Post-traumatic stress disorder (PTSD) is a common mental health condition. Most people will experience trauma at some point in their lives. For some, trauma will lead to challenges as they try to cope with PTSD symptoms in unhealthy ways, like numbing pain or memories with drugs and alcohol.
- Eight million adults struggle with post-traumatic stress disorder every year.
- Up to 75% of people who have suffered abuse or violent traumatic events misuse substances.
- Thirty-three percent of people who live through traumatic disasters, illnesses, and accidents have substance abuse issues.
- Up to 84% of people with major depression have co-occurring PTSD.
PTSD and addiction frequently co-occur together. Symptoms of PTSD can be debilitating, and people often try to cope with intrusive PTSD symptoms by abusing drugs and alcohol. The problem is that self-medicating with drugs and alcohol is a temporary solution to a long-term problem.
What Is Post-Traumatic Stress Disorder (PTSD)?
Post-traumatic stress disorder is tied to your fight, flight, or freeze response. It can occur after you are involved in a traumatic event or experience ongoing distress like abuse. PTSD happens when you continue to “relive” past traumatic events in the present.
Certain present-day situations may trigger the same feelings and survival response (fight, flight, or freeze) as the past trauma. When this happens, your body interprets the perceived danger as occurring right now. This activates the same survival response that occurred when the trauma happened, which may cause panic, anxiety, dissociation, and other distress.
When you are stuck in trauma, it’s difficult to process or move beyond the source of stress. This can result in:
- Emotional pain
- Avoidance
- Anxiety
- Substance use disorders
- Depression
- Eating disorders
Experiences that may lead to PTSD include:
- Assault
- Rape
- Sexual, emotional, or physical abuse
- Military combat
- Natural disasters
- Witnessing someone else go through trauma
Stress and anxiety are natural reactions to traumatic events. Acute stress is “normal” trauma that occurs up to a month after an event. This stress is considered PTSD when symptoms persist for over a month.
What Is Complex Trauma?
You might have heard of “complex trauma” or “complex PTSD.” It’s the name given to types of PTSD that don’t stem from a time-limited event. Complex trauma is also known as chronic post-traumatic stress disorder. General PTSD is usually caused by a single traumatic event or occurrence, like a rape. Complex PTSD results from ongoing or repetitive exposure to stressful events.
Examples of situations that can lead to complex PTSD include:
- Abusive relationships
- Chronic illnesses
- Childhood neglect or abuse
- Human trafficking
- Witnessing abuse or other trauma
- Being held captive or a prisoner of war
Symptoms of complex or chronic PTSD are similar to those of general PTSD, but complex PTSD symptoms may include more dissociation from trauma and other aspects of life.
What Are the Symptoms of PTSD?
There are five components of PTSD:
- Experiencing a traumatic event.
- Re-experiencing the event.
- Attempting to (mentally) avoid the event.
- Suffering from the experience of reliving and attempting to avoid the event.
- Experiencing an increase in anxiety-related arousal symptoms.
You may experience these five components through PTSD symptoms like:
- Having nightmares, bad dreams, or repetitive bad memories about the traumatic event.
- Experiencing “flashbacks” and feeling like you’re going through the trauma all over again.
- Losing awareness of time and surroundings in the present.
- Disassociating from current events and surroundings.
- Feeling intense emotions when thinking about the event.
- Experiencing physical sensations, like a rapid heartbeat or breathlessness, when thinking about the traumatic event.
- Avoiding talking or thinking about the event.
- Avoiding people or places that remind you of the event.
- Losing interest in social activities or events that used to bring joy.
- Being unable to remember certain aspects of the traumatic event.
- Feeling numb, detached, or pessimistic.
- Being unable to feel or express positive thoughts or moods.
- Trouble falling asleep or sleeping through the night.
- Outbursts of anger or irritation.
- Experiencing hypervigilance (excessive awareness of surroundings) or feeling easily startled and on edge.
PTSD may be underdiagnosed because of the nature of its symptoms. For instance, avoidance is a common PTSD symptom. Because of this, some people don’t share their experiences with healthcare providers. This can mean they are misdiagnosed, or that they won’t receive the treatment they need. In groups that commonly experience trauma, like people in the military or police forces, there is sometimes a stigma against seeking behavioral health treatment. This may prevent them from getting the help they need. Victims of sexual abuse or violence can be scared or reluctant to share the experience that triggered their PTSD. Some people may seek professional help but not tell the whole story or admit how much of an impact the traumatic event has had on their life and mental health.
Post-Traumatic Stress Disorder and Addiction
The link between PTSD and substance abuse is significant. Alcohol use disorders and drug addiction are common ways people deal with the effects of trauma in unhealthy ways. Using substances to self-soothe PTSD symptoms can quickly lead to a cycle of substance abuse that escalates into addiction. Approximately 80% of people who have PTSD have at least one co-occurring mental health disorder. This is also known as a dual diagnosis. Conditions that commonly co-occur with PTSD include:
- Depression
- Anxiety disorders
- Substance use disorders
- Borderline personality disorder
- Paranoid personality disorder
- Bipolar disorder
- Eating disorders
Alcohol and drug abuse often become a way to self-medicate PTSD symptoms and other mental health issues. You may begin to rely on substances to get through your day or sleep at night. Despite providing short-term relief, substance abuse will ultimately worsen your symptoms of PTSD. In return, you may increase substance abuse to ease the rise in symptoms. This leads to a dangerous cycle, with each problem making the other worse.
You may use certain substances that directly “treat” the symptoms you’re experiencing. For example, you may use alcohol or marijuana for their depressant effects to combat the feelings of hypervigilance or anxiety related to PTSD. The problem is that the relief these drugs provide is temporary, and PTSD symptoms often come back even stronger when you’re not using.
Treatment of Co-Occurring PTSD and Addiction
If left untreated, PTSD symptoms may get worse. Emotional pain and avoidance can become a familiar part of your life. PTSD can influence your thoughts and behaviors, and untreated PTSD can cause or worsen co-occurring mental health issues. Both the substance use disorder and PTSD must be addressed in addiction treatment. Separating the problems and addressing them individually is not effective, since they can fuel each other and have close behavioral patterns.
Therapies proven effective in treating PTSD and addiction include:
Cognitive Behavioral Therapy (CBT)
People with trauma often develop strong associations and responses to situations that trigger PTSD. Cognitive behavioral therapy helps change these associations and responses. This therapy approach encourages you to explore the relationship between your thoughts, emotions, and behaviors. You’ll learn to recognize unhealthy thoughts and beliefs and replace them with accurate, positive ones.
Eye Movement Desensitization and Reprocessing Therapy (EMDR)
EMDR uses bilateral stimulation of your eyes to address internal associations with trauma. EMDR works on the same biological processes as rapid eye movement (REM) sleep. There are several phases of EMDR, and you’ll typically see significant results in six to 12 sessions.
During EMDR, you track a light or the therapist’s hand as it moves back and forth. You may recall the traumatic memory or a related situation and talk about beliefs around it. EMDR helps you re-process the memory and transform it in a way that loosens its hold on you. You’ll develop healthier thoughts around the event and calm your fight, flight, or freeze response when reminders of the event arise in the present day.
Dialectical Behavior Therapy (DBT)
DBT is a type of cognitive behavioral therapy that helps you identify and change destructive thoughts and behaviors. It emphasizes:
- Mindfulness
- Regulating emotions
- Improving interpersonal skills
- Managing distress
DBT can help you manage intense emotions that accompany trauma.
Experiential Therapies
Experiential approaches like yoga, adventure therapy, art therapy, and psychodrama allow you to tackle trauma symptoms from different angles. These approaches help you land in your body again and work with emotions in new ways, even processing those feelings you have trouble putting into words.
Exposure Therapy
A controversial approach for its potential to retraumatize, exposure therapy has shown promise in addressing PTSD and drug or alcohol abuse. In this approach, you’re gradually exposed to activities, scenarios, or objects that produce anxiety or fear. This could be imagining the scenario—not actually being in it. The goal is to experience less fear or anxiety around the trigger the more exposure you get to it within the safe space of therapy.
If You’re Struggling, We Can Help
You don’t have to deal with PTSD and addiction alone, and you shouldn’t deal with them separately. Footprints to Recovery provides a safe, accepting space where you’ll receive trauma-focused addiction treatment that can help you loosen the grip these challenges have on your life. Call us today.
References
- https://www.ptsd.va.gov/understand/common/common_adults.asp
- https://www.ptsd.va.gov/understand/related/problem_alcohol_use.asp
- https://www.sciencedirect.com/science/article/abs/pii/S0145213414000350
- https://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml
- https://www.ptsd.va.gov/professional/treat/essentials/complex_ptsd.asp
- https://www.ptsd.va.gov/professional/treat/cooccurring/index.asp#:~:text=Co-Occurring%20Conditions%20Most%20people%20with%20PTSD%E2%80%94about%2080%25%E2%80%94have%20one,are%20linked%20to%20physical%20health%20problems%20as%20well.
- https://psycnet.apa.org/fulltext/2010-12932-003.html
- https://pubmed.ncbi.nlm.nih.gov/30084217/
- https://www.verywellmind.com/self-medication-in-ptsd-2797539#:~:text=People%20with%20PTSD%20are%20up%20to%2014%20times,in%20hope%20of%20developing%20more%20effective%2C%20targeted%2C%20treatments.
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5356401/
