress (such as cortisol levels, epinephrine, norepinephrine, blood pressure, and heart rate). However, short-term effects, self-reports, and other behavioral measures suggest that massage therapy (and touch in general) can reduce stress, anxiety, and depression. So, further research is certainly needed.

As to whether massage therapy helps reduce suicide rates and thoughts of suicide, the limited research available shows no direct link between the two. Stress is often a contributing factor, but suicide is a complex issue that involves many other factors. And because of that, the most effective approach involves personalized and integrated treatment. It’s possible that massage therapy is an effective option in conjunction with other treatments for some people, but not all.

In fact, this is true for most of the CAM options, which is why there’s such a variety of categories, used in various combinations, for many different conditions. However, those seeking treatment might not know whether massage therapy would benefit them if it’s not offered. Almost 75% of MTFs that plan to offer CAM are doing so based on the preferences expressed by their patients. Consider requesting massage therapy in order to encourage its availability in the future.

Ask the expert

To learn more about mental fitness or ask an HPRC expert about other issues that affect performance, visit susupo.eu.org.

About the author

Sarah Steward, of the Henry M. Jackson Foundation, is a Social Health Scientist for the Consortium for Health and Military Performance (CHAMP) at the Uniformed Services University of the Health Sciences (USUHS).

Disclosure: *The opinions and assertions expressed herein are those of the authors and do not necessarily reflect the official policy or position of USUHS or DoD. The contents of this publication are the sole responsibility of the author and do not necessarily reflect the views, opinions, or policies of The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. Mention of trade names, commercial products, or organizations does not imply endorsement by the U.S. Government. The author has no financial interests or relationships to disclose.

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